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中国西南地区农村居民的健康公平性。

Health Equity of Rural Residents in Southwest China.

机构信息

School of Public Health, Kunming Medical University, Kunming, China.

First Affiliated Hospital of Kunming Medical University, Kunming, China.

出版信息

Front Public Health. 2021 Mar 23;9:611583. doi: 10.3389/fpubh.2021.611583. eCollection 2021.

Abstract

The Chinese government stresses healthcare reform to improve the health of all residents in urban and rural areas. However, much research showed that inequities still existed in health status and health services utilization in China, especially in economically disadvantaged areas. Southwest China's Yunnan Province is an ethnic frontier region with lagging economic development. This study analyzed health equity among rural residents with various socio-economic and demographic statuses in Yunnan Province. Research on this area concerns rural residents. Our study was based on a household study sample consisting of 27,395 participants from six counties in Yunnan. For all participants, data on demographic and socio-economic characteristics, and health status were collected. The chi-square test and logistic regression were used to analyze factors influencing health. The concentration index was used to evaluate health equity. For all respondents, the 2-week prevalence, the prevalence of chronic diseases, and the required hospitalization rate were 7.3, 12.8, and 9.2%, respectively. After adjusting the age proportion of the sixth population census of Yunnan Province, the 2-week prevalence was 7.1%, the prevalence of chronic disease was 10.7%, and the hospitalization rate was 8.4%. The concentration indexes (CIs) reflecting health equity among the respondents with different incomes and educational levels were negative. There was health inequity among respondents with different incomes and educational levels. The respondents with lower incomes and educational levels had worse health. The common influencing factors included gender, age, ethnicity, occupation, marriage status, and the number of family members. Females, the aged, ethnic minorities, farmers, and the divorced or widowed had worse health status than the control groups. Larger numbers of family members correlated with better health. The respondents with lower incomes or educational levels had higher chronic disease prevalences. The associations between the 2-week prevalence, required hospitalization rate, and age were U-shaped; the lowest age group and the highest age group had higher rates. In conclusion, more attention should be paid to females, the aged, ethnic minorities, farmers, the divorced or widowed, residents with low income and low educational level, and those with chronic diseases.

摘要

中国政府强调医疗改革,以提高城乡居民的健康水平。然而,大量研究表明,中国的健康状况和卫生服务利用仍存在不平等现象,尤其是在经济落后地区。中国西南部的云南省是一个经济发展滞后的民族边疆地区。本研究分析了云南省不同社会经济和人口统计学特征的农村居民的健康公平性。对这一领域的研究涉及农村居民。我们的研究基于一个由云南省六个县的 27395 名参与者组成的家庭研究样本。对所有参与者,收集了人口统计学和社会经济特征以及健康状况的数据。使用卡方检验和逻辑回归分析影响健康的因素。使用集中指数评估健康公平性。对于所有受访者,两周患病率、慢性病患病率和需要住院治疗率分别为 7.3%、12.8%和 9.2%。调整云南省第六次人口普查的年龄比例后,两周患病率为 7.1%,慢性病患病率为 10.7%,住院治疗率为 8.4%。反映不同收入和教育水平受访者健康公平性的集中指数(CI)为负值。不同收入和教育水平的受访者存在健康不平等。收入和教育水平较低的受访者健康状况较差。共同的影响因素包括性别、年龄、民族、职业、婚姻状况和家庭成员人数。女性、老年人、少数民族、农民和离婚或丧偶者的健康状况比对照组差。家庭成员人数越多,健康状况越好。收入较低或教育水平较低的受访者慢性病患病率较高。两周患病率、需要住院治疗率与年龄之间的关系呈 U 型;最低年龄组和最高年龄组的患病率较高。总之,应更多地关注女性、老年人、少数民族、农民、离婚或丧偶者、收入较低和教育水平较低的居民以及患有慢性病的居民。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30dd/8021781/c58e50264ee0/fpubh-09-611583-g0001.jpg

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