Health Of Residents Research Articles

Aircraft-related noises increased but compensation decreased in Chinese airports

The rapid development of the aviation industry has brought convenience and noise hazards, altering the modes of travel but adversely affecting public health. Noise pollution is one of the essential factors affecting public health. This study offers a comprehensive examination of noise pollution data associated with the aviation industry, focusing on an array of airlines operating over 400 domestic routes within China from 2014 to 2019. It scrutinizes the noise emissions during the Lateral, Flyover, and Approach phases. It employs European Union standards to derive a formula for noise compensation relative to passenger volume, elucidating the quantum of noise indemnity allocable per passenger. (1) An upward trend in noise emissions is observed annually within China's civil aviation sector, with marked disparities in emission levels across various airports and airlines. (2) The mean annual value of noise compensation has shown a general decline, with China Express Airlines assuming a principal role in these compensations. (3) There is a correlation between noise compensation, noise emissions, and passenger volumes. Utilizing aircraft with low-emission and high passenger capacities significantly reduces airline compensation costs and safeguards the health of passengers and nearby residents.

Quantifying the Wild: Public Acceptance and Challenges of Urban Wildscapes in Chiba, Japan

People’s reduced connection with nature has led to many health problems. In the NBS framework, urban wildscapes (UWSs) are considered an important solution. They can contribute to improving the health of residents and ecosystems within the city. However, overly wild green spaces may also be offensive to residents. It is necessary to understand the public’s acceptance of UWSs. Current studies on the acceptance of UWSs have used vague terms to generalize the “wildness degree”. In this study, we attempted to quantify the degree of wildness using plant height and plant abundance in Japan and analyzed the results through mediated effect analysis. We discovered the following: 1. Japanese residents have low acceptance of UWSs in vacant lots. 2. The use of “height” and “abundance” may be a more objective way to quantify wildness. 3. The negative effects of abundance can be minimized. The negative effect of height cannot be controlled. This study addresses a gap in the study of Asian cities and proposes a novel approach to quantifying “wildness.” It improves the health benefits of UWSs. Furthermore, it can offer guidance on the management and construction of urban green spaces.

Introduction to the forensic research via omics markers in environmental health vulnerable areas (FROM) study.

This research group (forensic research via omics markers in environmental health vulnerable areas: FROM) aimed to develop biomarkers for exposure to environmental hazards and diseases, assess environmental diseases, and apply and verify these biomarkers in environmentally vulnerable areas. Environmentally vulnerable areas-including refineries, abandoned metal mines, coal-fired power plants, waste incinerators, cement factories, and areas with high exposure to particulate matter-along with control areas, were selected for epidemiological investigations. A total of 1,157 adults, who had resided in these areas for over 10 years, were recruited between June 2021 and September 2023. Personal characteristics of the study participants were gathered through a survey. Biological samples, specifically blood and urine, were collected during the field investigations, separated under refrigerated conditions, and then transported to the laboratory for biomarker analysis. Analyses of heavy metals, environmental hazards, and adducts were conducted on these blood and urine samples. Additionally, omics analyses of epigenomes, proteomes, and metabolomes were performed using the blood samples. The biomarkers identified in this study will be utilized to assess the risk of environmental disease occurrence and to evaluate the impact on the health of residents in environmentally vulnerable areas, following the validation of diagnostic accuracy for these diseases.

Does internet use benefit health?-PSM-DID evidence from China's CHARLS.

Amid the increasing global internet penetration, understanding the impact of internet use on residents' health is crucial. This aids in formulating more effective health policies and provides empirical evidence for promoting health equity and improving overall public health. Drawing on the China Health and Retirement Longitudinal Study (CHARLS), this paper employs the Propensity Score Matching-Difference in Differences (PSM-DID) method to examine the impact of the internet on individual health and further explores the pathways through which the internet affects health. We introduce the research background and significance in the introduction. Then, in the theoretical analysis, it incorporates internet variables into the Becker health demand model to analyze changes in health demand and impact pathways. The empirical analysis tests the theoretical findings, leading to empirical results. Finally, the study discusses the results and provides relevant recommendations. The findings indicate significant positive effects of the internet on both physical and psychological health. These effects are realized through reducing health information asymmetry, lowering health costs, and increasing exposure to health-promoting environments. In the heterogeneity analysis, economic-related internet content shows a significant positive impact on resident health. Intensive internet use adversely affects psychological health. The beneficial effects of the internet on health are more pronounced among older individuals, those covered by medical insurance, and regions with higher levels of digital economy. Based on these findings, the study offers policy recommendations concerning individuals' internet use patterns, the digital evolution of the healthcare industry, and government infrastructure development.

