Shanghai University of Finance and Economics, Shanghai, China.
Yunlin University of Science and Technology, Douliu, China.
Front Public Health. 2022 Apr 25;10:810488. doi: 10.3389/fpubh.2022.810488. eCollection 2022.
The COVID-19 pandemic influences various aspects of society, especially for people with low socioeconomic status. Health education has been proven to be a critical strategy in preventing a pandemic. However, socioeconomic characteristics may limit health education among low socioeconomic status groups. This study explores consumption-related health education inequality and the factors that contribute to this, which are variable across China during COVID-19.
The 2020 China COVID-19 Survey is a cross-sectional study in China, based on an anonymous online survey from 7,715 samples in 85 cities. It employed machine-learning methods to assess household consumption and other contributing variates associated with health education during the pandemic. Concentration Index (CI) and Horizontal Index (HI) were used to measure consumption-related inequalities in health education, respectively. Moreover, Wagstaff decomposition analysis was employed to identify other contributing variables to health education inequality.
The result indicates that participants with more education, better income, and positive consumption preferences undertake higher health education during COVID-19. The CI and HI of consumption-health education inequality are 0.0321 ( < 0.001) and 0.0416 ( < 0.001), respectively, which indicates that health education is concentrated in wealthy groups. We adapted Lasso regression to solve issues and omit variables. In terms of other socioeconomic characteristics, Annual Income was also a major contributor to health education inequalities, accounting for 27.1% ( < 0.001). The empirical results also suggests that education, health status, identification residence, and medical health insurance contribute to health education inequality.
The difference in Household consumption, annual income, rural and urban disparity, and private healthcare insurance are critical drivers of health education inequality. The government should pay more attention to promoting health education, and healthcare subside policy among vulnerable people. Significantly to improve awareness of undertaking health education with lower education, rural residential, to enhance confidence in economic recovery and life after COVID-19.
新冠疫情影响社会的各个方面，尤其是社会经济地位较低的人群。健康教育已被证明是预防大流行的关键策略。然而，社会经济特征可能会限制社会经济地位较低群体的健康教育。本研究探讨了与消费相关的健康教育不平等及其背后的因素，这些因素在中国各地的新冠疫情期间存在差异。
2020 年中国新冠疫情调查是一项在中国开展的横断面研究，基于来自 85 个城市的 7715 个样本的匿名在线调查。该研究采用机器学习方法评估家庭消费和其他与大流行期间健康教育相关的变量。集中指数（CI）和水平指数（HI）分别用于衡量健康教育方面的消费相关不平等。此外，还采用 Wagstaff 分解分析来确定健康教育不平等的其他相关变量。
研究结果表明，受教育程度较高、收入较好、消费偏好为积极的参与者在新冠疫情期间接受了更高水平的健康教育。消费-健康教育不平等的 CI 和 HI 分别为 0.0321（<0.001）和 0.0416（<0.001），表明健康教育集中在富裕群体。我们采用 Lasso 回归来解决问题并省略变量。就其他社会经济特征而言，年收入也是健康教育不平等的主要因素，占 27.1%（<0.001）。实证结果还表明，教育、健康状况、户籍和医疗保险对健康教育不平等有贡献。
家庭消费、年收入、城乡差距和私人医疗保险的差异是健康教育不平等的关键驱动因素。政府应更加关注促进弱势群体的健康教育和医疗补贴政策。显著提高对接受健康教育的意识，包括教育程度较低、农村户籍的人群，增强他们对经济复苏和新冠疫情后生活的信心。
