中國(guó)老年人健康狀況的城鄉(xiāng)差異及其動(dòng)態(tài)變化 -基于2011-2018年CHARLS數(shù)據(jù)的實(shí)證分析

摘要本文使用CHARLS的2011、2013、2015和2018年數(shù)據(jù)，從綜合健康狀況、生理健康、心理健康和認(rèn)知能力四個(gè)維度對(duì)我國(guó)城鄉(xiāng)老年人健康狀況的差異進(jìn)行了較為全面的刻畫(huà)，在此基礎(chǔ)上用Logit回歸分析影響中國(guó)城鄉(xiāng)老年人健康差異的人口統(tǒng)計(jì)學(xué)、經(jīng)濟(jì)社會(huì)地位和生活方式等其他因素。在動(dòng)態(tài)變化方面，本文從橫向維度比較中國(guó)老年人在2011年至2018年四輪調(diào)查數(shù)據(jù)中健康狀況的差異，分析中國(guó)老年人健康的整體變化；從縱向維度比較連續(xù)四期存在老年人個(gè)體的健康變化，分析老年人健康與年齡的關(guān)系。研究結(jié)果顯示，我國(guó)城鎮(zhèn)老年人和農(nóng)村老年人的健康狀況存在顯著差異，經(jīng)濟(jì)社會(huì)地位高低和是否參與社交活動(dòng)等因素可以部分解釋這種差異。此外，我國(guó)老年人的健康狀況并沒(méi)有隨著經(jīng)濟(jì)和醫(yī)療技術(shù)的改善變好，反而存在變差的趨勢(shì)。關(guān)鍵詞：老年人健康；城鄉(xiāng)差異；動(dòng)態(tài)變化目錄摘要 1Abstract 2目錄 31引言 42文獻(xiàn)綜述 43研究方法與數(shù)據(jù) 73.1研究?jī)?nèi)容 73.2數(shù)據(jù)庫(kù)選擇 83.3變量說(shuō)明 83.3.1因變量 83.3.2自變量 103.3.3控制變量 104老年人健康狀況的城鄉(xiāng)差異及其影響因素 114.1城鄉(xiāng)差異的描述性分析 114.2我國(guó)城鄉(xiāng)老年人健康差異影響因素分析 135我國(guó)老年人健康狀況城鄉(xiāng)差異的動(dòng)態(tài)變化 185.12011至2018年四輪調(diào)查數(shù)據(jù)老年人健康狀況的變化 185.2橫向動(dòng)態(tài)研究：2011至2018年城鄉(xiāng)老年人健康狀況差異的變化 215.3縱向動(dòng)態(tài)研究：2011年至2018年城鄉(xiāng)老年人健康差異與年齡關(guān)系的分析 246結(jié)論和討論 28參考文獻(xiàn) 291引言中國(guó)人口老齡化速度較快，據(jù)2010年的第六次全國(guó)人口普查資料，我國(guó)60歲以上人口占比13.26%；而2020年第七次全國(guó)人口普查統(tǒng)計(jì)顯示，我國(guó)60歲及以上人口達(dá)2.64億，占總?cè)丝诘?8.70%。十年間，我國(guó)60歲以上占總?cè)丝诘谋戎厣仙?.44個(gè)百分點(diǎn)。隨著老年人口占比的持續(xù)上升，老年人的健康問(wèn)題逐漸成為學(xué)界重點(diǎn)研究的議題。從個(gè)體的福利層面來(lái)說(shuō)，老年人的健康狀況與其晚年生活的幸福程度緊密相連。從醫(yī)保體系的運(yùn)轉(zhuǎn)來(lái)說(shuō)，我們國(guó)家的醫(yī)療保險(xiǎn)體制存在系統(tǒng)老齡化的風(fēng)險(xiǎn)ADDINZOTERO_ITEMCSL_CITATION{"citationID":"ex9yGGme","properties":{"formattedCitation":"(\\uc0\\u20309{}\\uc0\\u31561{},2009)","plainCitation":"(何等,2009)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":298,"uris":["/users/8674806/items/RGC5EHA4"],"itemData":{"id":298,"type":"article-journal","abstract":"在人口老齡化背景下,退休年齡不變、退休后不繳費(fèi)的政策,必然導(dǎo)致基本醫(yī)療保險(xiǎn)\"系統(tǒng)老齡化\"。文章運(yùn)用壽險(xiǎn)精算與非壽險(xiǎn)精算相結(jié)合的方法,建立分析模型揭示了這一趨勢(shì),研究\"系統(tǒng)老齡化\"對(duì)基本醫(yī)療保險(xiǎn)基金的影響,并以Z市社會(huì)醫(yī)療保險(xiǎn)中心提供的數(shù)據(jù)進(jìn)行測(cè)算分析。在此基礎(chǔ)上,提出完善制度以降低\"系統(tǒng)老齡化\"程度,進(jìn)而降低基金風(fēng)險(xiǎn)、實(shí)現(xiàn)基本醫(yī)療保險(xiǎn)制度持續(xù)健康運(yùn)行的若干政策建議。","container-title":"中國(guó)人口科學(xué)","ISSN":"1000-7881","issue":"02","language":"中文;","note":"116citations(CNKI)[2021-12-8]<北大核心,CSSCI>","page":"74-83+112","source":"CNKI","title":"基本醫(yī)療保險(xiǎn)“系統(tǒng)老齡化”及其對(duì)策研究","author":[{"family":"何","given":"文炯"},{"family":"徐","given":"林榮"},{"family":"傅","given":"可昂"},{"family":"劉","given":"曉婷"},{"family":"楊","given":"一心"}],"issued":{"date-parts":[["2009"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(何文炯等,2009)，老年人健康狀況的優(yōu)劣對(duì)我國(guó)醫(yī)療保障制度的運(yùn)轉(zhuǎn)具有重要影響。