Research On Measurement And Decomposition Of Health Inequalities Of Chinese Residents

Health plays an important role in human society.In modern society,the importance of health is more prominent.However,the distribution of health in the population is not equal.There is important theoretical significance to study health inequality from the perspective of socioeconomics.significance.Since the reform and opening,the health of Chinese residents has been greatly improved,showing the tremendous achievements China has made in the field of health.Especially since the 18th CPC National Congress,the Party Central Committee with General Secretary Xi Jinping as the core has paid great attention to the health of the people and has initiated Healthy China program.Under such a policy background,to study the inequality of health among Chinese residents has important practical significance.Health inequality refers to the uneven distribution of health among the population.After reviewing the existing literature on the issue of the topic,the inequality of health is analyzed as two layers of meaning:health inequality includes fair inequality and unfair inequality in health.The so-called fair inequality refers to the health inequality caused by irresistible factors such as heredity,luck,personal preferences,and unfair inequality refers to the health inequality caused by the inequality of social and economic factors,which can and should be reduced.On the basis of analysis above,the object of this paper is set to two aspects:one is to measure the health inequality of Chinese residents,the other is to decompose the health inequality to fair inequality and unfair inequality and calculate the contributions to health inequality of each socioeconomic factors quantitatively.From which,the structure of health inequality of Chinese residents is revealed.Two preparations are made as the basis to measure and decompose the health inequality of Chinese residents,one is to identify socioeconomic factors that affect the health of residents.Through non-parametric test,statistical modelling and other methods,socioeconomic variables that are highly relevant to health are identified from three levels of individuals,families and regions.Individual level includes better education,employer and higher professional status;family level includes high income families,ability to cope with risk,reliable relatives and friends,have a high standard of living hand have diverse friends;regional level includes eastern and western,which represent the impact of comprehensive regional differences such as public services.The results show that family-level socio-economic factors affect the health of residents more than individual-level variables.The other is the conversion of self-rated health classification data.Through appropriate technical ways,the self-evaluation health score is converted into continuous numerical data,and the inherent cut-point shift problem of the self-rated health data is corrected.To obtain the first objective,a new method which differs from common way in which Gini coefficient or Theil index is used to measure the pure inequality of a single social or economic variable is applied.By the new method,health and socioeconomic factors are considered when health inequality is measured.Under the framework of measurement of health inequality which built by professor Wagstaff who is an economist in the world bank,a socioeconomic-related concentration index is constructed to measure the health inequality of Chinese residents,which is different from other papers on the same topics to construct income-related health inequality concentration index.The concentration index constructed in this paper is better to measure the health inequality of Chinese residents than others because socioeconomic factors include not only income,which is an agreement reached by the scholars.In the course of constructing concentration index,principle component analysis is applied to combine the multidimensional socioeconomic variables into a single indicator without losing too much information.The result of the concentration index of health inequality of Chinese residents is 0.3439,which measure the health inequality appropriately because of the socioeconomic implications of the measurement.The second objective is divided into two tasks,one is to decompose the health inequality index into fair inequality and unfair inequality,the other is to decompose the health inequality between different groups such as male and female,or urban and rural residents into fair inequality and unfair inequality.On which,the contribution of socioeconomic factors to the total health inequality,to the inequality between male and female and to the inequality between urban and rural residents is quantitatively calculated.In order to fulfil the two tasks,a counter-fact decomposing frame is constructed,and the fair inequality is defined the part that still exist under the premise of the absolute equal distribution of all socioeconomic factors.Because the absolute equal distribution is impossible to be observed,it is counter-fact.The decomposition technique of concentration index of health inequality originates from Wagstaff's paper,and the result shows that,44.29%of the whole health inequality is fair,and the rest is unfair which can be explained by the inequality of socioeconomic factors and should be reduced by promoting social and economic development.According to the data distribution characteristics,decomposition based on logit model,Oaxaca-Blinder decomposition,and decomposition based on quantile regression are applied to the decomposing of health inequality between male and female,and essentially the former two methods are decomposition of mean difference,and the third method is decomposition of distribution difference.The result shows that,on average,there is about 40%of the health inequality between male and female can be explained by socioeconomic factors which is unfair.Specially,the result of decomposition based on logit model is 38.7%,and it is 42.1%based on Oaxaca-Blinder decomposition.Because the data used in Oaxaca-Blinder decomposition is adjusted by correcting the cut point,that is the inherent health differences between male and female were reduced,a higher proportion of health inequality can be explained by socioeconomic factors in Oaxaca-Blinder decomposition.The result confirms that there is good effect on correction of cut point by the conversion of self-rated health data.From the result of quantile regression decomposition,the health inequality between male and female is different in each quantile.In the low quantile and high quantile quantile,unfair inequality proportion is very high,reaching 60%;while in the middle quantile,unfair inequality proportion is not so high,even negative,which means that the mechanism of socioeconomic factors effecting health inequality is different.According to the data distribution characteristics similarly,decomposition of the inequality between urban and rural residents is divided into two parts,one is decomposition of the inequality between urban and rural residents without migrant workers,and the other is decomposition of the inequality between urban and migrant workers.Decomposition based on logit model and Oaxaca-Blinder decomposition are applied to decomposition of the inequality between urban and rural residents.From a longitudinal comparison,the unfair health inequality proportion in Oaxaca-Blinder decomposition is higher than the result in decomposition based on logit model,the former is 67.7%,and the later is 53.2%,which can be explained by the affect of self-rated data conversion.From horizon comparison with the result of decomposition of the inequality between male and female,the unfair health inequality proportion of the inequality between urban and rural residents is higher.Considering the difference of the extent of urbanization of migrant workers,decomposition on continuum group is applied to decompose the health inequality between urban and migrant workers.The result shows the unfair inequality proportion is different between the urban residents and the migrant workers with different extent of urbanization.In general,over 60%of the health inequality between the urban residents and the migrant workers can be explained by socioeconomic factors which is unfair,the higher extent of urbanization of the migrant workers,the lower proportion of unfair inequality between the urban residents and the migrant workers.From the view of the contributions of each socioeconomic factor affecting health inequality,the socioeconomic factors that have the greatest contribution to the whole health inequality in turn are high income family,employer,ability to cope with risks of family;the socioeconomic factors that have the greatest contribution to the health inequality between male and female are high living standard family,employer and high income family;the socioeconomic factors that have the greatest contribution to the health inequality between urban and rural residents are credible relatives and friends,employers and high income family.It can be seen that the socio-economic factors at the family level contribute greatly to the health inequality of Chinese residents,the occupational status,as well as the professional identity,also contributes significantly to the health inequality of the residents.Compared with the domestic literature on research in health inequality,there are mainly three innovations in this paper.The first is to construct a truly social and economic health inequality measurement index;the second is a more propriate data processing technology,which realizes the conversion of self-rated health from classification data to numerical data;The third one is to apply decomposition method between groups to decompose the health inequality between male and female and between urban and rural residents,and clearly reveals the structure of Chinese residents' health inequality.Based on the results of this paper,we can achieve the policy goal of reducing the health of Chinese residents by promoting the equalization of the corresponding socio-economic variables which contribute to the health inequality of Chinese residents greatly.