Community-University Partnerships: The Benefits of Collaboration in Measuring Public Support for a Community Recreation Center

Community recreation centers (CRCs) are gaining popularity across the country. While many support the argument that CRCs improve quality of life by building social capital and improving the physical health of residents, that support does not necessarily translate into community support for the funding and construction of CRCs. Some communities undertake surveys to try to gauge the support for CRCs but have had mixed results on the insights provided by those surveys. Furthermore, public perceptions about the accuracy and usefulness of survey data could lead to stakeholder disregard for the data produced by them. This case study focuses on the benefits of a robust partnership between a local community and a regional university in developing a survey research project to analyze support for building a CRC. In this paper, we emphasize the value of producing trusted data and provide lessons on how community-university partnerships can achieve similar objectives. The first lesson is that community-university partnerships, by emphasizing local connections, can help foster trust in survey research projects. Second, strategic community-university partnerships can derive additional benefits such as division of labor, expertise, and cost savings. Third, by embracing the above two benefits, collaboration is not only possible, but can produce tailored survey research projects that provide stakeholders insights into critical questions. Finally, community-university partnerships that are structured around shared values can help communities solve critical policy issues effectively and efficiently. This case study details these lessons through an examination of a robust community-university partnership that led to the passage of a ballot referendum to build a CRC. This community-university model of collaboration provides a framework for communities and universities to work together to serve the public good.

A community proactive health management model for family doctors in Shandong, China.

Background Chronic disease management is an essential part of public health management and a fundamental means of slowing down the progression of major diseases. Unlike traditional medical care, proactive health management focuses on the combination of prevention and treatment. Proactive health management can reduce the re-admission rate of patients with chronic diseases, improve long-term prognosis, and effectively reduce the disability and mortality rates of major health events. This study aimed to establish a proactive health management model based on a grid-based medical service team arrangement, and to explore the effect of this model on managing chronic diseases in community health service institutions. Methods A grid-based medical service team was established in Binzhou, Shandong, China, consisting of general practitioners, nurses, public health doctors, health promoters and community grid liaison staff. Each team was responsible for several areas to monitor critical populations within the grid and compile statistics on the health management of these key populations in 2022-2023. Results A total of 2050 patients with coronary artery disease, 4973 patients with hypertension, and 1621 patients with type 2 diabetes were followed up in 2022. Compared with 155,612 resident health records in 2022, the number of records increased by 140.50% in 2023. The number of patients with hypertension under health management in 2023 increased by 50.92%; patients with type 2 diabetes increased by 74.65%; and the number of coronary artery disease increased by 42.00%. After the implementation of grid management, the hospitalisation rate for patients with type 2 diabetes significantly decreased in 2023 (P P >0.05). Conclusion The grid-based community proactive health management model makes full use of the advantages of community resources and improves the pertinence and coverage of community health services. Moreover, it reduces hospitalisation for patients with type 2 diabetes.

Impact of urban and rural residents medical insurance on self-rated health of residents in China: a panel study from the China family panel studies national baseline survey.

This study aimed to investigate the health performance of the Urban and Rural Residents Medical Insurance (URRMI) scheme in China and to make practical recommendations and scientific references for its full implementation in China. This is a panel study that uses data from the China Family Panel Studies from 2018 to 2020, which is separated into treated and control groups each year, utilizing the key approach of propensity score matching and difference-in-difference (PSM-DID). Using 1-to-1 k-nearest neighbor matching, we proportionate the baseline data. Using difference-in-difference model, we examine the mean treatment impact of the outcome variables. Using a 500-time random sample regression model, we validate the robustness of the model estimation. The result was credible after matching, minimizing discrepancies. Good overall performance of self-rated health with an average Hukou status of, respectively, 0.8 and 0.4 in the treated and control group, primarily in rural and urban regions separately. The participation of URRMI significantly impacted self-rated health of residents, with a 0.456-unit improvement probabilities observed (p < 0.1). Additionally, the individuals are categorized into urban and rural, and those with urban hukou had a 0.311 expansion in the probability of having better health status compared to rural hukou (p < 0.05). Other factors, such as age, highest education, annual income, medical expenditure, hospital scale, clinic satisfaction, and napping, also impacted self-rated health. Moreover, elder individuals, higher education levels, and higher medical expenditure having a higher probability of improvement. The study utilized a placebo test to verify the robustness of the URRMI regression. The estimated coefficients showed that basic medical insurance did not significantly improve the health of insured residents under the URRMI scheme. The study demonstrates the crucial role of PSM-DID in determining the influence of URRMI on self-rated health status. It indicates that purchasing in URRMI has a favorable influence on the health of residents, advancing enhanced self-rated health effectiveness. It does, however, reveal geographical disparities in health, with urban dwellers faring far better than those who live in the suburb. Study suggests expanding URRMI coverage, narrowing urban-rural divide, increasing insurance subsidies, reforming laws, and developing effective advertising strategies.