與西方一些發(fā)達(dá)國(guó)家不同，我國(guó)的城鎮(zhèn)社會(huì)和農(nóng)村社會(huì)存在顯著差異。這種差異體現(xiàn)在很多方面，首先城鄉(xiāng)居民的經(jīng)濟(jì)狀況相差較大，雖然我國(guó)城鄉(xiāng)居民人均可支配收入比值從2010年的3.23下降為2021年的2.50，但差距依然較大。其次城鄉(xiāng)居民在教育資源、醫(yī)療資源和文化資源等的可及性也存在顯著差異。據(jù)以往學(xué)者研究，經(jīng)濟(jì)收入、受教育程度等都可能對(duì)老年人的健康產(chǎn)生重要影響?；谝陨媳尘?，本文選擇從城鄉(xiāng)差異的視角出發(fā)，利用中國(guó)健康與養(yǎng)老追蹤調(diào)查（ChinaHealthandRetirementLongitudinalStudy,CHARLS）數(shù)據(jù)研究我國(guó)60歲及以上老年人的健康狀況及其動(dòng)態(tài)變化。在這一思路下，本文將利用多個(gè)健康評(píng)價(jià)指標(biāo)較為全面地刻畫(huà)老年人的健康狀況，并且利用多期數(shù)據(jù)分析我國(guó)老年人健康城鄉(xiāng)差異的動(dòng)態(tài)變化。2文獻(xiàn)綜述健康不僅是民眾福利的重要組成部分，也是一種重要的人力資本(Grossman,1972)，對(duì)社會(huì)發(fā)展起著重要作用，因此和健康有關(guān)的內(nèi)容一直是學(xué)術(shù)界的研究熱點(diǎn)。在學(xué)術(shù)界，健康是一個(gè)復(fù)雜的概念，每個(gè)學(xué)科對(duì)于健康的定義不盡相同。經(jīng)濟(jì)學(xué)中以醫(yī)學(xué)等學(xué)科對(duì)人體生理狀況的研究為基礎(chǔ)，利用醫(yī)學(xué)指標(biāo)度量人們的身體狀況ADDINZOTERO_ITEMCSL_CITATION{"citationID":"9JbYS1oT","properties":{"formattedCitation":"(\\uc0\\u33891{}&\\uc0\\u29579{},2014)","plainCitation":"(董&王,2014)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":326,"uris":["/users/8674806/items/HUSC53J5"],"itemData":{"id":326,"type":"article-journal","abstract":"健康在經(jīng)濟(jì)中具有非常重要的地位和作用。但是,對(duì)于健康和健康人力資本的確切定義、外延和內(nèi)涵,經(jīng)濟(jì)學(xué)中很少有文獻(xiàn)能厘清。其實(shí),由于健康概念本身的復(fù)雜性,健康在不同學(xué)科中的含義一般都不盡相同。經(jīng)濟(jì)學(xué)中一般用健康這一概念來(lái)描述人體身體狀況的一個(gè)狀態(tài)區(qū)間,這一區(qū)間可以按照身體機(jī)能的好壞程度和活動(dòng)能力的大小強(qiáng)弱用數(shù)值來(lái)加以標(biāo)識(shí)。這一標(biāo)識(shí)數(shù)值的大小則代表了健康狀況的好壞或健康水平的高低。以此為基礎(chǔ),經(jīng)濟(jì)學(xué)中已經(jīng)發(fā)展出一系列的指標(biāo)來(lái)衡量和測(cè)度健康。","container-title":"福建論壇(人文社會(huì)科學(xué)版)","ISSN":"1671-8402","issue":"12","language":"中文;","note":"15citations(CNKI)[2021-12-9]<北大核心,CSSCI>","page":"19-26","source":"CNKI","title":"經(jīng)濟(jì)學(xué)中的“健康”:定義和度量——學(xué)科比較的視角","title-short":"經(jīng)濟(jì)學(xué)中的“健康”","author":[{"family":"董","given":"希望"},{"family":"王","given":"弟海"}],"issued":{"date-parts":[["2014"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(董希望和王弟海,2014)，學(xué)者們通過(guò)比較指標(biāo)的數(shù)值大小來(lái)衡量人們的健康水平。不過(guò)，準(zhǔn)確度量老年人的健康狀況是一項(xiàng)困難的工作ADDINZOTERO_ITEMCSL_CITATION{"citationID":"5DBTuQob","properties":{"formattedCitation":"(Strauss&Thomas,1998)","plainCitation":"(Strauss&Thomas,1998)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":335,"uris":["/users/8674806/items/SHVN5I7M"],"itemData":{"id":335,"type":"article-journal","abstract":"Overthepast20years,investmentinhumanresourceshastakencenterstageinthestudyofdevelopingeconomies.Avoluminoussetofwagefunctionestimatesprovidesthebasisforcalculatingmarketreturnstoeducationforvirtuallyeverycountryintheworld.Studieshavealsolookedattheeffectsofschoolingonnon-marketoutcomes.Sincehealth,likeschooling,isaformofhumancapital,onemightexpectittoalsoberelatedtolabormarketsuccess.Employershaveanincentivetoraisewagesabovetheminimumsupplypriceoflabor,andtoexcludethoseinpooresthealthfromthelabormarketbecausetheyaretoocostlytohire.Thereisageneralconsensusthatincomehasastrongeffectondemandforhealth.Workremainstobedoneonwhichdimensionsofhealthmatter,whichpopulationgroupsaremostaffectedandunderwhatlabormarket(orother)conditionshealthemergesasimportant.Questionsoftheimpactofhealthdynamics,particularlyinresponsenegativeeconomicshocksandaging,havebarelybeentouchedinlow-incomeenvironments.","container-title":"Jo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eople.\n\nMethods:\nThisanalysiswascarriedoutoncross-sectionaldataofQoLassessmentamong750elderlyindividualsaged60–90yearswhoweredwellinginurbanpopulationofBabol,theNorthofIran.ThemultiplelinearregressionmodelwasusedtoestimatetheassociationbetweengenderandHRQoLaftercontrollingsociodemographiccharacteristicsandchronicdiseaseconditions.\n\nResults:\nWomenhadsignificantlylowerscoreinHRQoLinallsubscalescomparedwithmenafteradjustingseveralconfoundingfactors(P=0.001).TheunadjustedmeandifferenceinoverallHRQoLscoreswas?11.2(95%confidenceinterval[CI]:?13.8,?8.6)points,butitwasreducedto?6.5(95%CI:?9.0,?3.9)pointsbetweengenderafteradjustingbyage,educationallevel,livingstatus,physicalactivity,smoking,abdominalobesity,diabetes,andhypertension.\n\nConclusions:\nAdjustingforsociodemographicandchronicdiseaseconditionsreducedtheeffectsizeofpoorerHRQoLforwomencomparedwithmenbutdidnotremovethesexdifferences.ThepoorerscoresofHRQoLinIranianwomenneedsfurtherphysical,psychological,andsocialsupportsinelderly.","container-title":"InternationalJournalofPreventiveMedicine","DOI":"10.4103/ijpvm.IJPVM_197_16","ISSN":"2008-7802","journalAbbreviation":"IntJPrevMed","note":"PMID:29184646\nPMCID:PMC5686916","page":"95","source":"PubMedCentral","title":"AreGenderDifferencesinHealth-relatedQualityofLifeAttributabletoSociodemographicCharacteristicsandChronicDiseaseConditionsinElderlyPeople?","volume":"8","author":[{"family":"Hajian-Tilaki","given":"Karimollah"},{"family":"Heidari","given":"Behzad"},{"family":"Hajian-Tilaki","given":"Arefeh"}],"issued":{"date-parts":[["2017",11,7]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(Hajian-Tilaki等,2017)在控制了其他可能影響健康的因素后發(fā)現(xiàn)伊朗女性的HRQoL(Health-RelatedQualityofLife)評(píng)分均值比伊朗男性低6.5。ADDINZOTERO_ITEMCSL_CITATION{"citationID":"zGE3FwDh","properties":{"formattedCitation":"(\\uc0\\u26446{}&\\uc0\\u39640{},2019)","plainCitation":"(李&高,2019)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":25,"uris":["/users/8674806/items/X9X6ZALP"],"itemData":{"id":25,"type":"article-journal","abstract":"基于2015年中國(guó)健康與養(yǎng)老服務(wù)追蹤調(diào)查(CHARLS)數(shù)據(jù),分析農(nóng)村老年人生活自理能力的性別差異。農(nóng)村男性老年人生活自理能力整體優(yōu)于女性,不同年齡段女性和男性生活自理能力的差異程度不同。同性別而言,老年人在各個(gè)年齡段工具性日常生活自理能力低于日常生活自理能力。