Study On The Measurement And Decomposition Of Health Inequality Of Urban And Rural Residents In Tianjin

Objective: The purpose of this study is to understand the health level of Tianjin residents and measure their health inequality,to explore the impact of social factors on health status,and the extent of contribution to the health inequality of urban and rural residents,in order to make the health administrative departments to formulate a specific health policy to improve the health level of the residents,and promote the equalization of basic health services to provide a scientific decision-making basis.Methods: Using a layered multi-stage sampling method,4 administrative districts were drawn from the six districts of Tianjin City,the four districts around the city and the six districts involved in agriculture;Extract 5 residential communities from each jurisdiction,50 families were surveyed in each community,and one family member(≥18 years old)was selected for each household survey,1002 questionnaires were distributed and 1002 questionnaires were recovered,of which 922 were valid questionnaires,and the questionnaire was 92.02%;The semi-structured interview method is used to gain in-depth understanding of the implementation of basic public health service projects in Tianjin,and to analyze the factors of health services affecting the health status of residents;Using Logistic regression to analyze the influencing factors affecting health;Using the Concentration Index to measure health inequalities,and through the decomposition of factors to calculate the contribution rate of various factors.Results: 1.Health status and influencing factors: 725(78.6%)was good for residents’ self-assessed health;Among them,80.2% residents in rural areas were in good health,and 77.3% in urban areas were in good health;The older you get,the worse your health is(OR=0.907,95%CI[0.869,0.945],P<0.01);Compared to those with junior high school and below,the self-assessment health of those with a high school is better(OR=4.159,95%CI[1.097,15.762],P<0.05);Regular exercisers are in better health than those who don’t exercise(OR=5.538,95%CI[2.327,13.181],P<0.001);With the increase of per capita annual income,residents rated themselves as in better health(OR=1.730,95%CI[1.086,2.754],P<0.05);Health file-builders are better at self-assessment than those who don’t(OR=4.085,95%CI[1.534,10.875],P<0.05);Residents who have not participated in health lecture are better in health than those who have attended health lecture(OR=0.040,95%CI[0.006,0.266],P<0.05).2.Health inequalities of residents: The overall health concentration index of Tianjin residents is 0.0254,the health concentration index of urban residents is 0.0266 and the health concentration index of rural residents is 0.0242.3.Breakdown of health inequalities among residents: The contribution of senior and low per capita annual income to health inequality was 14.12% and 11.90% respectively;the contribution rate of exercise to health inequality is-3.18%;the contribution rate of Basic public health services to health inequality is-1.65%,a greater contribution to reducing health inequalities among residents in agricultural areas(-3.99%vs0.26%;Among them,the contribution rate of health inequality of residents in agriculture-related areas was-5.22%.Conclusion: 1.There is a health inequality in favor of the rich,both in urban areas and in rural areas,that is the better the economic situation of the residents,the better health.2.The age increases the health inequality of the residents,and exercise can alleviate the health inequality of the residents.3.Income is an important factor affecting the health inequality of residents,increasing the health inequality of residents.4.Basic public health services can reduce health inequalities to some extent,especially for rural residents;The establishment of health files can promote the improvement of the health level of residents,and participation in health lectures can reduce the level of health inequalities.