Liu Y, Rao K, Fei J
Harvard School of Public Health, Cambridge, MA 02138, USA.
Health Policy. 1998 May;44(2):103-22. doi: 10.1016/s0168-8510(98)00010-4.
Drawing on experiences from China and Russia (the world's two largest transitional economies), this paper empirically examines the impact of economic reforms on health status. While China's overall health status continued to improve after the economic reform, Russia experienced a serious deterioration in its population health. The observed differences in health performance between China and Russia can be explained by the different impacts of economic reforms on three major socioeconomic determinants of health. Depending on whether or not the reform improves physical environment (as reflected in income level and nutritional status), social environment (including social stability and security system), and health care, we would observe either a positive or a negative net effect on health. Despite remarkable differences in overall health development, China and Russia share some common problems. Mental and social health problems such as suicides and alcohol poisoning have been on the rise in both countries. These problems were much more serious in Russia, where political and social instability was more pronounced, associated with Russia's relatively radical reform process. With their economies moving toward a free market system, health sectors in China and Russia are undergoing marketization, which has had serious detrimental effect on the public health services.
借鉴中国和俄罗斯（世界上两个最大的转型经济体）的经验，本文实证研究了经济改革对健康状况的影响。经济改革后，中国的整体健康状况持续改善，而俄罗斯的人口健康状况却严重恶化。中国和俄罗斯在健康表现上的差异可以通过经济改革对健康的三大社会经济决定因素的不同影响来解释。根据改革是否改善了物质环境（如收入水平和营养状况所反映）、社会环境（包括社会稳定和安全体系）以及医疗保健，我们会观察到对健康产生的正或负净效应。尽管在整体健康发展方面存在显著差异，但中国和俄罗斯也有一些共同问题。两国的自杀和酒精中毒等心理和社会健康问题都在增加。这些问题在俄罗斯更为严重，那里的政治和社会不稳定更为明显，这与俄罗斯相对激进的改革进程有关。随着两国经济向自由市场体系迈进，中国和俄罗斯的卫生部门正在经历市场化，这对公共卫生服务产生了严重的不利影响。