同一項(xiàng)目不同性別之間,則女性生活自理能力均低于男性,在70歲之后,男性工具性日常生活自理能力下降較快。年齡、子女?dāng)?shù)量、自評(píng)健康、養(yǎng)老保險(xiǎn)、醫(yī)療保險(xiǎn)及慢性病在一定程度上造成了農(nóng)村老年人生活自理能力上的性別差異。結(jié)合農(nóng)村老年人生活自理能力的性別差異,制定老年健康相關(guān)政策,對(duì)提高老年人生活質(zhì)量有一定的現(xiàn)實(shí)意義。","container-title":"人口與發(fā)展","ISSN":"1674-1668","issue":"02","language":"中文;","page":"39-49","source":"CNKI","title":"農(nóng)村老年人生活自理能力性別差異分析——基于CHARLS(2015)數(shù)據(jù)的實(shí)證分析","volume":"25","author":[{"family":"李","given":"芬"},{"family":"高","given":"向東"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(李芬和高向東,2019)利用CHARLS2015數(shù)據(jù)分析得農(nóng)村老年女性的生活自理能力顯著低于農(nóng)村的男性老年人。在家庭交往與支持方面，學(xué)者們主要關(guān)注“與子女同住”、“隔代照料”和“子女對(duì)老年人的代際支持”等因素對(duì)中國(guó)老年人健康的影響。ADDINZOTERO_ITEMCSL_CITATION{"citationID":"lOBDzKWu","properties":{"formattedCitation":"(\\uc0\\u33891{}\\uc0\\u26195{}\\uc0\\u33459{}&\\uc0\\u21016{},2018)","plainCitation":"(董曉芳&劉,2018)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":523,"uris":["/users/8674806/items/VY32YLHB"],"itemData":{"id":523,"type":"article-journal","abstract":"本文基于中國(guó)健康與養(yǎng)老追蹤調(diào)查2011和2013年數(shù)據(jù),利用有序Probit模型研究子女的居住安排對(duì)老年人的自評(píng)身體和精神健康的影響。實(shí)證結(jié)果發(fā)現(xiàn),與子女同住的父母其自評(píng)身體和精神健康狀況更佳,老人與子女居住距離越遠(yuǎn),其自評(píng)的身體和精神狀況越差。進(jìn)一步分析顯示,這種影響存在男女、城市和農(nóng)村之間的異質(zhì)性:與子女同住的母親的精神健康更佳而父親不顯著;與子女同住的農(nóng)村父母其精神與身體健康會(huì)更佳,而城市地區(qū)則不顯著。此外,進(jìn)一步分析顯示,理想的居住偏好和實(shí)際住居安排的一致的父母,他們的身體和精神健康更優(yōu)。","container-title":"中國(guó)經(jīng)濟(jì)問(wèn)題","DOI":"10.19365/j.issn1000-4181.2018.05.04","ISSN":"1000-4181","issue":"05","language":"中文;","note":"15citations(CNKI)[2022-2-21]<北大核心,CSSCI>","page":"38-54","source":"CNKI","title":"高堂在,不宜遠(yuǎn)居嗎?——基于CHARLS數(shù)據(jù)研究子女居住安排對(duì)父母健康的影響","author":[{"family":"董","given":"曉芳"},{"family":"劉","given":"茜"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(董曉芳和劉茜,2018)基于CHARLS2011和2013兩期數(shù)據(jù)的差分研究發(fā)現(xiàn)，子女與父母的居住距離與父母的生理和心理健康狀況存在相關(guān)關(guān)系，與子女住得越近的父母可能更健康，并且在農(nóng)村老年人群體中這一結(jié)果更加明顯。而隔代照料與老年人健康之間的關(guān)系，則存在爭(zhēng)議：部分學(xué)者ADDINZOTERO_ITEMCSL_CITATION{"citationID":"JJkqkYWj","properties":{"formattedCitation":"(\\uc0\\u40077{},2019;\\uc0\\u21556{},2018)","plainCitation":"(鮑,2019;吳,2018)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":570,"uris":["/users/8674806/items/BWYATQH7"],"itemData":{"id":570,"type":"article-journal","abstract":"在市場(chǎng)力量和人口老齡化的雙重影響下,隔代照料和代際贍養(yǎng)已經(jīng)成為現(xiàn)代家庭分工的重要特征之一。本文利用2015年中國(guó)健康與養(yǎng)老追蹤調(diào)查數(shù)據(jù),分析隔代照料對(duì)祖輩代際贍養(yǎng)預(yù)期的影響。研究發(fā)現(xiàn),隔代照料對(duì)祖輩代際贍養(yǎng)預(yù)期具有顯著的正向影響。