我国健康机会的时空差异及其对健康结果的影响——基于共同富裕视角与健康中国战略

Spatial and Temporal Differences in Health Opportunities and their Impact on Health Outcomes in China:Base on the Perspective of Common Prosperity and the Strategy of Healthy China

在共同富裕背景下,文章基于“健康中国2030”战略思想构建了多维度的健康机会指标评价体系,测度了2009~2018年我国省际健康机会指数,利用Theil指数和空间自相关方法揭示了其区域差异与空间关联特征,通过地理探测器方法探究了各维度健康机会对居民健康的影响强度。研究发现:(1)我国健康机会呈现由东向西递减的分布特征,全国总体区域差异在逐渐缩小。(2)我国健康机会集聚特征显著,呈现东部地区“高高”聚集而西部地区“低低”聚集的特征,尚未形成全局性的以高带低发展格局,暗示着在强调全国健康机会整体水平提高外,更应加强区域协同提升。(3)2009~2013年健康服务是居民健康结果的最强影响因素,但随着时间的推移,健康服务的影响力有所减弱,而健康保障、健康环境与健康产业对居民健康结果的影响力逐渐增强,2014~2018年健康保障影响力超过健康服务,成为居民健康结果的最强影响因素。四个维度健康机会交互作用均大于其各自对居民健康结果的影响力,这一结论在全国及东、中、西三大区域中均成立。

In the context of promoting common prosperity,this paper establishes a multidimensional health opportuni⁃ty index evaluation system,aligning with the strategic vision outlined in“Healthy China 2030”.The study measures China’s inter-provincial health opportunity index from 2009 to 2018,employing Theil index and spatial autocorrelation methods to unveil regional disparities and spatial correlation characteristics.The intensity of health opportunities’influ⁃ence on residents’health across different dimensions is explored using the geographical detector method.The key find⁃ings are as follows:(1)The distribution of health opportunities in China exhibits a decreasing trend from east to west,with overall regional differences gradually narrowing.(2)Significant concentration of health opportunities is observed in China,characterized by a“high”concentration in the eastern region and a“low”concentration in the western re⁃gion.The overall pattern of high and low development has not yet solidified,emphasizing the need to strengthen region⁃al coordination alongside the broader goal of enhancing the overall level of health opportunities in the country.(3)From 2009 to 2013,health services emerged as the dominant influencing factor on residents’health outcomes.However,over time,the impact of health services weakened,giving way to a gradual increase in the influence of health security,health environment,and health industry on residents’health outcomes.Notably,from 2014 to 2018,health security surpassed health services,becoming the strongest influence on the health outcomes of the population.Furthermore,the interaction among the four dimensions of health opportunities proves to be more substantial than their respective individual influ⁃ences.This conclusion holds true not only nationally but also across the three regions of east,central,and west.