地理研究 ›› 2017, Vol. 36 ›› Issue (7): 1257-1270.doi: 10.11821/dlyj201707006

• 研究论文 • 上一篇    下一篇

社会经济及环境因子对不同收入群体自评健康的影响

顾丽娟1,2,3(), 曾菊新1,3()   

  1. 1. 华中师范大学地理过程分析与模拟湖北省重点实验室,武汉 430079
    2. 女王大学地理与规划系,金斯顿 K7L3N6,加拿大
    3. 湖北省发展和改革委员会/华中师范大学,武汉城市圈研究院,武汉 430079
  • 收稿日期:2016-12-13 修回日期:2017-04-07 出版日期:2017-07-31 发布日期:2017-09-13
  • 作者简介:

    作者简介:顾丽娟(1989- ),女,河南周口人,博士研究生,主要从事健康地理研究。 E-mail: gulijuan25@mails.ccnu.edu.cn

  • 基金资助:
    国家建设高水平大学公派研究生项目;加拿大研究会主席第一梯队基金;国家自然科学基金项目(41371183,41501145);教育部人文社会科学青年基金项目(13YJCZH284)

The impacts of socioeconomic and environmental factors on self-rated health status among different income groups in China

Lijuan GU1,2,3(), ROSENBERG Mark2, Juxin ZENG1,3(), Mark ROSENBERG2   

  1. 1. Key Laboratoryfor Geographical Process Analysis & Simulation, Central China Normal University, Wuhan 430079, China;
    2. Department of Geography and Planning, Queen's University, Kingston, Ontario K7L3N6, Canada
    3. Hubei Provincial Development and Reform Commission/Central China Normal University, Research Institute of Two-Oriented Society Construction in Wuhan Urban Agglomeration, Wuhan 430079, China
  • Received:2016-12-13 Revised:2017-04-07 Online:2017-07-31 Published:2017-09-13

摘要:

对健康影响因素的干预是将“健康中国”战略落实到实处的重点,而深入探究健康的影响因子是实施有效干预的前提。结合中国当前工业化、环境退化及收入差距扩大化的背景,基于中国综合社会调查2013年数据,采用多层次Logistic回归分析模型,从个体、社区及省级三个层次,深入解析社会经济及环境因子对较低、中等及较高收入群体自评健康状况的影响。结果表明:① 个体与地方特征对自评健康有不同程度的影响。个体特征的解释力最强,省级因子解释力最弱。② 社会经济因子对健康的作用在不同收入群体间差异很大。通常被认为是有益于健康的因子如收入、教育水平、政府服务等仅对中低等收入群体有显著作用。③ 环境因子与健康呈正相关性,且此相关性对较高收入群体最强。④ 环境污染可以抵消一部分社会经济发展的健康促进作用。⑤ 除了不平等的社会经济条件,环境不公正是导致健康不公平的另一重要原因。

关键词: 健康, 社会经济发展, 污染, 环境不公正, 多层次Logistic回归分析, 收入群体

Abstract:

China's rapid socioeconomic growth in recent years and the simultaneous increase in many forms of pollution are generating contradictory pictures of residents' health status. To understand this twofold phenomenon and explore the influencing factors of health is the key point to realize the "healthy China" strategy and the prerequisite to take any effective action. Given the rapid economic development, the severe environmental degradation, and the rising health inequalities among different income groups in modern China, this paper applies multilevel analysis to the 2013 China General Social Survey data on social development and health and the China Statistical Yearbook data. Three-level logistic models from the individual, community and provincial levels are developed to investigate the impact of socioeconomic development and environmental degradation on self-reported health, differentiating among lower, middle and higher income groups. The results of the multi-level logistic analysis demonstrate that for all the three income groups, individual-level factors contribute more to the explanation of health than community-level or provincial-level factors. Income, job and education increase the likelihood of rating health positively for the lower and middle groups but have little or no effects on the higher-income group. Compared to the lower and middle groups, residents from the high-income group can buffer themselves from the adverse effect of the environmental degradation. Environmental risks have a mediating effect on the relationship between socioeconomic development and health. These outcomes indicate that the complex interconnections among socioeconomic development and environmental degradation have differential effects on health status among different income groups. Besides social inequality, environmental injustice is another cause of health inequities among different income groups in modern China. This study is the first empirical research exploring the interplay of socioeconomic development and environmental degradation on health by conducting analysis on lower, middle and higher income groups respectively. The results provide an in-depth understanding of health and its key impacting factors and offer some concise policy implications to improve the health status of general populations in a more efficient way.

Key words: health, socioeconomic development, pollution, environmental injustice, multi-level Logistic model, income groups