分組結(jié)果顯示,其一,隔代照料對(duì)農(nóng)村戶籍祖輩代際贍養(yǎng)預(yù)期的影響略低于城市戶籍祖輩;其二,隔代照料對(duì)55歲及以上祖輩代際贍養(yǎng)預(yù)期的影響顯著,隨著年齡的增加,其邊際效應(yīng)呈階梯型增長(zhǎng)趨勢(shì),但對(duì)55歲以下祖輩的影響不顯著;其三,隔代照料對(duì)不同居住安排的祖輩代際贍養(yǎng)預(yù)期均具有正向影響,且對(duì)與子女同住祖輩代際贍養(yǎng)預(yù)期的影響大于不與子女同住的祖輩。","container-title":"中國(guó)農(nóng)村觀察","ISSN":"1006-4583","issue":"04","language":"中文;","page":"82-93","source":"CNKI","title":"隔代照料對(duì)祖輩代際贍養(yǎng)預(yù)期的影響——基于CHARLS(2015)數(shù)據(jù)的實(shí)證分析","author":[{"family":"鮑","given":"瑩瑩"}],"issued":{"date-parts":[["2019"]]}}},{"id":67,"uris":["/users/8674806/items/5MQUX4QG"],"itemData":{"id":67,"type":"thesis","abstract":"隨著社會(huì)的發(fā)展,我國(guó)老年人的平均壽命和健康水平都有了極大的提高,但在具有不同社會(huì)經(jīng)濟(jì)地位特征的人群間仍存在顯著差異。由社會(huì)經(jīng)濟(jì)地位不同所導(dǎo)致的老年人健康不平等問(wèn)題受到廣泛關(guān)注。在此背景下,論文對(duì)我國(guó)老年人健康不平等與社會(huì)經(jīng)濟(jì)地位的關(guān)系進(jìn)行了實(shí)證分析,以期為應(yīng)對(duì)老齡化問(wèn)題的相關(guān)研究提供參考的可能。首先,論文對(duì)老年人健康不平等的相關(guān)概念進(jìn)行了界定,對(duì)國(guó)內(nèi)外健康不平等的相關(guān)研究進(jìn)行了綜述。選取了“中國(guó)健康與養(yǎng)老追蹤調(diào)查（CHARLS）”作為本研究的數(shù)據(jù)基礎(chǔ),通過(guò)數(shù)據(jù)的整理與清洗,共獲取2011年基線調(diào)查及2013年跟蹤調(diào)查中55歲以上老年人樣本7795個(gè)。然后,構(gòu)建了以自評(píng)健康（SAH）與日常生活能力（ADL）為基礎(chǔ)的老年人健康水平指標(biāo),并對(duì)收入及相關(guān)人口學(xué)特征與老年人健康水平的關(guān)系進(jìn)行了描述性統(tǒng)計(jì)。分析發(fā)現(xiàn),高收入、高教育水平、城市、男性因素對(duì)老年人健康水平存在顯著的正向效應(yīng)。進(jìn)一步地,通過(guò)對(duì)收入及相關(guān)人口學(xué)特征與老年人健康水平關(guān)系的交叉分析得到:1)老年男性的健康水平受收入水平的影響相對(duì)老年婦女更大,低收入老年男性的健康水平顯著低于老年女性。2)低學(xué)歷老年人的健康水平隨收入水平下降顯著降低,對(duì)收入水平的變化最為敏感。其次,從地域角度對(duì)老年人健康不平等狀況進(jìn)行了宏觀分析。分析結(jié)果顯示,2011年與2013年我國(guó)老年人的健康水平的Moran指數(shù)分別為0.3242和0.4774,具有顯著的正向聚集效應(yīng),健康水平存在東高西低的態(tài)勢(shì)。對(duì)省際數(shù)據(jù)做進(jìn)一步分析可發(fā)現(xiàn),相鄰地區(qū)的健康水平相似,高值地區(qū)與高值地區(qū)聚集,低值地區(qū)與低值地區(qū)聚集,僅北京、安徽、河北、貴州呈現(xiàn)空間負(fù)相關(guān)的現(xiàn)象。再次,對(duì)當(dāng)前主流的健康不平等測(cè)度方法進(jìn)行了綜述比較,并選取了E指數(shù)作為本研究中老年人健康不平等程度的測(cè)度指標(biāo)。測(cè)度結(jié)果表明,我國(guó)老年人存在著顯著的親富人健康不平等,且這種不平等在農(nóng)村地區(qū)和低學(xué)歷老年人中更為嚴(yán)重。最后,對(duì)健康不平等的影響因素進(jìn)行了實(shí)證分析。健康回歸方程的結(jié)果顯示,在其它因素不變的情況下,對(duì)數(shù)收入每提高一個(gè)單位,老年人健康水平提高0.0073。此外,子女的學(xué)歷對(duì)老年人的健康有著顯著的正向效應(yīng),其系數(shù)達(dá)到0.0089,子女的社會(huì)經(jīng)濟(jì)地位與老年人的社會(huì)經(jīng)濟(jì)地位有很強(qiáng)的相關(guān)性?；贓指數(shù)法及回歸方程的參數(shù)估計(jì)結(jié)果對(duì)健康不平等的動(dòng)態(tài)分解則表明,收入分布效應(yīng)對(duì)于健康不平等變化的貢獻(xiàn)高達(dá)73.7%,在影響我國(guó)老年人健康不平等的相關(guān)因素中占據(jù)主導(dǎo)地位。","genre":"碩士","language":"中文;","note":"2citations(CNKI)[31-10-2021]","publisher":"南京郵電大學(xué)","source":"CNKI","title":"我國(guó)老年人健康不平等的測(cè)度及其影響因素研究","URL":"/kcms/detail/detail.aspx?dbcode=CMFD&dbname=CMFD201901&filename=1018898977.nh&uniplatform=NZKPT&v=YAR5AHpPUBPPGSPX7iZPBig3sH08OqUBp%25mmd2BdM5Ru9inUwGD7o17D7XUTVyaMgj%25mmd2B8H","author":[{"family":"吳","given":"崢"}],"accessed":{"date-parts":[["2021",10,31]]},"issued":{"date-parts":[["2018"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(鮑瑩瑩,2019;吳崢,2018)研究認(rèn)為隔代照料通過(guò)增加老年人的社交活動(dòng)、鍛煉習(xí)慣和與子女的交往對(duì)老年人的健康產(chǎn)生正面的積極影響；部分學(xué)者ADDINZOTERO_ITEMCSL_CITATION{"citationID":"XG7wB1tW","properties":{"formattedCitation":"(\\uc0\\u40644{}\\uc0\\u31561{},2016)","plainCitation":"(黃等,2016)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":532,"uris":["/users/8674806/items/JT42K9DE"],"itemData":{"id":532,"type":"article-journal","abstract":"學(xué)術(shù)界就隔代照料對(duì)老年人健康的影響意見(jiàn)上并不一致。