我国中老年群体健康不平等的早期根源追溯--基于机会不平等的测度与分解  

The Origins of Health Inequality of Middle-aged and Elderly People in China:Measurement and Decomposition Based on Inequality of Opportunity

作　　者：白春玲 陈东[1] BAI Chunling;CHEN Dong(School of Economics,Shandong University,Jinan 250100,China)

机构地区：[1]山东大学经济学院,山东济南250100

出　　处：《人口与经济》2022年第2期104-123,共20页Population & Economics

基　　金：教育部人文社会科学基金项目“老年健康不平等的早期根源追溯研究”(18YJA790010);山东省自然科学基金项目“机会不平等视角下的老年群体健康差异与干预研究:基于生命周期的动态跟踪”(ZR2019MG005);山东大学人文社会科学重大项目“大数据背景下健康老龄化中国方案的难点突破研究”(19RWZD03)。

摘　　要：机会不平等是隐藏在我国中老年群体健康不平等背后的深层次原因,促进机会平等亦是实现健康公平的焦点问题。基于Roemer机会平等理论,利用CHARLS 2011—2018年4期追踪数据,实证检验“环境”因素和“努力”因素对中老年健康的整体影响,并依托事前参数法、Shapley分解和非线性Oaxaca-Blinder模型测度与分解机会不平等程度,最后基于方差分解进一步衡量相对“努力”的贡献度。结果表明,“环境”因素中,儿童期社会经济地位、16岁以前居住在城镇地区及其社区环境对中老年健康具有长期正向影响,“努力”因素中,受教育程度的作用最为明显,能够显著改善中老年时期的健康水平;“环境”对“努力”存在偏效应,儿童期社会经济地位越好,越有可能养成良好的生活习惯和接受更高水平的教育;与“环境”相关的事前机会不平等绝对系数为0.105,儿童期家庭经济情况、父母受教育程度和幼时父母健康是形成机会不平等的主要因素;性别、城乡、出生队列间的机会不平等差异主要源于系数效应,即“环境”对健康结果影响程度的不同;纳入相对“努力”后,生活方式和受教育程度两个相对“努力”变量对健康不平等的解释率为12.17%。关注儿童时期家庭社会经济环境,从儿童期开始将贫困、教育、医疗等纳入健康干预措施是破除健康机会不平等的重要路径。Inequality of opportunity is the underlying reason behind the health inequality of the middle-aged and elderly in China.Promoting equal opportunities is also the focus of realizing health equity.Based on Roemer’s theory,the research examines the effect of“circumstance”and“effort”on the health of middle-aged and elderly people,and also measures and decomposes the degree of opportunity inequality by parametric estimation,Shapley and nonlinear Oaxaca-Blinder model.At last,the contribution of relative“effort”is further measured based on variance decomposition.The results show that,among the“circumstance”factors,children’s social-economic status,living in urban areas before the age of 16 and community environment have long-term positive effects on the health,while among the“effort”factors,education brings about the most significant influence.“Circumstance”has a bias effect on“effort”,that is the better the children’s socialeconomic status,the more chances to form better life habit and receive high education.The degree of opportunity inequality is 0.105 where family economic conditions,parents’education and parents’health at an early age are the main sources.The heterogeneity among gender,regional and birth cohort mainly derive from the influential difference of“circumstance”on health.After relative“effort”is listed,lifestyle and education account for 12.17%of total inequality.Therefore,focusing on the socio-economic environment of families during childhood and including poverty,education,and health care in health interventions from childhood is an important way to break down health inequalities.

关 键 词：中老年群体 健康不平等 机会不平等 环境 努力 

分 类 号：C913.6[经济管理]