Hydrogeologic and hydrochemical inputs to emerging wetlands on the shores of the receding Salton Sea, California

AbstractThe Salton Sea has experienced significant recession over the past two decades due to changes in the diversion of Colorado River water to the Salton Trough for agricultural irrigation. As a result, wetlands have emerged in some exposed playa areas along the Salton Sea, primarily in regions with extensive agricultural return flows and agricultural drainage. One notable wetland system, known as the Bombay Beach Wetlands, has formed on the north shore of the Salton Sea, in an area devoid of agriculture. In many other areas with limited or no agriculture, wetlands have failed to develop, leaving exposed playa surfaces as the Salton Sea recedes. These dry playa surfaces pose a significant threat to the health of local residents due to the presence of toxins contained in windblown dust associated with playa deposits. In this study, stable water isotope data, combined with other hydrological information, led to identification of two potential water sources for the Bombay Beach Wetlands. The first possibility proposes that thermal artesian waters alone contribute to the wetlands' water source, while the second hypothesis involves a combination of drainage from Salton Sea bank storage water mixing with the thermal artesian water. The thermal artesian water discharges into drainage channels that flow towards the Bombay Beach Wetlands, initially devoid of possible groundwater baseflow until reaching the wetlands. Studies were subsequently done along the full reach of the drainage channels receiving thermal artesian water. Dissolved solids content, P and N nutrients, arsenic, and stable water isotopes were tested synoptically along the drainage channels. Channel investigations led to the development of a novel model of salinization, which is linked to channel discharge, channel morphometrics, and channel incision.

Highly sensitive formaldehyde detection using biomass hydrogel with core-shell structure

The indoor formaldehyde concentration is in trace quantities; however, it considerably deteriorates indoor air quality and poses a serious threat to human health and ecosystems. Since current formaldehyde analyzers are only suitable for high-concentration detection or are expensive, there is a pressing need for an easy-to-use, storable, and highly sensitive formaldehyde detector. In this study, we developed a colorimetric sensing sphere using affordable and eco-friendly sodium alginate as a porous matrix. Polyethyleneimine, a molecule rich in amino groups, and an indicator are embedded in the matrix to create a core-shell structured, responsive porous hydrogel colorimetric sensor for indoor formaldehyde detection. The sensing sphere exhibits high sensitivity and excellent detection limits at a polyethyleneimine to pH agent mass ratio of 23:1, reaching a sensitivity of 0.02 mg/m3 and a detection limit of 0.06 mg/m3. The sensing sphere demonstrates superior selectivity among common indoor pollutants and remains unaffected by temperature (up to 70 ℃) or humidity (20–80 %) changes. Moreover, the core-shell structure of the colorimetric sensor ball addresses the poor stability and storage issues. The core-shell structure resists interference from external environmental changes, offering remarkable stability for 6 months and longer, hence, facilitating easy transportation and storage. The colorimetric sensing sphere is simple, cost-effective, and reliable for ordinary households, thus maintaining the indoor air quality and health of residents.

Building towards a healthier future

The design of a neighbourhood has a major influence on the health of the people living there. Researchers in the Building Health project are investigating how environments can be designed to promote the health of local residents, which could then reduce the strain on health and care services, as Stine Hellum Braathen and Hege Hidle Aaser explain.

Poverty Traps and Mortality From Liver Diseases in the United States.