利用2014年中國(guó)老年社會(huì)追蹤調(diào)查數(shù)據(jù),探討中國(guó)老年人隔代照料的數(shù)量和強(qiáng)度,以及其對(duì)于老年人軀體健康和心理健康的影響。我國(guó)老年人平均照料孫子女?dāng)?shù)量為0.52個(gè),73.29%的老年人提供隔代照料,17.57%的老年人每周至少照料孫子女一次;在控制了社會(huì)人口特征和代際支持變量后,發(fā)現(xiàn)主要是隔代照料的強(qiáng)度而非隔代照料的數(shù)量對(duì)我國(guó)老年人健康產(chǎn)生影響;提供低強(qiáng)度隔代照料的老年人對(duì)其自評(píng)健康有負(fù)面作用,提供高強(qiáng)度的隔代照料則對(duì)老年人孤獨(dú)感狀況有積極作用。","container-title":"人口與發(fā)展","ISSN":"1674-1668","issue":"6","language":"中文;","note":"79citations(CNKI)[2022-3-1]<北大核心,CSSCI>","page":"93-100+109","source":"CNKI","title":"隔代照料對(duì)于中國(guó)老年人健康的影響探析","volume":"22","author":[{"family":"黃","given":"國(guó)桂"},{"family":"杜","given":"鵬"},{"family":"陳","given":"功"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(黃國(guó)桂等,2016)則發(fā)現(xiàn)，隔代照料對(duì)老年人的軀體健康存在負(fù)面影響。在代際支持方面，ADDINZOTERO_ITEMCSL_CITATION{"citationID":"QCcWeUSi","properties":{"formattedCitation":"(\\uc0\\u34203{}\\uc0\\u31561{},2020)","plainCitation":"(薛等,2020)","noteIndex":0},"citationItems":[{"id":131,"uris":["/users/8674806/items/734AE83Q"],"itemData":{"id":131,"type":"article-journal","abstract":"基于2015年\"中國(guó)健康與養(yǎng)老追蹤調(diào)查\"(CHARLS)數(shù)據(jù),通過(guò)Logistic回歸探討社會(huì)經(jīng)濟(jì)地位與子女代際支持對(duì)老年健康的影響。研究發(fā)現(xiàn),個(gè)人年收入、受教育年限和子女經(jīng)濟(jì)支持均對(duì)老年健康有顯著正向效應(yīng),子女情感支持雖有正向影響,但不顯著,回歸結(jié)果具有穩(wěn)健性。鑒于我國(guó)特殊的城鄉(xiāng)二元經(jīng)濟(jì)結(jié)構(gòu)壁壘,文章進(jìn)一步分析城鄉(xiāng)異質(zhì)性,并簡(jiǎn)要討論其產(chǎn)生的可能原因。研究認(rèn)為,提高養(yǎng)老金待遇水平、促進(jìn)子女良性代際支持、實(shí)施\"精準(zhǔn)養(yǎng)老\"是早日實(shí)現(xiàn)\"健康中國(guó)\"戰(zhàn)略目標(biāo)的重要途徑。","container-title":"統(tǒng)計(jì)與決策","ISSN":"1002-6487","issue":"16","la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的改善。ADDINZOTERO_ITEMCSL_CITATION{"citationID":"mmttwy3z","properties":{"formattedCitation":"(\\uc0\\u26446{}\\uc0\\u20122{}\\uc0\\u38738{}\\uc0\\u31561{},2022)","plainCitation":"(李亞青等,2022)","noteIndex":0},"citationItems":[{"id":581,"uris":["/users/8674806/items/MZQCQTDZ"],"itemData":{"id":581,"type":"article-journal","abstract":"在\"優(yōu)先發(fā)展農(nóng)業(yè)農(nóng)村\"的新時(shí)代,要實(shí)現(xiàn)全民健康,需要重點(diǎn)關(guān)注農(nóng)村居民的健康問(wèn)題?；贑HARLS數(shù)據(jù),本文以精神抑郁和認(rèn)知健康為被解釋變量實(shí)證分析了醫(yī)療保險(xiǎn)對(duì)農(nóng)村中老年人精神健康的影響。研究發(fā)現(xiàn):(1)醫(yī)療保險(xiǎn)對(duì)農(nóng)村中老年人特別是弱勢(shì)群體的精神健康有顯著的促進(jìn)作用,且顯著體現(xiàn)在男性、60歲及以上老人和低收入群體。居住在農(nóng)村的中老年人比居住在城鎮(zhèn)的更顯著受益于醫(yī)療保險(xiǎn);(2)分位數(shù)回歸和更換被解釋變量回歸驗(yàn)證了結(jié)果的穩(wěn)健性;(3)機(jī)制分析表明,醫(yī)療保險(xiǎn)通過(guò)提高農(nóng)村中老年人的安全預(yù)期和生活滿意度來(lái)提升其精神健康水平。