基于分位数回归和通径分析的少数民族中老年流动人口健康状况影响因素研究

Study on the Factors to Influence the Health Status of Middle-aged and Elderly Ethnic Minority Migrant Popula⁃tions Based on Quantile Regression and Passageway Analysis

目的:了解我国少数民族中老年流动人口健康状况的影响因素,为有效开展针对这一人群的健康干预和改善其健康状况提供参考。方法:使用2017年中国流动人口动态监测调查数据库(CMDS)中2771例≥45岁的少数民族中老年流动人口相关数据,采用SPSS 26.0进行Mann-Whitney U检验和Kruskal-Wallis H检验,采用多重线性回归及分位数回归对健康状况的影响因素进行分析,并采用Amos24.0对健康状况的影响因素进行通径分析。结果:不健康者336人(12.1%),社会融合较差者1031人(37.2%),接受健康教育较差1563人(56.4%),有慢性病者534人(19.4%);健康与不健康者在性别、年龄、文化程度、婚姻状况、流动范围、流动时间、流动原因、社会融合、健康教育、慢性病患病等方面均存在统计学差异(P<0.05);多元logistic回归分析结果显示,流动时间、流动原因、社会融合较差、接受健康教育较差、有慢性病等因素显著影响研究对象的健康状况(P<0.05);分位数回归分析结果显示,流动时间、流动原因、社会融合情况、接受健康教育状况和慢性病患病情况在不同分位点均对健康状况产生了影响(P<0.05);通径分析结果显示,慢性病、健康教育和社会融合对少数民族中老年流动人口的健康状况直接产生作用,流动时间、流动原因对健康状况产生间接影响作用。结论:关注流动时间及原因对少数民族中老年流动人口健康状况的影响;多措并举提高其社会融合,以减少身心问题产生,使其更好融入流入地;关注少数民族中老年流动人口慢性病患病情况,加强对其的健康教育和健康管理服务,提升健康素养,改善健康状况。

Objective To understand the factors influencing the health status of the middle-aged and elderly migrant popula⁃tion of ethnic minorities in China,and provide a reference for effective health interventions and improvement of their health status.Methods Using data related to 2771 cases of middle-aged and elderly ethnic minority migrant population aged≥45 years old from the 2017 China Migration Dynamic Monitoring Survey Database(CMDS),the Mann-Whitney U test and Kruskal-Wallis H test were conducted using SPSS 26.0,and multiple linear regression and quantile regression were used to analyze the influencing fac⁃tors of health status.And Amos 24.0 was used to conduct a pass-through analysis of the factors influencing health status.Results 336(12.1%)were unhealthy,1031(37.2%)were poorly integrated,1563(56.4%)were poorly educated,and 534(19.4%)had chronic illness.There were statistically significant differences between healthy and unhealthy subjects in terms of gender,age,education level,marital status,range of mobility,duration of mobility,reasons for mobility,social integration,health education,and chronic diseases.The results of multiple logistic regression analysis showed that time of mobility,reason for mobility,poor social integration,poor health education,and chronic disease significantly affected their health status(P<0.05).The results of quantile regression analysis showed that time of mobility,reason for mobility,social integration,health education and chronic disease had an effect on health status at different quantile points(P<0.05).The results of path analysis showed that chronic disease,health education and social integration had a direct effect on the health status of middle-aged and elderly ethnic minority migrant population,while time and reason for mobility had an indirect effect on their health status.Conclusion It is sug⁃gested to focus on the influence of movement time and reasons on the health of the floating population,take multiple measures to im⁃prove the social integration to reduce physical and mental problems into the inflow place,pay attention to the chronic diseases of the floating population,strengthen health education and health management services to improve their health literacy and health status.