中国妇幼健康水平的区域差异和影响因素

Regional differences and influencing factors of the health level of women and children in China

以孕产妇死亡率、围产儿死亡率作为中国妇幼健康水平的主要表征指标,运用变异系数、空间自相关、面板回归等方法对2005—2015年间中国妇幼健康水平进行空间格局变化和影响因素分析。结果表明:(1)2005—2015年以来中国妇幼健康水平整体呈上升趋势,西部增长幅度高于中东部地区,但整体保持“东-中-西”梯度递减的态势;(2)2005—2015年中国妇幼健康水平的相对差异显著,孕产妇死亡率的差异随时间呈波动变化、围产儿死亡率的差异随时间趋于上升;其中,西部地区的地带内差异最大、东部次之、中部最小;(3)妇幼健康水平的莫兰指数表现为“W”形的变化趋势,空间集聚程度逐渐减小,中东部地区形成稳定热点区、西部地区形成稳定冷点区;(4)产前检查率、城镇化水平和人均公共卫生支出的发展对妇幼健康的发展有促进作用,环境温度、高危孕产妇比例、女性文盲率的增加对妇幼健康的发展起抑制作用。

Taking maternal mortality and perinatal mortality as the main indicators, and using coefficient variation, spatial autocorrelation, and panel regression analyze the spatial pattern and its influencing factors about women and children health from 2005 to 2015 in China. The results show that:(1)The overall health level of women and children is on an upward trend, and the growth rate in the western region is the highest in China, but the overall trend is gradient ’EastCentral-West’ decreasing.(2)The relative difference of the health level of women and children is remarkable. The difference in maternal mortality rate fluctuates, and the difference in perinatal mortality rate tends to increase during the ten years, in which, the difference in the western region is the largest, followed by the eastern region, and the central region smallest.(3)The horizontal Moran’s index of women and children health shows a "W"-shaped change trend, and the degree of spatial agglomeration decreases gradually. The stable hot spots arise in the central and eastern regions, and the stable cold spots in the western regions.(4)Prenatal examination rate,urbanization level and per capita public health expenditure promote the development of women and children health, while the proportion of environment temperature, high-risk maternal women, and female illiteracy rate restrain its improvement.