為此,應(yīng)進(jìn)一步擴(kuò)大醫(yī)療保險(xiǎn)的參保覆蓋面,增進(jìn)制度公平以提升農(nóng)村居民的安全預(yù)期,并加...","container-title":"財(cái)經(jīng)科學(xué)","ISSN":"1000-8306","issue":"01","language":"中文;","page":"87-100","source":"CNKI","title":"醫(yī)療保險(xiǎn)對(duì)農(nóng)村中老年人精神健康的影響——基于CHARLS數(shù)據(jù)的實(shí)證分析","author":[{"family":"李","given":"亞青"},{"family":"王","given":"子龍"},{"family":"向","given":"彥霖"}],"issued":{"date-parts":[["2022"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(李亞青等,2022)利用分位數(shù)回歸模型發(fā)現(xiàn)參加醫(yī)療保險(xiǎn)能夠顯著改善我國(guó)農(nóng)村老年人的抑郁問(wèn)題并且提高了老年人的認(rèn)知水平。ADDINZOTERO_ITEMCSL_CITATION{"citationID":"8uyJu1TF","properties":{"formattedCitation":"(\\uc0\\u26361{}&\\uc0\\u35885{},\\uc0\\u19981{}\\uc0\\u35814{})","plainCitation":"(曹&譚,不詳)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":584,"uris":["/users/8674806/items/JQSF3VI3"],"itemData":{"id":584,"type":"article-journal","abstract":"本文使用中國(guó)健康與養(yǎng)老追蹤調(diào)查（CHARLS）數(shù)據(jù)，運(yùn)用雙重差分傾向得分匹配模型，分析2016年起漸次實(shí)施的城鄉(xiāng)居民醫(yī)保整合，是否顯著改善了農(nóng)村中老年人健康，以及制度改革對(duì)健康影響的作用路徑。研究發(fā)現(xiàn)，城鄉(xiāng)居民醫(yī)保整合對(duì)農(nóng)村中老年人健康有促進(jìn)作用，提高了農(nóng)村中老年人基礎(chǔ)性及工具性日常生活能力；其影響的作用路徑在于通過(guò)提升農(nóng)村中老年人的醫(yī)療服務(wù)利用，增加了過(guò)去一個(gè)月中農(nóng)村中老年人的門診就醫(yī)次數(shù)，減少了農(nóng)村中老年人患病未就診的行為；與此同時(shí)，城鄉(xiāng)居民醫(yī)保整合部分引發(fā)了事前道德風(fēng)險(xiǎn)，導(dǎo)致農(nóng)村中老年人的體檢頻率相比于新農(nóng)合時(shí)期有所下降，一定程度上削減了整合的健康效應(yīng)。研究的政策含義是，現(xiàn)行醫(yī)療保險(xiǎn)制度...","container-title":"農(nóng)業(yè)技術(shù)經(jīng)濟(jì)","DOI":"10.13246/ki.jae.20220214.002","ISSN":"1000-6370","language":"中文","page":"1-17","source":"CNKI","title":"城鄉(xiāng)居民醫(yī)保整合與農(nóng)村中老年人健康——基于CHARLS數(shù)據(jù)的經(jīng)驗(yàn)研究","author":[{"family":"曹","given":"鑫志"},{"family":"譚","given":"曉婷"}]}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(曹鑫志和譚曉婷,2022)利用2016年全面實(shí)施的城鄉(xiāng)居民醫(yī)保統(tǒng)籌這一政策沖擊，基于CHARLS2011和2018兩期數(shù)據(jù)研究發(fā)現(xiàn)，城鄉(xiāng)居民醫(yī)保通過(guò)提升醫(yī)保報(bào)銷水平從而增加了農(nóng)村老年人對(duì)醫(yī)療服務(wù)的利用，對(duì)農(nóng)村老年人的工具性日常生活能力提升有積極影響?？梢园l(fā)現(xiàn)，在中國(guó)老年人健康研究領(lǐng)域，學(xué)者們已經(jīng)達(dá)成了較多共識(shí)。但是在中國(guó)城鄉(xiāng)老年人的健康差異研究方面，還存在較多爭(zhēng)議和不足。ADDINZOTERO_ITEMCSL_CITATION{"citationID":"ZhoUm6tV","properties":{"formattedCitation":"(\\uc0\\u21608{},2008)","plainCitation":"(周,2008)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":552,"uris":["/users/8674806/items/L25VRB4D"],"itemData":{"id":552,"type":"article-journal","abstract":"本文利用2005年全國(guó)1%抽樣調(diào)查數(shù)據(jù)對(duì)60歲以上老年人群的健康狀況評(píng)價(jià)指標(biāo)的群體差異作出詳細(xì)的分析。分析表明中國(guó)老年人整體對(duì)自身的健康評(píng)價(jià)狀況不容樂(lè)觀。比較而言,女性老年人比男性老年人更傾向于報(bào)告較低的生活自理能力。從城鄉(xiāng)差別來(lái)看,城市老年人的生活自理能力要高于鎮(zhèn)、更高于農(nóng)村老年人。