山东省城乡居民健康不平等及其分解研究

发布时间：2018-07-20 11:49

【摘要】：研究背景健康是人类存在和发展的基础,追求健康是人类社会的共同奋斗目标。改革开放以来,随着经济社会的迅速发展、医疗卫生技术水平的进步以及社会保障制度的逐步完善,居民的健康状况明显改善,期望寿命大幅提高。但居民健康水平在不同地区之间、不同人群之间的不平等现象依然存在,特别是由收入等社会经济因素导致的健康不平等出现加剧的趋势。研究目的本论文利用全国第五次卫生服务调查山东省部分的数据,通过对自评健康相关数据进行分析,了解城乡居民自评健康不平等的影响因素,探索居民自评健康的不平等程度,并对城乡居民健康不平等的来源进行分析,并按其重要性进行排序,在此基础上有针对性的提出改善山东省城乡居民自评健康不平等的对策建议。研究方法资料来源于山东省第五次全国卫生服务调查数据。第五次卫生服务调查采用多阶段分层整群随机抽样的方法进行抽取,共抽取20个样本县(市、区),共12000户(近4万人)纳入本次调查。本研究根据需要选取15岁以上的居民共27599人。利用STATA12.0软件进行统计分析,对变量进行描述性统计分析、单因素卡方检验以及Logistic回归分析,探索影响居民自评健康结果的因素,利用集中指数分解法探索各个影响因素对居民自评健康结果不平等的贡献率。主要结果(1)山东省城乡居民自评健康不良率为12.4%,其中城镇居民自评健康不良率为11.3%,农村居民自评健康不良率为13.7%。(2)L ogistic回归结果显示,影响城乡居民自评健康不良结果的因素中,年龄、婚姻状况、受教育程度、就业状况、居住地区、厕所类型、家庭人均收入等差异有统计学意义(P0.05)。(3)山东省城镇居民自评健康不良结果的集中指数为-0.125,农村居民自评健康不良结果的集中指数为-0.287,集中曲线均位于绝对公平线的上方。(4)城镇地区,收入、受教育水平、厕所类型对自评健康不良的贡献率分别为64.492%、26.603%、10.492%；农村地区收入、年龄、受教育水平对自评健康不良的贡献率分别为48.394%、13.842%、10.412%。结论与建议山东省城乡居民自评健康存在亲穷不平等,农村居民自评健康不平等程度大于城镇居民。城乡居民自评健康不平等的来源中收入是第一位的贡献因素,受教育程度是主要贡献因素。城镇地区,厕所类型是影响居民自评健康不平等的第三位贡献因素；农村地区年龄是影响居民自评健康不平等的第二位贡献因素；就业状况会扩大农村地区自评健康不平等、缩小城镇地区自评健康不平等。针对上述结论提出的政策建议有：缩小收入差距,促进收入分配公平性；提高居民受教育水平,普及健康相关知识；加强农民技能培训,提高农民技能；加快推进对棚户区、城中村改造工作。
[Abstract]:Background Health is the foundation of human existence and development, and the pursuit of health is the common goal of human society. Since the reform and opening up, with the rapid development of economy and society, the progress of medical and health technology and the gradual improvement of social security system, the health status of residents has been obviously improved, and the life expectancy has been greatly increased. However, the health level of residents in different regions and between different groups of people still exist inequality, especially the income and other social and economic factors caused by the health inequality is increasing trend. Objective to study the influencing factors of self-rated health inequality in urban and rural residents by analyzing the data of the fifth national health service survey in Shandong Province. To explore the inequality degree of residents' self-assessment of health, and analyze the sources of health inequality of urban and rural residents, and rank it according to its importance. On this basis, the author puts forward countermeasures and suggestions to improve the health inequality of urban and rural residents in Shandong Province. The data of the research methods were derived from the data of the Fifth National Health Service Survey of Shandong Province. The fifth health service survey adopted the method of multi-stage stratified cluster random sampling. A total of 20 sample counties (cities and districts) were selected and 12000 households (nearly 40 thousand people) were included in the survey. In this study, 27599 residents over 15 years old were selected according to their needs. Using STATA12.0 software for statistical analysis, descriptive statistical analysis of variables, single-factor chi-square test and logistic regression analysis were used to explore the factors that affect the health outcomes of residents self-rated. The contribution rate of various influencing factors to the inequality of residents' self-rated health outcomes was explored by means of concentrated exponential decomposition method. The main results were as follows: (1) the rate of self-rated poor health of urban and rural residents in Shandong Province was 12.4. among them, the rate of self-rated health of urban and rural residents was 11.3 and that of rural residents was 13.7%. (2) the results of L ogistic regression showed that, among the factors influencing the self-assessment of poor health of urban and rural residents, Age, marital status, education, employment status, residence area, toilet type, There were significant differences in family per capita income (P0.05). (3). The concentration index of self-assessment of poor health results of urban residents in Shandong Province was -0.125, and that of rural residents was -0.287. The concentration curve was located on the line of absolute fairness. Above. (4) Urban areas, The contribution rate of income, education level and toilet type to self-rated health was 64.4920.26.603and 10.492.The contribution rate of income, age and education level to self-rated health was 48.39413.842and 10.412in rural areas, respectively. Conclusion and it is suggested that urban and rural residents in Shandong Province have inequality in self-assessment of health, and the degree of self-assessment of health of rural residents is greater than that of urban residents. Income is the first contributing factor and education level is the main contributing factor among the sources of self-rated health inequality of urban and rural residents. In urban areas, toilet type is the third contributing factor to self-assessment health inequality; age is the second contributing factor to self-assessment health inequality in rural areas; employment situation will expand self-assessment health inequality in rural areas. Reduce self-assessment of health inequality in urban areas. In response to the above conclusions, the policy recommendations are: narrowing the income gap, promoting income distribution equity; improving the education level of residents, popularizing health-related knowledge; strengthening farmers' skills training, improving farmers' skills; accelerating the promotion of shantytown, Transformation of villages in cities.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R195

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