Elderly Health Inequality in China and its Determinants: A Geographical Perspective.

Chenjing Fan,Wensheng Miao,Wei Ouyang,Yan Song,Li Tian

doi:10.3390/ijerph16162953

Abstract

Inter-regional health differences and apparent inequalities in China have recently received significant attention. By collecting health status data and individual socio-economic information from the 2015 fourth sampling survey of the elderly population in China (4th SSEP), this paper uses the geographical differentiation index to reveal the spatial differentiation of health inequality among Chinese provinces. We test the determinants of inequalities by multilevel regression models at the provincial and individual levels, and find three main conclusions: 1) There were significant health differences on an inter-provincial level. For example, provinces with a very good or good health rating formed a good health hot-spot region in the Yangtze River Delta, versus elderly people living in Gansu and Hainan provinces, who had a poor health status. 2) Nearly 2.4% of the health differences in the elderly population were caused by inter-provincial inequalities; access (or lack of access) to economic, medical and educational resources was the main reason for health inequalities. 3) At the individual level, inequalities in annual income served to deepen elderly health differences, and elderly living in less developed areas were more vulnerable to urban vs. rural-related health inequalities.

Highlights

IntroductionHealth inequalities are differences in health that are deemed to be avoidable and unjust, and such inequalities can be revealed through observed patterns of health outcomes across populations [1]
Health inequalities are differences in health that are deemed to be avoidable and unjust, and such inequalities can be revealed through observed patterns of health outcomes across populations [1].The subject of health inequalities has attracted the attention of scholars in public health, and numerous studies have shown that poor people might suffer from unequal social resources, and these inequalities are manifested in poor health outcomes [2]
The global Moran's I index of China's elderly ill-health score was 0.207 at the provincial-level and passed the 5% significance test. This indicates that the health status of the elderly tended to cluster spatially, with a good health province clustered near other good health provinces

Summary

Introduction

Health inequalities are differences in health that are deemed to be avoidable and unjust, and such inequalities can be revealed through observed patterns of health outcomes across populations [1]. The subject of health inequalities has attracted the attention of scholars in public health, and numerous studies have shown that poor people might suffer from unequal social resources, and these inequalities are manifested in poor health outcomes [2]. Reducing health inequalities is a result of social progress and may have a profound impact on the future development of a society [6]. From the perspective of geography and economics, we can better understand inequalities in the health levels of different populations. Curtis (2004) [6] constructed a set of conceptual frameworks that synthesized the relationships between health and different factors such as health care, social policy, economics, consumption and ecological environment, all of which may have a strong

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Conclusion