Poverty traps, locations with multigenerational poverty, result from structural and economic factors that can affect health of residents within these locations. The aim of this study was to define poverty traps within the contiguous United States and their impact on outcomes from liver diseases or cancers. A systematic census-tract level analysis was used to spatially define regions that encompassed poverty traps. Clusters of prevalent poverty and mortality from chronic liver diseases or liver cancers were identified. Temporal trends and the relationship between race and ethnicity, type of space and escape from poverty traps on disease mortality within hot spots were determined. The proportion of census tracts enduring multigenerational poverty within counties was strongly associated with mortality from liver disease or cancer. There was a highly significant clustering of persistent poverty and increased mortality. Hot spots of high-mortality areas correlated with factors related to income, ethnicity, and access to health care. Location or noneconomic individual factors such as race and ethnicity were important determinants of disparities within hot spots. Distinct groups of poverty traps were defined. The highly characteristic demographics and disease outcomes within each of these groups underscored the need for location-specific interventions. Poverty traps are a major and important spatially determined risk factor for mortality from liver diseases and cancers. Targeted location-specific interventions and economic development aimed at addressing the underlying causes of poverty and enhancing prosperity will be required to reduce mortality from liver diseases within poverty traps.

Aerodynamic parameters of buildings at different floors in the immediate vicinity

AbstractThe immediate vicinity of buildings of different floors causes damages of the smoke and ventilation channels work of the low-rise buildings. This is dangerous for the resident's health and lives. To determine the impact of high-rise buildings on the operation of air channels of a nearby two-story building, experimental research has been carried out in a wind tunnel. Charts and analytical formulas have been designed for determining the buildings aerodynamic coefficients depending on wind directions and the channels height. An increase of the channel height results in an increase in static rarefaction in smoke and ventilation channels. Increasing rarefaction increases the efficiency of the natural ventilation system and ensures the residents health and life.

Item response theory in building environment engineering: A novel approach to identifying key residential environment items

The residential environment significantly influences residents’ health, quality of life, and well-being. Therefore, it is essential to assess the residential environment and implement improvement measures when problems are identified. In this context, the use of assessment tools such as BREEAM, LEED, and CASBEE has increased rapidly in recent years. Identifying key items with these assessment tools is crucial for prioritizing improvements to residential environment. This study introduces the novel application of item response theory (IRT) to building environment engineering data in order to identify key items from the CASBEE Residential Health Checklist. The strength of IRT lies in its ability to consider variations in scores for each item and the relative relationships between items, thereby enabling the identification of significantly influential key items. Examining Japanese residences, IRT identified 6 environmental items and 7 spatial items from a total of 44 items in the CASBEE Residential Health Checklist. Additionally, these environmental and spatial components were ranked by their explanatory power for the overall assessment of the residential environment. These findings contribute to prioritizing improvements in residential environments and provide a brief assessment method. IRT can be applied to other regions and building types, potentially enabling the identification of key items unique to each case. Thus, IRT is a versatile method with broad applicability for identifying key items in residential environment assessments.

The effectiveness of multidisciplinary interventions based on health belief model on musculoskeletal pain in the elderly living in nursing homes: a study protocol for a randomized controlled trial

BackgroundDue to the burden of musculoskeletal diseases in the elderly and the multifactorial nature of such conditions, controlling the pain caused by these disorders requires multidisciplinary approach. This approach requires the participation of the elderly in applying effective prevention measures. This study aims to design a multidisciplinary educational intervention based on health belief model (HBM) for elderly residents of nursing homes.MethodsThis is a parallel randomized clinical trial among elderly people aged 60 years and over living in a nursing home who suffer from musculoskeletal pain. Eligible participants will be divided into two groups including the intervention group who will receive a multidisciplinary intervention (vitamin D consumption, psycho-social stress management, and physiotherapy) and the control group who will receive usual care. Data collection instruments will include demographic data, the Depression, Anxiety, and Stress Scale (DASS), the visual analogue scale (VAS), and a self-designed questionnaire containing the HBM constructs. The interventions will be carried out by the educational team (general practitioner, psychologist, physiotherapist, and health education specialist). Interventions include changing the wrong beliefs of the elderly, taking 800 units of vitamin D daily, daily walking exercise by the elderly for at least 30 min and maintaining proper body posture during daily activities, muscle relaxation, relaxation techniques, regular exercise, examining their diet and eliminating stimulants (such as smoking and coffee), regular visits with friends and family, and deep breathing techniques. All questionnaires will be completed by the elderly before, after, 3, and 6 months after the intervention.DiscussionThe present study will evaluate the effect of an educational intervention based on a multifaceted pain control approach for elderly people who reside in nursing homes in order to reduce musculoskeletal pain in the elderly living in nursing homes. One of the features of this study is its focus on improving the health of elderly residents in nursing homes. Given the increase in the elderly population worldwide, the findings from the current trial might benefit elderly populations.Trial registrationIRCT20220904055881N1. Registered on 11 February 2023.

