Research On The Health And Security Strategies Of The Elderly In Rural China Under Life Course Perspective

The health needs and health security of the elderly in rural areas have gradually become a hot issue.In the context of “Healthy China ”and “Rural Revitalization”,from the perspective of life course,a comprehensive understanding of the health status of the elderly in rural areas can accurately target and control the risk factors affecting health and the degree of influence;It is not only an effective way to improve the health level of the elderly in rural areas,but also helps to grasp the direction of the reform of rural social security policy from the theoretical level.This paper focuses on the life course theory,health capital demand theory,health service utilization model,to construct the theoretical framework of this paper.And,based on the CHARLS data,merged life history survey data and the third follow-up survey data,and 6732 samples were selected.This paper focus on the overall health status of the elderly in rural areas,the influencing factors of the rural elderly's health,the causes and difficulties of the health of the elderly in rural areas.And discusses the path selection and countermeasures of the health insurance for the elderly in rural areas.Taking the life course as the axis,this paper explore the health status and security strategies of the elderly in rural areas from the aspects of individual,family and social medical care,which has a close logical relationship and is also an important part of health issues.The main conclusions are as follows:First,on the level of health: the overall health level of the elderly in rural areas is poor,and there are health inequalities related to family economic level.The health characteristics of the elderly are as follows: The elderly self-rated health is below the "general level",the prevalence of chronic diseases is high,and the proportion of the elderly with difficulties in self-care is high.The elderly with better family economic level have better self-assessment health and self-care ability,while the prevalence of chronic diseases is higher.Second,on the influencing factors of health: On the one hand,the bad factors in the early stage of life change the growth rate,stock and depreciation rate of healthy capital through the cumulative effect of time,thus affecting the healthy development track.In addition,as a time cumulative variable,education level can intervene and offset early disadvantage,to change people's access to health resources and awareness to a certain extent.On the other hand,the influence of factors in the old age on health is more significant.For the variables that are difficult to intervene(old age,female,no marriage history,low education level,etc.),the rural elderly with these characteristics are the key groups that should be paid attention to in health insurance.The external controllable variables(poor mental health,poor lifestyle,no social insurance,poor family economic conditions,etc.)are the key factors to intervene in the health insurance strategy.In addition,Health demand is the main reason for the elderly to choose medical and health services.Medical burden restricts the release of health needs of the elderly.Third,on the causes of health inequality: The biggest contribution rate of self-rated health difference is family factors.The main cause of chronic diseases: medical and health service utilization factors.The biggest contribution rate of ADL difference is individual factors;and the IADL is family factors.With the increase of age,the influence degree of early factors on the health inequality of the elderly gradually weakens.In the contribution rate of health inequality,the economic level and age factors is relatively large.The utilization of medical and health services has a positive effect on reducing the health difference of the poor.However,due to the disadvantage cycle effect of medical burden,the health difference of poor people will be further expanded.According to the above conclusion,the difficulties of improving the health level of the elderly in rural areas are as follows: the weaker health measures and concepts on prevention,the weakened ability of family to protect the health of the elderly;relatively lagging rural health security capacity.Accordingly,to improve of the health level of the elderly in rural areas,we should pay attention to the connection of individual,family and social medical factors.From the perspective of prevention: to improve the health awareness of the elderly in rural areas.Secondly,based on the family,strengthen the ability of family health care,and clarify the main position of family in rural elderly health care.Explore the promotion of care service in rural areas,and actively pay attention to the mental health and life style of the elderly.Thirdly,through the development of basic public health services to improve the ability of identify health risks,to improve the accessibility of health services for the elderly.To improve the compensation mechanism of medical insurance to alleviate the medical burden;In addition,we should strengthen the prevention and treatment of chronic diseases.To protect the health of the elderly in rural areas combining prevention,care and treatment.Based on the perspective of life course,this paper combines three levels of individual,family and social medical care.On the basis of life course theory,health capital demand theory and medical and health service utilization theory,the theoretical analysis framework is constructed.This paper comprehensively and systematically discusses the causes of the health status of the elderly in rural areas.To a certain extent,this paper broadens the thinking of the research on the health of the elderly,and provides a reference for the research on the health problems of the elderly.It has certain practical significance and academic value.