社会经济及环境因子对不同收入群体自评健康的影响

doi:10.11821/dlyj201707006

Abstract

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

Lijuan GU, ROSENBERG Mark, Juxin ZENG, Mark ROSENBERG. The impacts of socioeconomic and environmental factors on self-rated health status among different income groups in China[J].GEOGRAPHICAL RESEARCH, 2017, 36(7): 1257-1270.

Figures/Tables 6

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Fig. 1

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References 36

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变量	类别	较低(%) (n=3928)	中等(%) (n=6627)	较高(%) (n=828)	P值
自评健康	不健康	26.8	24.5	11.2	<0.001
自评健康	健康	73.2	75.4	88.8
性别	男	50.2	49.5	56.9	0.001
性别	女	49.8	50.5	43.1
年龄(岁)	17~49	42.5	52.7	51.6	<0.001
	50~59	20.6	19.0	17.0
	60~74	27.2	21.3	23.7
	75以上	9.7	7.0	7.7
BMI	小于24	71.1	68.8	63.3	<0.001
BMI	24以上	28.9	31.2	36.6
婚姻状况	已婚	77.7	79.5	81.7	<0.001
婚姻状况	其他	22.3	20.5	18.1
社交生活的频度	每周数次	37.5	36.2	36.6	<0.001
	每月数次	23.2	27.9	22.3
	每年数次	22.8	22.5	24.1
	从不	16.4	13.5	16.9
大部分人都可信	不同意	33.2	26.2	25.3	<0.001
	不确定	15.5	16.6	12.2
	同意	51.2	57.2	62.5
锻炼身体的频度	每周数次	14.8	19.6	31.8	<0.001
	每月数次	8.2	13.3	13.5
	每年数次	13.2	18.9	17.8
	从不	63.8	48.2	36.7
主要居住地	城市	56.8	63.3	71.2	<0.001
	农村	43.2	36.7	28.8
家庭年收入	(元)	32492.7	62369.2	127811.8	<0.001
职业	非农业	31.6	44.8	51.9	<0.001
	农业	27.0	20.5	11.3
	没有工作	41.4	34.7	36.8
教育程度	文盲	17.3	10.3	6.8	<0.001
	初中	59.3	49.8	38.0
	高中	15.4	21.0	24.9
	大学及以上	7.9	18.9	30.3
基本医疗保险	没有	12.9	8.9	9.7	<0.001
基本医疗保险	有	87.0	91.9	90.3

变量	简称
人均GDP(元)	GDP
城市人口占比(%)	城镇化
每百户家用汽车(辆)	私家车
每千人拥有的医疗床位(个)	医疗机构
对电、热、燃气、水的生产和供应的固定资产投资(亿元)	电热水投资
政府公共安全投入(亿元)	公共安全投入
政府对医疗卫生及计划生育的投入(亿元)	医疗卫生投入
政府对公共交通的投入(亿元)	公共交通投入
每万人拥有的公共交通车辆数	公交车辆
城市人均绿地面积(km²)	城市绿化
县人均绿地面积(km²)	县绿化
县自来水普及率(%)	县自来水
镇自来水普及率(%)	镇自来水
镇绿化率(%)	镇绿化
乡自来水普及率(%)	乡自来水
废气中SO₂排放量(万t)	SO₂
废气中氮氧化物排放量(万t)	NO_x
废气中烟(粉)尘排放量(万t)	烟(粉)尘
工业和生活污水中氨氮排放量(万t)	氨氮
工业和生活污水中化学需氧量排放量(万t)	COD

指标	因子1	因子2	共同度
大气污染	0.91	0.13	0.85
噪音污染	0.89	0.17	0.83
水污染	0.89	0.20	0.82
工业废物	0.83	0.26	0.76
食品污染	0.79	0.33	0.73
生活垃圾	0.75	0.33	0.67
绿地稀缺	0.73	0.40	0.69
野生动物灭绝	0.17	0.86	0.77
土地退化	0.12	0.85	0.74
森林退化	0.33	0.83	0.79
荒漠化	0.31	0.83	0.77
用水短缺	0.54	0.59	0.63
方差贡献率(%)	44.61	30.86	75.47

指标	因子 1	因子 2	因子 3	因子 4	共同度
氨氮	0.92	0.21	0.13	0.15	0.93
烟（粉）尘	0.89	0.23	-0.22	-0.02	0.90
SO₂	0.86	0.33	-0.15	-0.17	0.90
COD	0.85	0.05	0.11	0.34	0.84
NOx	0.84	0.38	-0.05	-0.24	0.91
镇自来水	0.29	0.81	-0.15	0.02	0.80
县自来水	0.21	0.76	-0.37	-0.03	0.76
乡自来水	0.16	0.67	-0.15	0.28	0.64
县绿化	0.16	0.65	0.06	0.04	0.57
城镇化	0.55	0.65	0.00	0.20	0.82
医疗机构	-0.27	-0.63	0.44	-0.13	0.71
GDP	0.57	0.61	0.21	0.24	0.82
公交车辆	0.28	0.58	0.32	0.30	0.75
医疗卫生投入	0.17	0.06	0.93	-0.05	0.89
公共安全投入	0.12	0.00	0.89	-0.14	0.88
公共交通投入	-0.24	-0.22	0.85	-0.19	0.87
电热水投资	-0.18	-0.35	0.73	0.08	0.73
城市绿化	-0.06	-0.03	-0.19	0.88	0.83
镇绿化	0.09	0.39	-0.15	0.82	0.86
私家车	0.44	0.42	0.42	0.52	0.84
方差贡献率(%)	24.23	21.32	17.91	10.82	74.28

	较低收入群体				中等收入群体				较高收入群体
	模型a	模型b	模型c	模型d	模型a	模型b	模型c	模型d	模型a	模型b	模型c	模型d
个体层次
城市(乡村)	1.12			1.17	1.06			0.98	1.07			1.14
ln(收入)	1.10^**			1.08^*	1.12^***			1.05^*	1.15			1.14
职业(没有工作)
非农业性工作	2.22^***			2.20^***	1.87^***			1.93^***	2.13^**			2.07^*
农业性工作	1.52^**			1.53^***	1.40^***			1.48^***	1.77			1.84
教育水平(文盲)
初中或小学	1.05			1.02	1.33^*			1.27^*	0.53			0.54
高中	1.58^*			1.53^*	1.43^**			1.39^*	0.42			0.42
大学或以上	1.56^*			1.50^*	1.37^*			1.35	0.23^**			0.22^**
基本医疗保险(没有)
有	0.83			0.83	1.04			0.96	1.06			0.96
社区层次
环境污染		1.14^***		0.96		1.22^**		1.11		1.10		0.99
生态退化		1.04		1.00		0.96		0.96		1.10		0.98
省层次
环境污染水平			1.18^**	1.18^*			1.22^***	1.14^*			1.30^*	1.30^*
城市化与现代化			1.08	1.10			0.95	0.97			0.87	1.02
政府服务			1.32^**	1.18			1.24^*	1.20			1.03	0.86
绿化水平			1.22^**	1.33^***			1.32^***	1.34^***			1.44^***	1.41^**
DIC值	4140.0	5239.9	5271.2	4101.4	5766.8	7650.3	7759.4	5658.7	321.6	867.2	889.5	268.7

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

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