Assessing the risks associated with indoor and outdoor air quality in relation to the geographic placement of nursing home

Indoor air quality significantly impacts the well-being and health of elderly residents in nursing homes. This study was conducted to explore the connection between indoor and outdoor PM (Particulate Matter) concentrations in nursing homes and their association with the facilities' location and construction characteristics. The findings revealed that indoor PM2.5 and PM10 concentrations ranged from 0.2 to 124 μg/m3 and 2–188.4 μg/m3, respectively, which were approximately 12.67 and 1.25 times higher than their outdoor counterparts. A strong correlation (P < 0.05) was identified between indoor PM levels and various factors, including proximity to parks, passenger terminals, and gas stations, as well as building attributes such as single-glazed windows, ceramic floor coverings, and the use of radiators. The risk assessment indicated that carcinogenic risk factors were well within acceptable limits for all nursing homes. However, it's important to note that certain PM components, particularly polycyclic aromatic hydrocarbons (PAH), may have long-term adverse effects on the health of nursing home residents. Even though indoor PM levels met the standards established by the U.S. Environmental Protection Agency (USEPA) for particulate matter risk assessments, the study emphasized that even low levels of indoor air pollutants can affect the health and well-being of older adults, particularly considering the increased vulnerability associated with aging. Consequently, the study underscores the importance of nursing home location selection and the regular monitoring of particulate matter concentrations. These measures are essential for enhancing air quality within nursing homes, ultimately contributing to the improved well-being and health of their residents.

Visitors' recreational & leisure experiences in urban river corridors? A case study of Hutuo River in Shijiazhuang, China

Various physical environmental factors influence the recreational experience of urban river corridors, and understanding visitors' perceptions of these factors holds significant implications for promoting the health and well-being of urban residents. This study specifically focuses on the Hutuo River corridor in Shijiazhuang, China, and conducted a semi-structured questionnaire survey with 620 participants. The findings reveal that visitors mainly come here to socialize with family and friends in a natural environment and escape the city's hustle and bustle. Safety, management and maintenance, and overall conditions are the primary features visitors are concerned about in their experience. When addressing usage constraints, visitors highlight accessibility issues, including traffic congestion and overcrowding. Additional limitations encompass deficiencies in physical facilities, such as shortages of shared bicycles, convenience amenities, fitness facilities, and services catering to vulnerable groups. Moreover,challenges include unavailable toilet services and insufficient shaded areas along the riverbanks. Sociodemographic attributes such as gender, age, marital status,education level, monthly income, and residential distance significantly influence the recreational experience of urban river corridors, emphasizing the importance of considering diversity in urban planning and design. By comprehensively exploring the dynamics of urban river corridor utilization from a social-ecological perspective, our study's findings offer insights relevant to future design and maintenance endeavors.

Numerical Analysis of the Effects of Different Window-Opening Strategies on the Indoor Pollutant Dispersion in Street-Facing Buildings

The idling of automobiles at street intersections can lead to pollutant accumulation which impacts the health of residents in street-facing buildings. Previous research focused on pollutant dispersion within street canyons and did not consider the coupling of indoor and outdoor pollutants. This paper employs the computational fluid dynamics (CFD) method to simulate the dispersion characteristics of vehicle emission pollutants in street canyons, primarily investigating the indoor and outdoor pollutant dispersion patterns under various window opening configurations (single-sided ventilation, corner ventilation, and different positions of the glass under corner ventilation). Additionally, the study considers the impacts of the aspect ratio and ambient wind speed. Studies have shown that corner ventilation is effective in reducing indoor pollutant levels. When the two window glass positions are far away from the center of the intersection, the average CO mass fraction in the single-sided ventilation room is reduced by 87.1%. The average indoor CO mass fraction on the leeward side decreases with the increasing wind speed and aspect ratio. At a wind speed of 8 m/s, the average indoor CO mass fraction on the leeward side decreases to 2.45 × 10−8. At an aspect ratio of 2, the indoor CO mass fraction on the leeward side decreases with increasing floors before stabilizing at approximately 4.77 × 10−9. This study suggests optimal window opening strategies to reduce indoor pollutant levels in street-facing buildings at street intersections, offering guidance to indoor residents on window ventilation practices.

