健康城市试点政策对老年人健康水平的影响——来自CHARLS数据的证据

The Health Impact of Healthy City Initiatives for the Elderly:Evidence from the CHARLS Data

在人口老龄化程度不断加深的背景下,如何提高老年人健康水平是全社会普遍关注的问题。文章利用2011~2018年中国健康与养老追踪调查数据,以“健康城市”试点政策为切入点,通过构建双重差分模型,系统考察了“健康城市”试点政策对老年人健康的影响及其作用机制。研究发现,健康城市试点政策提高了老年人健康水平,政策实施后老年人自评健康水平提高、患慢性病的可能性下降、抑郁情绪得分降低、日常活动需帮助的可能性下降、医疗费用减少。异质性研究发现,健康城市试点政策对城镇老年人和低龄老年人的健康促进作用更强,在空气污染水平较低、行政等级较高、养老和医疗卫生设施较完善的城市健康促进作用更为明显;健康促进效应主要通过“设施适老化改造”和“服务适老化供给”等机制产生影响。据此,文章建议进一步扩大健康城市建设范围,采取差异化的建设方案,充分发挥健康城市创建对老年人健康的促进作用。

In an aging population,it is a common concern to improve the health of the elderly.Using data from the China Health and Retirement Longitudinal Study(CHARLS)from 2011 to 2018,this study employs a difference-in-differences(DID)model to examine the impact of the Healthy City Pilot policy on the elder people's health and its underlying mechanisms.The results show that the Healthy Cities Pilot improves older adults'health,as evidenced by higher self-rated health,lower healthcare costs,reduced chronic disease,decreased depression,and improved ability to perform activities of daily living.Heterogeneity analyses reveal stronger health promotion effects among urban and younger elderly,and also in cities with lower pollution,better facilities and services.The mechanisms of"elderly-oriented facilities adaptation"and"elderly-oriented service provision"underlie the positive health impacts of the policy.The paper recommends expanding and differentiating Healthy City policy to fully utilize its elderly health promotion potential.