中国老年人健康老龄化的城乡差异及其变迁趋势——基于生命历程和健康公平视角的分析

Urban-Rural Differences and Trends in Healthy Ageing of Chinese Elderly:An Analysis Based on the Life Course and Health Equity Perspective

利用中国老年健康影响因素跟踪调查(CLHLS)2005年、2008年、2011年、2014年和2018年的追踪调查数据,基于多维指标构建了健康老龄化指数(HAI1和HAI2),从生命历程和健康公平的视角出发,分析中国老年人健康老龄化城乡差异及其变迁趋势。研究发现,城镇老年人的健康老龄化水平明显优于农村老年人,这主要是由于城镇老年人在童年期家庭背景、成年期社会经济地位以及制度保障等方面具有优势;健康老龄化的城乡差异随着年龄增长而弱化,呈现“收敛效应”,并且这一模式在连续出生世代中的效应也变得更弱,这主要是由于与早期世代相比,新世代城镇老年人的健康老龄化水平大幅度下降。应完善健康老龄化指标体系,加强动态监测,并注重老年群体在生命历程中的劣势累积效应,确保健康老龄化水平提升策略的有效性和超前性。

Using data from CLHLS 2005,2008,2011,2014 and 2018,this paper constructs a healthy ageing index based on multi-dimensional indicators to portray the age trajectory of healthy ageing of Chinese older adults.From the perspective of life course and health equity,this study analyzes the urban-rural differences and trends in the age trajectory of healthy ageing.The results indicate that the healthy ageing level of urban older adults is significantly better than that of rural older adults,mainly due to the urban advantages in childhood family background,socioeconomic status in adulthood,and institutional support.The urban-rural difference in healthy ageing weakens as age increases,showing a “convergence effect”.This difference has also narrowed across cohorts,mainly because the healthy ageing level of the younger cohorts in urban areas has declined substantially compared to older cohorts.This study discusses policy implications in improving the healthy ageing index system,strengthening dynamic monitoring,and focusing on the effectiveness of healthy ageing intervention policies from the perspective of life course and health equity.