公共健康服务水平的改进对生育水平的影响研究——基于《“健康中国2030”规划纲要》的准自然实验

Study on the Influence of the Improvement of Public Health Service Level on Fertility Level:Quasi Natural Experiment Based on“The Outline of‘Healthy China 2030’”

在我国,公共健康服务水平的改进是否可以提高生育水平一直是没有得到探讨的问题。2016年实施的《“健康中国2030”规划纲要》提出了明确的健康服务保障指标以及目标值,这为探讨公共健康服务水平与生育行为之间的关系提供了准自然实验条件。因此,采用双重差分的研究方法,利用中国家庭追踪调查(CFPS)数据分析中国公共健康服务水平对个人生育行为的影响。研究结果表明,公共健康服务水平对个人的生育行为有显著的正向影响,且对低收入人群、受教育水平低的人群和城市居民的影响更明显。在当前公共健康服务资源有限的情况下,可以优先考虑将公共健康服务资源向高龄孕、产、妇、农村居民以及城乡低收入人群倾斜性配置,这将有助于提高生育率。总之,解决当前生育率低迷的问题需要采取多种措施,综合施策,尤其是需要加强支持性政策与生育政策间的协同配合,不能忽视公共健康服务的积极作用,要为育龄群体提供充足的公共健康服务资源。

Whether the improvement of the public health service level can raise the fertility level has not been discussed in China.The Outline of“Healthy China 2030”Plan implemented in 2016 put forward clear target values of health service and security indicators which provides a quasi-natural experimental condition for exploring the relationship between public health service level and reproductive behavior.Therefore,the research method of difference-in-differences was adopted to analyze the impact of China’s public health service level on individual reproductive behavior by using the data of the China Family Tracking Survey(CFPS).The results show that the level of public health services has a significant positive impact on individual reproductive behavior,and the impact on low-income people,people with low education level and urban residents is more significant.In the current situation of limited public health service resource,priority can be given to the allocation of public health service resources to elderly pregnant women,rural residents and urban and rural low-income groups,which will help to increase the fertility rate.In short,to solve the current low fertility rate problem,we need to take a variety of measures and comprehensive policies,especially the need to strengthen the coordination between supportive policies and fertility policies,can not ignore the positive role of public health services,and provide adequate public health service resources for the reproductive age group.