中国老年人口健康预期寿命的社会分层分析

Social Stratification Analysis on Healthy Life Expectancy of the Elderly Population in China

依据不同社会经济特征人群的健康预期寿命差异,分析不同社会阶层的老年人口健康不平等问题,为确定养老及医疗等公共政策的“兜底”人群提供实证依据。基于中国老年徤康影响因素纵向数据(2008、2011和2014年),以多状态生命表模型为分析方法,选取城乡、收入水平和受教育水平作为社会分层指标,运用IMaCH软件,综合分析不同社会分层指标对老年人健康状况的影响。研究发现,城市居住、收入较高及受教育水平较高的老年人具有较高的平均预期寿命和健康预期寿命,但健康预期寿命占比相对较低;随着年龄增长,不同社会分层人群的平均预期寿命和健康预期寿命差异不断减小。预测显示,在2026年前后我国老年人口的失能率将达到“收敛”状态,在此之前失能水平呈上升趋势。中国老年人口健康不平等问题具有社会分层的刚性结构特征。健康平等的目标呼吁关注社会经济地位较低的老年群体,重点改善这一“兜底”人群在养老和医疗方面的基本公共服务和基础保障水平。

According to the difference of healthy life expectancy among people with different social and economic characteristics,this paper analyzed the social stratification structure of healthy inequality among the elderly population,and provided an empirical basis for determining the“bottom”of public policies such as pension and medical care.Based on the longitudinal data of tracking survey on the influencing factors in China(2008,2011 and 2014),the influence of different social stratification indexes on the healthy status was analyzed by using IMaCH software,taking the multi-state life table model as the analysis method,selecting residence,income level and education level as the indicators of social stratification.The study found that the elderly with living in city,with higher income and higher education have higher average life expectancy and life expectancy,but the healthy life expectancy was relatively low.With the increase of age,the difference was decreasing.According to the forecast of the disability rate from 2014 to 2030,it was expected to reach a state of"convergence"around 2026,before which the disability level was on the rise.The health inequality of the elderly population in China was characterized by the rigid structure of social stratification.The efforts of healthy equality need to focus on the vulnerable groups in the lower social strata and focus on improving the basic public services and basic security levels of pension and health care for this''bottom"group.