School of Business, Jiangxi University of Science and Technology, Nanchang, 330013, China.
Laboratoire Physico-Chimie des Interfaces Complexes, ESPCI Paris, 10 rue Vauquelin, F-75231, Paris, France.
Int J Equity Health. 2023 Apr 1;22(1):59. doi: 10.1186/s12939-022-01805-2.
Poverty vulnerability has been defined as the likelihood of a family falling into poverty in the upcoming months. Inequality is a major cause of poverty vulnerability in developing countries. There is evidence that establishing effective government subsidies and public service mechanisms significantly reduces health poverty vulnerability. One of the ways to study poverty vulnerability is by using empirical data such as income elasticity of demand to perform the analysis. Income elasticity refers to the extent to which changes in consumers' income affect changes in demand for commodities or public goods. In this work, we assess health poverty vulnerability in rural and urban China. We provide two levels of evidence on the marginal effects of the design and implementation of government subsidies and public mechanisms in reducing health poverty vulnerability, before and after incorporating the income elasticity of demand for health.
Multidimensional physical and mental health poverty indexes, according to the Oxford Poverty & Human Development Initiative and the Andersen model, were implemented to measure health poverty vulnerability by using the 2018 China Family Panel Survey database (CFPS) as the data source for empirical analysis. The income elasticity of demand for health care was used as the key mediating variable of impact. Our assessment was conducted by a two-level multidimensional logistic regression using STATA16 software.
The first level regression indicates that the marginal utility of public mechanism (PM) in reducing urban and rural vulnerability as expected poverty on physical and mental health (VEP-PH&MH) was insignificant. On the other hand, government subsidies (GS) policies had a positive suppression effect on VEP-PH&MH to a relatively low degree. The second level regression found that given the diversity of health needs across individual households, i.e., the income elasticity of demand (HE) for health care products, PM and GS policies have a significant effect in reducing VEP-PH&MH in rural and urban areas. Our analysis has verified the significant positive impact of enacting accurate GS and PM policies on effectively reducing VEP-PH&MH in rural as well as urban areas.
This study shows that implementing government subsidies and public mechanisms has a positive marginal effect on reducing VEP-PH&MH. Meanwhile, there are individual variations in health demands, urban-rural disparities, and regional disparities in the effects of GS and PM on inhibiting VEP-PH&MH. Therefore, special consideration needs to be given to the differences in the degree of health needs of individual residents among urban and rural areas and regions with varying economic development. Furthermore, considerations of this approach in the current worldwide scenario are analyzed.
贫困脆弱性被定义为家庭在未来几个月陷入贫困的可能性。不平等是发展中国家贫困脆弱性的一个主要原因。有证据表明,建立有效的政府补贴和公共服务机制可以显著降低卫生贫困脆弱性。研究贫困脆弱性的方法之一是使用收入弹性等实证数据进行需求分析。收入弹性是指消费者收入变化对商品或公共品需求变化的影响程度。在这项工作中,我们评估了中国农村和城市的卫生贫困脆弱性。我们提供了政府补贴和公共机制设计和实施对降低卫生贫困脆弱性的边际效应的两个层次的证据,在纳入卫生需求收入弹性之前和之后。
采用多维身心健康贫困指数,根据牛津贫困与人类发展倡议和安德森模型,利用 2018 年中国家庭追踪调查数据库(CFPS)作为实证分析的数据源,衡量卫生贫困脆弱性。卫生保健需求的收入弹性被用作影响的关键中介变量。我们的评估是使用 STATA16 软件进行的两级多维逻辑回归。
一级回归表明,公共机制(PM)降低城乡预期贫困身心健康脆弱性(VEP-PH&MH)的边际效用不显著。另一方面,政府补贴(GS)政策对 VEP-PH&MH 有一定的正向抑制作用,但程度相对较低。二级回归发现,考虑到个体家庭对健康的多样化需求,即医疗产品的收入弹性(HE),PM 和 GS 政策对降低城乡 VEP-PH&MH 具有显著影响。我们的分析验证了制定准确的 GS 和 PM 政策对有效降低城乡 VEP-PH&MH 的显著积极影响。
本研究表明,实施政府补贴和公共机制对降低 VEP-PH&MH 具有积极的边际效应。同时,在 GS 和 PM 对抑制 VEP-PH&MH 的影响方面,存在个体健康需求、城乡差异和区域差异。因此,需要特别考虑城乡居民个体健康需求程度的差异,以及经济发展水平不同地区的差异。此外,还分析了这一方法在当前全球范围内的应用。