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[儿童健康不平等的社会决定因素研究]

[Research on the social determinants of child health inequalities].

作者信息

Feng Xing-lin, Shen Juan, Guo Yan

机构信息

Department of Health Policy and Administration, Peking University School of Public Health, Beijing 100191, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2010 Jun 18;42(3):252-7.

Abstract

OBJECTIVE

To investigate the impact of social determinants of health on the inequality of child health and health care utilization.

METHODS

Information of 1 118 children aged 0 to 16 is extracted from the Chinese Family Panel Studies (CFPS) year 2008 cross sectional survey data for the analysis. Age standardized concentration curves and concentration indices are employed to assess the inequalities for incidence of low birth weight, self reported good health, adequate timing of breast feeding, health insurance coverage and incidence of catastrophic health expenditures for these children. Concentration indices are decomposed to four levels of social determinants of health(community, family, mother and individual level) to understand their contributions to health inequality respectively.

RESULTS

There are health inequalities existing in the investigated children, among which social factors at mother and family level have the largest contribution.

CONCLUSION

To respond to the call by the WHO to achieve health equity through action on the social determinants of health in a generation, the inequalities of health and health care utilization amongst Chinese children should be put on the policy agenda, and social policies should intervene from multiple social dimensions, especially from family and mother levels.

摘要

目的

探讨健康的社会决定因素对儿童健康不平等及医疗保健利用的影响。

方法

从2008年中国家庭追踪调查(CFPS)横断面调查数据中提取1118名0至16岁儿童的信息进行分析。采用年龄标准化浓度曲线和浓度指数评估这些儿童低出生体重发生率、自我报告的健康状况良好、母乳喂养时机适宜、医疗保险覆盖情况及灾难性医疗支出发生率的不平等情况。将浓度指数分解为健康的社会决定因素的四个层次(社区、家庭、母亲和个体层面),以分别了解它们对健康不平等的贡献。

结果

被调查儿童中存在健康不平等现象,其中母亲和家庭层面的社会因素贡献最大。

结论

为响应世界卫生组织提出的在一代人的时间内通过针对健康的社会决定因素采取行动来实现健康公平的号召,中国儿童健康及医疗保健利用方面的不平等应提上政策议程,社会政策应从多个社会层面进行干预,尤其是家庭和母亲层面。

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