实现健康中国战略2030年人均预期寿命目标路径研究

Study on the paths to achieve the goal of life expectancy by 2030 under the Healthy China Strategy

目的:从健康社会决定因素角度,评估相关因素发展对中国人均预期寿命的影响,基于因素发展路径预测中国2030年人均预期寿命,分析健康中国战略2030年人均预期寿命目标的实现路径,提出政策建议。方法:利用1990—2017年跨国面板数据,采用个体固定效应模型分析人均预期寿命与健康社会决定因素相关性,基于因素发展路径模拟(高、中、低三种方案)预测中国2030年人均预期寿命,并与战略目标值比较分析。结果:人均GDP、受教育程度、卫生人力密度等与人均预期寿命正向相关,PM2.5、交通事故死亡率、个人现金卫生支出占比与人均预期寿命负向相关。按照中方案,中国2030年人均预期寿命可达79.22岁(95%CI:78.00~80.47),可以实现健康中国战略2030年设定的79.0岁目标。在快速发展的情景下,高方案的预测值可达81.46岁(95%CI:80.23~82.70);在发展受阻和疫情冲击的双重负向作用下,低方案的预测值仅为76.48岁(95%CI:75.21~77.77),甚至低于2019年77.3岁历史值。结论:在推进健康中国建设过程中,应明确制定健康责任部门考核指标,推动健康融入所有政策落地;将短期发展与中长期发展相结合,分层分阶段实现发展目标;改善区域间人均预期寿命发展的不平衡,带动人均预期寿命整体提高。

Objective:From the perspective of social determinants of health,this paper evaluates the impacts of related factors on life expectancy in China,predicts life expectancy in 2030 based on the key factors development paths,analyzes the realization of the goal of life expectancy by 2030 based on the Healthy China Strategy,and puts forward policy suggestions.Methods:The transnational panel data from 1990 to 2017 and fixed effect model were used to analyze the correlation between life expectancy and social determinants of health,predict life expectancy based on the key factors development paths simulation(high,medium or low),and compare the predicted values with the strategic target.Results:Per capita GDP,educational attainments,health workforce density and other factors showed a strongly positive correlation with life expectancy,while PM2.5,traffic accident mortality rate and the proportion of out-of-pocket(OOP)health expenditure showed a negative correlation.According to the medium-scenario path,China s life expectancy is expected to reach 79.22 years(95%CI:78.00~80.47)by 2030,which is close to the 79.0 targeted by 2030 under the Healthy China Strategy.In the rapidly developing scenario path,the predicted value of the high-scenario path was found to be up to 81.46 years(95%CI:80.23~82.70)of life expectancy.Under the dual negative effects of stalled development and the impact of COVID-19,the predicted value of the low-scenario path was found to be only 76.48 years(95%CI:75.21~77.77),which is almost even lower than the historical value of 77.3 years of life expectancy we had in 2019.Conclusions:In the process of constructing Healthy China,the assessment indicators of health responsible departments should be clearly formulated to promote the implementation of“Health in all policies”;combine short-term development with medium-and long-term development paths in order to achieve the targeted goals at different levels and stages of development;improve the balance of life expectancy among regions,and bring about an overall increase of life expectancy in China.