中国老年人健康差异时空变化及其影响因素分析  

Changes of time and space differences in health status and their influencing factors among the elderly in China

作　　者：杜本峰[1] 郭玉 

机构地区：[1]中国人民大学人口与发展研究中心健康科学研究所,北京100872 [2]硬石伟业国际市场研究咨询公司

出　　处：《中国公共卫生》2015年第7期870-877,共8页Chinese Journal of Public Health

基　　金：国家自然科学基金(71373272);教育部人文社会科学研究规划基金(12YJAZH012);中国人民大学"985"工程项目

摘　　要：目的了解中国老年人健康差异时空变化及其影响因素,为改善老年人的健康状况提供参考依据和理论支持。方法收集北京大学和中国老龄科研中心2002—2008年在华北、东北、东部沿海及中西部22个调研省份（不包括海南省）的＂中国老年长寿跟踪调查＂中参加2002、2005和2008年横截面调查的45 244名老年人的健康相关数据,应用Arc GIS 10.0分析老年人健康随时间变化的地区差异,并通过多层线性模型分析老年人健康变化的影响因素。结果 2002—2008年中国不发达地区老年人健康自评较差,中东部省份老年人自评健康状况好于西部省份的老年人,地区内部差异较大;与时间变量系数相关的固定效应显示,年龄65~80岁老年人健康自评下降速度较〉80岁老年人高0.09,男性老年人健康自评提高速度较女性老年人高0.03,汉族老年人健康自评下降速度较少数民族老年人高0.04,60岁以前职业为非农业的老年人健康自评增长速度提高0.03,生活来源是否够用和是否参加锻炼对健康自评的变化趋势均有负向预测作用,生活能自理和不患慢性病对健康自评均有正向预测作用,近2年患过重病的老年人健康自评增长速度提高0.07。结论老年人的健康自评状况在地区内部差异较大,且随时间发生较大变化;老年人健康自评的主要影响因素为年龄、性别、民族、60岁以前职业、生活来源、参加锻炼、生活自理能力、患慢性病情况等。Objective To examine spatial and temporal variations in health disparities among Chines elderly and their influencing factors and to provide references for improving the health of the elderly. Methods We extracted health-related data of 45 244 elderly involved in 3 waves of cross-sectional survey in 2002,2005 and 2008 for the＇ Follow-up Study on Elderly Longevity in China＇ conducted by Peking University and China Aging Research Center in 22 provinces at north,northeast,east coast,and midwest region of China. We adopted Arc GIS10 in spatio-temporal change analysis on health of the elderly and multiple linear model in analysis on influence factors of the changes. Results Self-rated health was poor among the elderly in underdeveloped areas of China in 2002- 2008. The self-rated health status of the elderly in middle east was better than those in the western region,with obvious internal differences. The analyses on time variable coefficient-related fixed effects revealed that the descent rate of self-rated health for the elderly aged 65- 80 years was 0. 09 higher than those over 80 years old and the rate of the elderly men was 0. 03 higher than the older women in China. The descent rate of self-rated health for the Han elderly was 0. 04 higher than that of the minority elderly. The elderly with non-agricultural occupation before the age of 60 years had a 0. 03 increase in self-rated health ascent rate. Whether having adequate living expenses and whether having physical exercise have negative prediction function on the change trend of self-rated health,whereas,being capable of taking care of oneself and not sufferings from chronic disease have positive prediction function for self-rated health. The elderly having serious disease had a 0. 07 increase in self-rated health ascent rate. Conclusion There is a great regional disparity in self-rated health among Chinese elderly and the disparity changes with time. The main influence factors for self-rated health among Chinese elderly include age,gender,nationality,occupa

关 键 词：老年人 健康个体差异 时空变化分析 多层线性模型 影响因素 

分 类 号：R195[医药卫生—卫生统计学]