本次調(diào)查的數(shù)據(jù)表明,西部地區(qū)老年人生活不能自理比例較高,對(duì)老年照料的服務(wù)需求的挑戰(zhàn)更大。","container-title":"南方人口","ISSN":"1004-1613","issue":"1","language":"中文;","note":"37citations(CNKI)[2022-3-2]<CSSCI>","page":"51-58","source":"CNKI","title":"中國(guó)老年人自評(píng)自理能力:差異與發(fā)展","author":[{"family":"周","given":"國(guó)偉"}],"issued":{"date-parts":[["2008"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(周國(guó)偉,2008)基于2005年全國(guó)1%抽樣調(diào)查數(shù)據(jù)從多個(gè)維度對(duì)我國(guó)60歲以上老年人的健康狀況進(jìn)行了描述性分析，發(fā)現(xiàn)城鎮(zhèn)老年人的自評(píng)健康狀況優(yōu)于農(nóng)村老年人，農(nóng)村中不能自理的老年人比例遠(yuǎn)高于城市老年人。ADDINZOTERO_ITEMCSL_CITATION{"citationID":"5ncILeeg","properties":{"formattedCitation":"(\\uc0\\u21776{},2010)","plainCitation":"(唐,2010)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":616,"uris":["/users/8674806/items/929XXLXM"],"itemData":{"id":616,"type":"article-journal","abstract":"抑郁癥狀是衡量老年人心理健康水平的有效指標(biāo)。本研究采用2006年中國(guó)城鄉(xiāng)老年人生活狀況追蹤調(diào)查10%數(shù)據(jù),運(yùn)用探索性因素分析、多元線性回歸和結(jié)構(gòu)方程模型等方法考察中國(guó)老年人的總體抑郁水平,比較抑郁水平的城鄉(xiāng)及年齡差異,并對(duì)老年人抑郁癥狀及影響因素進(jìn)行探索。結(jié)果顯示,我國(guó)老年人抑郁癥狀較輕,心理健康處于良好水平。農(nóng)村老年人抑郁癥狀較城鎮(zhèn)老年人明顯。健康水平、經(jīng)濟(jì)狀況、社會(huì)支持可有效地預(yù)測(cè)老年人的抑郁癥狀。城鄉(xiāng)在影響因素模型中起調(diào)節(jié)效應(yīng),健康水平和經(jīng)濟(jì)狀況對(duì)老年人抑郁水平的影響作用受城鄉(xiāng)因素的影響,對(duì)于農(nóng)村老年人,經(jīng)濟(jì)狀況的影響作用大于健康水平;在城鎮(zhèn)老年人中表現(xiàn)出完全相反的模式。對(duì)于不同的老年人群,應(yīng)采取有針對(duì)性的政策和措施,方能有效減緩老年人抑郁癥狀,促進(jìn)心理健康。","container-title":"人口研究","ISSN":"1000-6087","issue":"3","language":"中文;","note":"76citations(CNKI)[2022-3-11]<北大核心,CSSCI>","page":"53-63","source":"CNKI","title":"城鄉(xiāng)因素在老年人抑郁癥狀影響模型中的調(diào)節(jié)效應(yīng)","volume":"34","author":[{"family":"唐","given":"丹"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"/citation-style-language/schema/raw/master/csl-citation.json"}(唐丹,2010)使用2006年中國(guó)城鄉(xiāng)老年人生活狀況追蹤調(diào)查10%數(shù)據(jù)進(jìn)行實(shí)證分析，研究發(fā)現(xiàn)城鄉(xiāng)因素在我國(guó)老年人抑郁癥狀模型中發(fā)揮了調(diào)節(jié)效應(yīng)，城鎮(zhèn)老年人的抑郁癥狀比農(nóng)村老年人輕。ADDINZOTERO_ITEMCSL_CITATION{"citationID":"S4KeO3b1","properties":{"formattedCitation":"(\\uc0\\u26446{}\\uc0\\u24314{}\\uc0\\u26032{}&\\uc0\\u26446{},2014)","plainCitation":"(李建新&李,2014)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":517,"uris":["/users/8674806/items/XIDKWMUC"],"itemData":{"id":517,"type":"article-journal","abstract":"本文利用2011年的中國(guó)老齡健康長(zhǎng)壽影響因素跟蹤調(diào)查(CLHLS)數(shù)據(jù),采用多維度健康測(cè)量對(duì)我國(guó)城鄉(xiāng)老年人健康差異進(jìn)行分析。研究結(jié)果表明:城鄉(xiāng)老年人口在健康方面存在差異,具體表現(xiàn)為農(nóng)村老人在生理健康上優(yōu)于城鎮(zhèn)老人,而在心理健康上城鎮(zhèn)老人優(yōu)于農(nóng)村老人,相對(duì)綜合的自評(píng)健康方面不存在統(tǒng)計(jì)上的顯著性差異。在控制一些重要的影響因素之后,城鄉(xiāng)老年人在生理健康上的差異實(shí)際上要比觀測(cè)到的大,而在心理健康上的差異實(shí)際上要比觀測(cè)到的小。另外,人口、社會(huì)經(jīng)濟(jì)、生活方式和外部支持等因素在各健康維度上的影響作用也不盡相同。","container-title":"人口學(xué)刊","ISSN":"1004-129X","issue":"05","language":"中文;","note":"111