“健康共富”理念下我国劳动者健康风险价值损益评估

Profit and Loss Assessment of Health Risk Value of Chinese Workers under the Concept of“Health Co-Prosperity”

健康风险评估是健康管理的基础。在健康中国与共同富裕背景下,评估我国劳动者健康风险价值损益,有助于深刻认识并纾解健康不平等问题,为制定针对性的健康干预措施提供科学依据。基于补偿性工资差值与享乐主义工资理论,构建包含内生疾病与外生环境健康风险的效用函数,从劳动者风险偏好视角构建健康风险价值损益评估的理论框架。采用中国家庭动态追踪调查(CFPS)与我国居民疾病死亡率匹配数据,借鉴统计生命价值核算的“工资—风险”法,利用扩展的二元健康风险明瑟收入方程来测度我国劳动者健康风险价值,并借助再中心化影响函数RIF回归对不同收入群体结果进行分解。研究发现:我国劳动者内生疾病死亡风险价值呈亏损状态,其中循环系统疾病是价值损失的主因;外生环境风险则体现为收益,并成为健康风险价值盈余的主导力量。不同收入群体的健康风险价值均有上升,且存在明显的健康—收入分层,各收入群体在内生疾病风险价值盈亏上相差不大,但高收入群体外生环境风险价值总量远高于低收入群体,价值损失也更为严重。提高健康风险的特征效应,并减少其结构效应的负面影响,有利于缓解不同收入群体的健康不平等。

Health risk assessment is the basis of health management.Under the background of Healthy China and common prosperity,assessing the profit and loss of health risk value of Chinese workers is helpful to deeply understand and alleviate health inequality objectively.It provides scientific basis for formulating targeted health intervention measures.Based on the compensating wage differential and hedonic wage theory,this paper constructs the utility function including endogenous diseases and exogenous environmental health risks.The theoretical framework of profit and loss assessment of health risk value is constructed from the perspective of workers’risk preference.Using the matching data of China Family Panel Studies(CFPS)and Chinese residents’disease mortality,this paper uses the“Wage-Risk”Method in Value of a Statistical Life(VSL)to measure the health risk value of Chinese workers by the extended binary health risk Mincer income equation;meanwhile,it decomposes the results of different income groups with the help of decentralized impact function RIF regression.The results show that the death risk value of endogenous diseases is in negative loss,in which the circulatory system disease is the main cause of value loss,while the exogenous environmental risks are reflected as a positive benefits and become the dominant force of health risk value surplus.The health risk value of different income groups increased,and there was an obvious health-income stratification.Although there is little difference in profit and loss of risk value of endogenous diseases among all income groups,the total amount of exogenous environmental risk value of high-income group is much higher than that of low-income group.The value loss is more serious.Improving the composition effect of health risks and reducing their wage structure effect can help alleviate health inequality among workers of different income groups.