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中国的收入不平等与多种疾病并存模式:基于中国健康与养老追踪调查(CHARLS)的微观层面分析

Income inequality and multimorbidity patterns in China: a micro-level analysis using CHARLS.

作者信息

Ouyang Mengqian, Liu Bowen, Xu Riping

机构信息

Department of Economics, Guangdong Institute of Public Administration, Guangzhou, China.

Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States.

出版信息

Front Public Health. 2025 Apr 16;13:1588325. doi: 10.3389/fpubh.2025.1588325. eCollection 2025.

Abstract

INTRODUCTION

Health inequality-particularly income-related health inequality-poses a global challenge, significantly affecting social and economic well-being. While previous research has investigated the link between income inequality and various health outcomes, including chronic diseases, studies focusing on multimorbidity remain limited.

METHODS

This study examines how income inequality affects multimorbidity in China, drawing on data from the China Health and Retirement Longitudinal Study. By employing the Kakwani Index, the analysis evaluates income inequality at the individual level and utilizes Latent Class Analysis to identify multimorbidity patterns. The research further explores how these effects vary across different age groups and regions. The study investigates the role of household economic decisions in shaping health outcomes. RIF regression is used to break down the contribution of income inequality to health disparities.

RESULTS

Lower relative wage income was strongly associated with an increased number of chronic diseases and heightened likelihood of specific multimorbidity patterns, particularly Respiratory-Cardiovascular diseases and overall disease burden. Redistribution of income partially alleviated the negative impact of income inequality on health outcomes. The effects of income inequality on health differ notably across age groups and geographical regions. Developmental expenditures (e.g., improving living conditions) were more effective in addressing income-related health disparities than direct increases in healthcare spending.

DISCUSSION

Policy responses need to focus on targeted income redistribution strategies and increased investment in developmental initiatives to address these growing health inequalities.

摘要

引言

健康不平等,尤其是与收入相关的健康不平等,构成了一项全球性挑战,对社会和经济福祉产生重大影响。虽然先前的研究已经调查了收入不平等与包括慢性病在内的各种健康结果之间的联系,但关注多种疾病并存情况的研究仍然有限。

方法

本研究利用中国健康与养老追踪调查的数据,考察收入不平等如何影响中国的多种疾病并存情况。通过采用卡克瓦尼指数,该分析在个体层面评估收入不平等,并利用潜在类别分析来识别多种疾病并存模式。该研究进一步探讨了这些影响在不同年龄组和地区之间如何变化。该研究调查了家庭经济决策在塑造健康结果方面的作用。回归分解法被用来剖析收入不平等对健康差异的贡献。

结果

相对工资收入较低与慢性病数量增加以及特定多种疾病并存模式的可能性增加密切相关,尤其是呼吸 - 心血管疾病和总体疾病负担。收入再分配部分缓解了收入不平等对健康结果的负面影响。收入不平等对健康的影响在不同年龄组和地理区域之间存在显著差异。发展性支出(如改善生活条件)在解决与收入相关的健康差异方面比直接增加医疗保健支出更有效。

讨论

政策应对措施需要侧重于有针对性的收入再分配策略,并增加对发展性举措的投资,以应对这些日益加剧的健康不平等问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50ac/12041221/31a1f069ffac/fpubh-13-1588325-g0001.jpg

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