Study On The Relationship Between Socioeconomic Factors And Children’s Health

Objective1.Understand the health status of children in China and examine whether there are differences in child health indicators between gender,age,urban and rural areas,and ethnic groups;2.Examining the impact of family socio-economic factors on children’s health status;3.Construct a Child Health Index(CHI)scoring model to understand the overall health status of children in China and analyze the impact of economic factors on CHI scores.MethodsThe child health indicators and family socio-economic factors are all from the China Health and Nutrition Survey(CHNS).The study selected relevant data from 2015,and the research subjects were 2130 children aged 4-17 who had good survey results.The macroeconomic indicators are selected from the 2015 China Statistical Yearbook data.Firstly,BMI,weight,height,waist circumference,systolic blood pressure,diastolic blood pressure,diarrhea,upper respiratory tract disease,headache,rash,asthma,joint pain,and heart disease were used to describe the morphology,function,and disease occurrence of children,and t-tests,analysis of variance,and chi square analysis were used to examine the differences between gender,urban and rural areas,and ethnic groups.Secondly,family socioeconomic factors are reflected by household income/CPI adjusted household income,children’s medical treatment methods,and insurance participation.Compare the differences between gender,urban and rural areas,and ethnic groups using t-tests and chi square tests for family socio-economic factors.Subsequently,logistic regression analysis and linear regression analysis were used to examine the impact of family socio-economic factors on childhood disease indicators,morphological indicators,and functional indicators.Finally,based on the Delphi method method,the CHI scoring model was constructed,and the index system was established with reference to relevant literature and comprehensive expert opinions.The weight was determined through the analytic hierarchy process,and the children’s scores were calculated and the differences between age,gender,urban and rural areas,and ethnic groups were compared;By using K-means clustering and second-order clustering analysis,children’s CHI scores were divided into two categories:high-level and low-level;By using linear regression analysis and logistic regression analysis,the effects of macroeconomic factors and household socio-economic factors on CHI scores and primary indicators were examined.Results1.Basic health status of childrenIn terms of morphological indicators,the BMI of male children(18.42 kg/m2)is higher than that of female children(17.87 kg/m2,p<0.05),urban children(18.43 kg/m2)is higher than rural children(18.03 kg/m2,p<0.05),and Han children(18.26 kg/m2)are higher than minority children(17.52 kg/m2,p<0.05).The height,weight,and waist circumference of urban children were higher than those of rural children(p<0.05).In terms of disease indicators,there is a statistically significant gender difference in the prevalence of diarrhea and dermatitis.The prevalence of diarrhea(1.31%)and dermatitis(1.05%)in male children is higher than that in female children(0.81%,0.20%,p<0.05);There is no statistical difference in disease indicators between urban and rural areas or ethnic groups.2.The impact of family socio-economic factors on children’s healthThe income of urban children’s households and CPI adjusted households is higher than that of rural children’s households and CPI adjusted households(p<0.05).The consultation rate of rural children with folk doctors(6.64%)is higher than that of urban children(1.85%,p<0.05),and the participation rate of rural children in commercial insurance(10.93%)is higher than that of urban children(6.11%,p<0.05).There is no statistical difference in health and economic indicators between gender and ethnicity.The increase in household income and CPI adjusted household income can lead to BMI(household income:β=0.07,95%CI:0.02～0.11,CPI adjusted household income:β=0.05,95%CI:0.01～0.09),weight(household income:β=0.27,95%CI:0.14～0.40,CPI adjusted household income:β=0.19,95%CI:0.03～0.36),systolic blood pressure(CPI adjusted household income:β=0.15,95%CI:0.02～0.29),diastolic blood pressure(household income:β=0.03,95%CI:0.02～0.04,CPI adjusted household income:β=An increase of 0.13,95%CI:0.08～0.18(p<0.05).Family income is a protective factor for upper respiratory diseases(OR=0.87,95%CI:0.78～0.99),muscle soreness(OR=0.83,95%CI:0.71～0.95),and heart disease(OR=0.85,95%CI:0.82～0.92),while CPI adjusted family income is a protective factor for upper respiratory diseases(OR=0.85,95%CI:0.74～0.97);In the analysis of health economic indicators on children’s disease indicators,the protective factors for upper respiratory tract diseases are consultation with private doctors(OR=0.50,95%CI:0.26～0.97),participation in medical insurance(OR=0.32,95%CI:0.16～0.61),and risk factors are commercial insurance participation(OR=1.64,95%CI:1.02～2.63);The risk factor for childhood diarrhea is receiving formal medical treatment(OR=7.01,95%CI:2.01～12.02);The risk factor for stomach pain in children is receiving formal medical treatment(OR=33.48,95%CI:12.41～54.17);The risk factor for asthma is consultation with a private doctor(OR=6.17,95%CI:1.28～11.06).3.The impact of economic factors on children’s health indexThe scoring system of children’s health index was preliminarily determined through relevant literature research and theoretical analysis.Expert consultation was conducted through the Delphi method.The recovery efficiency of the two rounds of expert consultation questionnaires and the degree of enthusiasm of experts were 86.7%and 100%respectively,and the Kendall harmony coefficient was 0.24 and 0.50 respectively(p<0.05).Establish 5 primary indicators including children’s physical health,children’s functional health,children’s illness,children’s mental health,and children’s behavioral health,as well as 26 secondary indicators such as children’s diarrhea and hypertension,and determine the weights and combination weights through Analytic Hierarchy Process.The results showed that the overall CHI score of children(on a percentage scale)was 52.53 points,with the 5-year-old group having the lowest score of 45.47 points;The 10 year old group scored the highest at 54.56 points,with statistically significant differences among different ages(p<0.05);The CHI score of urban children was 53.34 points,higher than that of rural children by 52.11 points(p<0.05);The impact of household income on CHI scores in family socio-economic factors(β=0.01,95%CI:0.01～0.02),children’s physical health(β=0.05,95%CI:0.02～0.09),Child Behavioral Health(β=0.02,95%CI:0.01～0.03)has an impact,and CPI adjusted per capital income has an impact on children’s behavioral health(β=0.01,95%CI:0.01～0.02)has an impact,and per capital consumption level has an impact on CHI score(β=0.31,95%CI:0.05～0.57),Children’s physical health(β=0.15,95%CI:0.11～0.19)has an impact.The cluster centers of high and low CHI scores after K-means clustering were 59.97 and 49.58,respectively(p<0.05).Children who participated in medical insurance tended to have higher levels of CHI scores(OR=3.40,95%CI:2.32～4.62);The clustering centers after second-order clustering were 53.73 points and 48.61 points,respectively(p<0.05).Children who participated in medical insurance(OR=1.41,95%CI:1.08～1.74)and received formal medical treatment(OR=2.71,95%CI:1.18～4.23)achieved higher levels of CHI scores.ConclusionThere are differences in the form,function,and disease indicators of children in China in terms of gender and urban and rural areas.Overall,there is a trend of male children being higher than female children,urban children being higher than rural children,and Han children being higher than minority children.An increase in family income will enhance children’s health,and the participation and consultation methods of children’s commercial insurance have an impact on their susceptibility to diseases.The level of children’s health reflected by the Child Health Index in China is not yet ideal,and there is a large room for development.It is necessary for society,schools,and families to strengthen children’s exercise and mental health construction.At the same time,the country should increase residents’ income to improve the overall health level of children.