School of Public Health (Shenzhen), Sun Yat-sen University, Gongchang Road 66, Shenzhen 518107, China.
Department of Health Policy and Management, School of Public Health, Peking University, Xueyuan Road 38, Haidian District, Beijing 100191, China.
Int J Environ Res Public Health. 2023 Mar 5;20(5):4612. doi: 10.3390/ijerph20054612.
Socioeconomic disparities in health within and across low- and middle-income countries pose a significant global public health concern. While prior research has demonstrated the importance of socioeconomic status on health outcomes, few studies have employed comprehensive measures of individual-level health such as quality-adjusted life years (QALYs) in exploring the quantitative relationship. In our study, we employed QALYs to measure individual-level health, using health-related quality of life scores based on the Short Form 36 and predicted remaining life years through individual-specific Weibull survival analysis. We then constructed a linear regression model to explore the socioeconomic factors that influence QALYs, providing a predictive model of individual-level QALYs throughout remaining lifetimes. This practical tool can help individuals predict their remaining healthy life years. Using data from the China Health and Retirement Longitudinal Study between 2011 and 2018, we found that education and occupation were the primary factors influencing health outcomes among individuals aged 45 and above, while income appeared to have less of an impact when education and occupation were simultaneously controlled for. To promote the health status of this population, low- and middle-income countries should prioritize the long-term advancement of their population's education while controlling unemployment rates in the short term.
在中低收入国家,健康方面的社会经济差异在国内和国家间都构成了重大的全球公共卫生关切。尽管先前的研究已经证明了社会经济地位对健康结果的重要性,但很少有研究采用质量调整生命年(QALYs)等综合个体健康指标来探索定量关系。在我们的研究中,我们使用 QALYs 来衡量个体健康,采用基于 36 项简短健康调查问卷的健康相关生活质量评分,并通过个体特定的 Weibull 生存分析预测剩余寿命年数。然后,我们构建了一个线性回归模型来探索影响 QALYs 的社会经济因素,提供了一个预测个体整个剩余寿命年限的 QALYs 模型。这个实用工具可以帮助个人预测他们剩余的健康寿命年数。使用 2011 年至 2018 年期间中国健康与退休纵向研究的数据,我们发现,在 45 岁及以上的人群中,教育和职业是影响健康结果的主要因素,而当同时控制教育和职业时,收入的影响似乎较小。为了促进这部分人群的健康状况,中低收入国家应该优先考虑长期提升其人口的教育水平,同时控制短期的失业率。