Advance Directives Change Frequently in Nursing Home Residents

ObjectivesTo describe the rate, timing, and pattern of changes in advance directives (ADs) of do not resuscitate (DNR) and do not hospitalize (DNH) orders among new admissions to nursing homes (NHs). DesignA retrospective cohort study. Setting and ParticipantsAdmissions to all publicly funded NHs in Ontario, Canada, between January 1, 2013, and December 31, 2017. MethodsResidents were followed until discharged from incident NH stay, death, or were still present at the end of study (December 31, 2019). They were categorized into 3 mutually exclusive baseline composite AD groups: Full Code, DNR Only, and DNR+DNH. We used Poisson regression models to estimate the incidence rate ratios of AD change between different AD groups and different decision makers for personal care, adjusted for baseline clinical and sociodemographic variables. ResultsA total of 102,541 NH residents were eligible for inclusion. Residents with at least 1 AD change accounted for 46% of Full Code, 30% of DNR Only, and 25% of DNR+DNH group. Median time to first AD change ranged between 26 and 55 weeks. For Full Code and DNR Only residents, the most frequent change was to an AD 1 level lower in aggressiveness or intervention, whereas for DNR+DNH residents the most frequent change was to DNR Only. About 16% of residents had 2 or more AD changes during their stay. After controlling for covariates, residents with a DNR-only order or DNR+DNH orders at admission and those with a surrogate decision maker were associated with lower AD change rates. Conclusions and ImplicationsMeasuring AD adherence rates that are documented only at a particular time often underestimates the dynamics of AD changes during a resident's stay and results in an inaccurate measure of the effectiveness of AD on resident care. There should be more frequent reviews of ADs as they are quite dynamic. Mandatory review after an acute change in a resident's health would ensure that ADs are current.

Spatiotemporal Pattern and Influencing Factors of Thermal Environment Based on SEM Model: A Case Study in Xi'an Metropolitan Area

The urban thermal environment is an important indicator for evaluating the ecological environment of a city. It directly affects the health of residents and the sustainable development of the urban economy. However, there is currently a lack of analysis on the impact pathways of the thermal environment considering both natural and human factors. Based on the MODIS MYD11A2 land surface temperature data, meteorological data, and human activity data of Xi'an metropolitan area in 2020, ArcGIS spatial geostatistical analysis was used to study the temporal and spatial distribution pattern of the thermal environment in different seasons, and redundancy analysis was utilized to select the main factors affecting the thermal environment. Then, structural equation modeling was used to quantify the direct and indirect effects of the dominant factors on the urban thermal environment. The results showed that:① The surface temperature in the Xi'an urban area showed a spatial pattern of higher temperatures in the north and lower temperatures in the south, with a decrease in temperature from the city center to the surrounding areas. The most severe heat environment pollution occurred in the summer. ② The redundancy analysis (RDA) results indicated that the main factors that affected the thermal environment were air temperature, impermeable surfaces, vegetation, and precipitation. ③ The results of the structural equation modeling (SEM) indicated that meteorological, surface, and anthropogenic factors affected the urban thermal environment mainly through direct pathways, which were much more important than all indirect pathways. Factors such as temperature, impervious surfaces, and point of interest density had a significant positive effect on the thermal environment (0.10 and 0.33). On the other hand, factors such as water bodies, precipitation, and vegetation had a significant negative effect on the thermal environment (-0.29 and -0.25). Human activities had a greater direct impact on nocturnal surface temperatures than surface and meteorological factors. Increasing economic efficiency is beneficial for mitigating the urban heat island effect. The results of the study can provide a reference for studying local climate change in urban heat islands and for the construction of green and ecologically livable urban environments.

The impact of decentralization of health services at the municipal level on health outcomes: evidence from China.

Under the system of health decentralization, there are differences in the level of expenditure decentralization at different levels of government, and their impact on residents' health may also be different. This paper is one of the first to evaluate the effect of decentralization of health services at the municipal level from a multi-dimensional health perspective. This paper uses the data of expenditure decentralization of health services at the municipal level to match the panel data from the China Household Panel Survey (CFPS) from 2010 to 2018, and uses the logit model, ordered logit model and two-way fixed effects model to empirically analyze the impact of health decentralization at the municipal level on health outcomes. Based on the perspective of multi-dimensional health, from the three aspects of physical health, depression status and cognitive ability, the six sub-indicators of self-rated health, BMI standards, depression scores (summation method), depression scores (factor method), phrase test scores and mathematics test scores are discussed separately. The results show that the decentralization of health services at the municipal level has a significant promotion effect on the multi-dimensional health of residents. The decentralization of health services at the municipal level has important theoretical significance for promoting the reasonable division of medical and health powers and expenditure responsibilities between provincial and municipal governments, improving the efficiency of health expenditure funds, and establishing a fiscal system that matches financial resources.