中国人口健康脆弱性地区差异与影响因素分析

通过构建人口健康脆弱性评价指标体系,利用集对分析法对中国31个省级行政区（不含港、澳、台）的健康脆弱性指数进行测算,同时引入障碍度模型考察脆弱性指数分布差异的影响因素,并对各省区主要障碍因子进行识别。研究发现：① 2014年中国人口健康脆弱性省际差异较大,总体上处于中、高水平,在空间上呈现明显的“西高、东低、中部居中”分异格局,与健康敏感性、应对性指数的地域分布不尽一致;② 各省区健康脆弱性指数分布的地域级差化特征明显,低脆弱省市均分布在东部地带,高脆弱省区均分布在西部地带,中度和较高脆弱水平的省区数量最多,在三大地带上均有分布;③ 健康脆弱性降低的主要障碍因子存在较大地区差异,促进经济发展、增加社保支出、加大卫生投入、改善医疗条件和优化生态环境对降低脆弱性尤为重要。

Distribution Characteristics of Health Vulnerability and Its Influence Factors in China

Health is a person's basic rights, is also the important content of well-off society construction in our country. Regional population health system is an essential subsystem of man-land relationship territorial system. Chinese residents’ health system has become more unstable, complicated and vulnerable due to industrialization, urbanization, population aging and changes of disease spectrum, worse environment and unhealthy lifestyle. By establishing an assessment index system of population health vulnerability, this article employed the set pair analysis method to measure the health vulnerability index of 31 provinces in China. In addition, the obstacle degree model was introduced to investigate the influencing factors of the vulnerability index distribution differences and the main obstacle factors. This article used the authoritative data, both from the statistical yearbooks and statistical bulletins published by government department. The findings showed that: 1) In 2014, the health vulnerability of Chinese residents varied vastly on a provincial level. Top five provinces were Guizhou, Xinjiang, Gansu, He’nan, and Yunnan. Among them, most were located in West China except He’nan province, while the last five ones were Liaoning, Jiangsu, Tianjin, Shanghai and Beijing, all in East China. From an overall perspective, the health vulnerability of Chinese residents was strong in the west, middle in the central area and weak in the east, which coincided with the distribution of health sensitivity index. The response index, however, was different in space distribution which was strong in the east, middle in the west and weak in central China; 2) According to the mean and standard deviation of vulnerability index, 31 provinces fell into four categories of degree, which were weak, middle, middle strong and strong respectively. Figures suggest that regional difference of the health vulnerability index among the provinces was apparent. The provinces of weak vulnerability were all distributed in the eastern area while the strongly vulnerable provinces were located in the western area; the middle and middle strong vulnerability provinces had lion’s share, distributed in all three areas. The sensitivity index, response index and their relationships were different among different vulnerability level provinces; 3) To promote residents’ health and reduce health vulnerability. it is important to maintain economic growth at a middle or high speed, increase residents’ income steadily and invest more in social security, public health, health care and environmental protection to improve the coping capacity of society. According to the “Healthy China 2030” plan issued in October of 2016, the next 15 years is an important period with strategic opportunities of construction of healthy China. This paper succeeds in drawing meaning full and practical conclusions by applying pair analysis method to study the health vulnerability. Meanwhile, the findings also expand and develop the theory and methodology for the health geography.