社会变迁与健康不平等——对第五次疾病转型的年龄—时期—队列分析  

Social Change and Health Inequalities——Evidence from the Fifth Phase of the Epidemiologic Transition in Urban China

作　　者：石智雷[1] 顾嘉欣 傅强 Shi Zhilei;Gu Jiaxin;Fu Qiang

机构地区：[1]中南财经政法大学公共管理学院、人口与健康研究中心 [2]加拿大英属哥伦比亚大学社会学系

出　　处：《社会学研究》2020年第6期160-185,245,共27页Sociological Studies

基　　金：国家社会科学基金重点项目“生育支持政策试点效果跟踪评估与生育友好型社会构建研究”(19ARK004)的阶段性研究成果;“收入分配与现代财政学科创新引智基地”(B20084)的资助。

摘　　要：本文使用疾病转型理论来刻画中国城市居民的健康与社会变迁过程。基于跨越22年的九期调查数据和年龄—时期—队列分析,我们认为中国的城市正在经历第五次疾病转型。改革开放以来,中国城市居民超重率和不动率的变化表现出显著的年龄、时期和队列效应。城市居民的超重率逐年上升;随着年龄的增长,人们的超重风险更高,运动时间更少;三年困难时期出生的队列在超重和步行时长两个指标上显著高于其他出生队列。在此转型过程中,基于超重和不动的健康不平等不仅与收入相关,还与教育和政治的分层存在关联。进一步研究发现,在我国社会转型过程中,城镇居民中不同阶层的超重率发生了变化:高社会经济地位群体的超重率先是高于低社会经济地位群体,随后发生逆转,低于低社会经济群体。Drawing upon the epidemiologic-transition theory,this study investigates social changes in China,in particular changes of the population’s health condition.Using nine waves of survey data from the China Health and Nutrition Survey( CHNS),we find a steady increase in the rate of overweight and inactivity among urban residents in China,which can be attributed to three types of temporal effects( i. e.,age,period,and cohort effects). The inequalities in overweight and inactivity are more relevant to education and political power instead of income. More specifically,a socio-economic crossover has been observed in the period effects of overweight,and the risks of overweight and inactivity increase with age. Moreover,birth cohorts experiencing the Great Famine during infancy and early childhood reported distinct patterns of overweight and time spent walking. These findings help us understand epidemiological transition in China,as well as providing a basis on which the effectiveness of public-health policies in China can be assessed.

关 键 词：社会变迁 健康不平等 不动 超重 年龄—时期—队列分析 

分 类 号：R195[医药卫生—卫生统计学]