“健康贫困”陷阱的自我强化与减贫的内生动力——基于中国家庭追踪调查(CFPS)的实证分析

Self-enforcement Effect of the“Health-Related Poverty”Trap and the Endogenous Motive Force for Poverty Alleviation:An Empirical Analysis Based on the China Family Panel Survey

健康与贫困存在累积循环的因果关系,落入健康贫困陷阱的群体减贫内生动力不足,挑战着政府惯常的扶贫思路和计划。文章使用CFPS数据,测算我国居民的健康梯度,从心理和行为双重视角检验了健康与贫困间的自我强化效应和内生脱贫动力机制。文章发现,健康不平等和经济收入不平等是导致健康与贫困低水平循环的直接原因;情绪消极、健康素养低、医疗保健行为不科学以及公共卫生水平差等,是强化健康与贫困间循环的间接原因;当条件成熟时,自我强化要素可转换为内生动力要素,有效实现脱贫。政府应当基于健康贫困群体独特的心理与行为偏好,制定针对性脱贫计划,如加大健康宣传与教育力度,重视贫困地区综合环境整治,将高质量的基层医疗服务资源、健康公共设施向贫困地区倾斜,鼓励私立医院健康有序发展。

The principle of Circular and Cumulative Causation(CCC)exists between health and poverty.The endogenous motive force for lifting people in health-related poverty traps out of poverty is not strong and this challenges government poverty policies.This paper calculates the health gradient of Chinese citizens,and studies the self-enforcement effect of the health-related poverty and endogenous motive force from poverty alleviation from the perspective of both psychology and behavior based on the CFPS.It finds that the inequities of health and income are the direct causes,and negative emotion,low health literacy,unscientific medical care behaviors and poor living conditions are the indirect causes of CCC.However,the self-enhancement effect elements will translate into endogenous motive force elements for poverty reduction under specific conditions.So,according to the psychology and behavior of the health-related poverty group,the government should advertise more healthy knowledge,improve the health environment and supply more high-quality medical service resources and public health facilities in poor areas,while encouraging private hospitals to develop in a healthy and orderly way.