我国流动人口的健康差异测度及其成因分解

Measurement of Health Disparity Within Floating Population in China and Its Decomposition of Causes

目的:研究我国流动人口群体内部的健康差异,测度各因素对于健康差异的影响及其贡献度,为进一步提升流动人口的健康公平性提供参考。方法:基于2017年全国流动人口卫生计生动态监测调查,采用集中指数法测量与分解流动人口基于收入的健康差异,并构建广义logistic回归模型分析综合健康影响因素的作用程度。结果:测得在自评健康、两周内不适和患慢性病指数3个健康指标上的集中指数分别为-0.0742、-0.1152和-0.1225,都存在“亲富人”的现象。年龄、性别、受教育程度、月收入以及住房类型是影响健康差异的主要因素,身份认同、行为适应与医疗资源可及性对于流动人口综合健康水平的提高有着重要的作用。结论:流动人口群体存在“亲富人”的健康差异,健康不良更多地集中在低收入群体。建议着重关注女性和老年流动人口的健康状况,不断完善社会支持体系建设,扩大保障性住房的覆盖范围,完善异地医保政策,以保障流动人口的健康权和发展权。

Objective:To study the health disparity within the floating population in China,and to measure the influence and contribution of various factors towards the health disparity,so as to provide reference for further improving the health equity of floating population.Methods:Based on the dynamic monitoring survey of health and family planning services for floating population in China in 2017,the concentration index method was used to measure and decompose the income-based health differences of the floating population,and the influence degree of factors affecting comprehensive health was analyzed by generalized logistic regression.Results:The measured concentration indices of self-assessed health,discomfort within two weeks and chronic disease index were-0.0742,-0.1152 and-0.1225,respectively,all of which were "pro-rich".Age,gender,education level,monthly income and housing type were the main factors affecting the health disparity.Identity,behavior adaptation and medical resource accessibility played important roles in improving the overall health of floating population.Conclusion:Floating population have "pro-rich" health disparity,and poor health is more concentrated in low-income groups.It is recommended to focus on the health status of women and the elderly floating population,continuously improve the construction of social support system,promote the coverage of affordable housing and improve medical insurance policy in non-resident place,thus ensuring the right to health and development of floating population.