Income-related inequality in health outcomes among older individuals in China: A measurement and decomposition analysis

Yixiao Wang
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Abstract

Population aging in China presents a significant challenge, with projections indicating that individuals aged 65 and above will exceed 30% of the total population by 2050, thereby increasing health-care and long-term care (LTC) demands. Therefore, this study aimed to examine income-related inequality in self-rated health (SRH) and functional ability among older individuals in China while also examining the contribution of socioeconomic factors to health inequality. Data were drawn from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey. Well-established tools, such as concentration curves, the Erreygers concentration index (EI), and decomposition analysis, were employed to elucidate income-related inequality in health within the sample. The results revealed that for SRH, both unstandardized and standardized concentration curves were observed below the 45° line, with unstandardized EI at 0.068 and standardized EI at 0.033. For functional ability, both unstandardized and standardized concentration curves were observed above the 45° line, with unstandardized EI at −0.016 and standardized EI at −0.003. These results suggest that, after controlling for demographic factors, the better-off group is more likely to report better SRH and less likely to experience functional limitations compared to the worse-off group. Furthermore, this inequality in health outcomes is predominantly driven by socioeconomic factors rather than demographic factors. For SRH, income emerges as the primary contributor to total inequality. Similarly, for functional ability, income emerges as the key factor driving inequality, disproportionately affecting the less affluent population. Consequently, it is crucial for the government to protect older individuals with lower socioeconomic status to mitigate income-related inequality in health by directly providing cash aids and formal LTC, which could contribute to promoting healthy aging in the context of global aging.
中国老年人健康结果中与收入相关的不平等:测量和分解分析
中国的人口老龄化是一项重大挑战,预计到 2050 年,65 岁及以上人口将超过总人口的 30%,从而增加医疗保健和长期护理(LTC)的需求。因此,本研究旨在考察中国老年人在自评健康(SRH)和功能能力方面与收入相关的不平等,同时考察社会经济因素对健康不平等的贡献。数据来自2018年中国健康长寿纵向调查。研究采用了集中曲线、艾瑞杰斯集中指数(EI)和分解分析等成熟工具来阐明样本中与收入相关的健康不平等。结果显示,在性健康和生殖健康方面,非标准化和标准化浓度曲线均低于 45° 线,非标准化 EI 为 0.068,标准化 EI 为 0.033。在功能能力方面,非标准化和标准化浓度曲线均高于 45°线,非标准化 EI 为-0.016,标准化 EI 为-0.003。这些结果表明,在控制了人口因素后,与经济条件较差的群体相比,经济条件较好的群体更有可能报告较好的性健康和生殖健康状况,而出现功能限制的可能性较小。此外,这种健康结果的不平等主要是由社会经济因素而非人口因素造成的。就性健康和生殖健康而言,收入是造成总体不平等的主要因素。同样,在功能能力方面,收入也是造成不平等的关键因素,对不太富裕的人群影响尤为严重。因此,政府必须保护社会经济地位较低的老年人,通过直接提供现金援助和正规的长期护理服务来缓解与收入有关的健康不平等,这有助于在全球老龄化的背景下促进健康老龄化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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