1 Hubei Key Laboratory for Geographical Process Analysis and Simulation, Central China Normal University, Wuhan, Hubei, China.
2 Department of Geography and Planning, Queen's University, Kingston, Ontario, Canada.
Int J Health Serv. 2017 Oct;47(4):752-777. doi: 10.1177/0020731417725470. Epub 2017 Aug 28.
China's rapid socioeconomic growth in recent years and the simultaneous increase in many forms of pollution are generating contradictory pictures of residents' well-being. This paper applies multilevel analysis to the 2013 China General Social Survey data on social development and health to understand this twofold phenomenon. Multilevel models are developed to investigate the impact of socioeconomic development and environmental degradation on self-reported health (SRH) and self-reported happiness (SRHP), differentiating among lower, middle, and higher income groups. The results of the logit multilevel analysis demonstrate that income, jobs, and education increased the likelihood of rating SRH and SRHP positively for the lower and middle groups but had little or no effect on the higher income group. Having basic health insurance had an insignificant effect on health but increased the likelihood of happiness among the lower income group. Provincial-level pollutants were associated with a higher likelihood of good health for all income groups, and community-level industrial pollutants increased the likelihood of good health for the lower and middle income groups. Measures of community-level pollution were robust predictors of the likelihood of unhappiness among the lower and middle income groups. Environmental hazards had a mediating effect on the relationship between socioeconomic development and health, and socioeconomic development strengthened the association between environmental hazards and happiness. These outcomes indicate that the complex interconnections among socioeconomic development and environmental degradation have differential effects on well-being among different income groups in China.
近年来,中国社会经济快速发展,同时多种形式的污染也在增加,这使得居民福祉呈现出矛盾的景象。本文运用多层分析方法,基于 2013 年中国综合社会调查数据中有关社会发展和健康的部分,来理解这一两重现象。我们建立了多层模型,用以研究社会经济发展和环境恶化对自评健康(SRH)和自评幸福感(SRHP)的影响,同时对低收入、中等收入和高收入群体进行了区分。逻辑回归多层分析的结果表明,收入、工作和教育提高了低收入和中等收入群体自评健康和自评幸福感的可能性,但对高收入群体的影响较小或没有影响。拥有基本医疗保险对健康状况几乎没有影响,但增加了低收入群体幸福感的可能性。省级污染物与所有收入群体的良好健康状况的可能性呈正相关,而社区级工业污染物增加了低收入和中等收入群体健康状况的可能性。社区级污染指标是低收入和中等收入群体不幸福感的强有力预测指标。环境危害对社会经济发展与健康之间的关系具有中介作用,而社会经济发展则加强了环境危害与幸福感之间的关联。这些结果表明,社会经济发展和环境恶化之间的复杂相互关系对中国不同收入群体的福祉具有不同的影响。