Neighborhood Social Determinants of Public Health: Analysis of Three Prevalent Non-communicable Chronic Diseases in Shenzhen, China

Abstract

Past literature has reported the ubiquitous differences in health outcomes associated with socioeconomic status across different international settings. Due to the absence of fine level aggregated data, however, rather limited studies have been conducted to explore the neighborhood social determinants of public health in developing countries, especially in China. Using district level official data in 2010, this study examines the neighborhood social determinants of three prevalent non-communicable diseases (NCDs) in Shenzhen, China. In total, 22 exploratory social variables are selected from five domains: employment, education, housing, demographic structure and income. Spatial regression in binary and stepwise form is used to recognize the most influential social determinants. Results indicate the social determinants vary with the three NCDs and they have some general similarities. Spatial binary regression identifies four principle social determinants of NCDs prevalence: employment, income, housing and demographic structure. One essential social determinant (percentage of the floating population) is identified for all the three diseases by stepwise regression. Our study highlights that the main social determinant related to the incidence rates of all NCDs is the indicator of demographic structure denoting percentage of the floating population. This paper advances the understanding of the essential social determinants of NCDs in China.