| With the further deepening of population aging process,compared with the length of life,the quality of life has increasingly become the focus of social attention.In particular,along with the transformation of the population growth pattern in China,the form of diseases has changed from infectious diseases to degenerative diseases.The incidence rate of chronic diseases become a basic index threatening the health of residents.On the other hand,mental illness continues to be prevalent internationally,of which depression is the most common,and the risk reaches its peak in middle and old age.At present,the domestic research on chronic diseases and depression in Chinese elderly population mostly focuses on the micro influencing factors.However,the development differences of regional socioeconomic also change the lifestyle of the elderly and determine their health exposure risks,which may further lead to the spatial inequality of health outcomes of the elderly in the region.However,there are few studies on the impact of macroeconomic factors on the health of the elderly in China,and no studies have been extended to the overall overview and spatial characteristics of the prevalence of chronic diseases and depression among the elderly in 338 prefecture level cities in China in consecutive years.Therefore,this paper draws lessons from and absorbs relevant international elderly health theories,and focuses on the plight of physical and mental health of the elderly in China-chronic diseases and depression.Based on the survey data of CHARLS 2011,2013,2015 and 2018 as well as the index data of national and local statistical yearbooks from 2011 to 2018,and fully consider the small sample and autocorrelation characteristics of empirical data,using Bayesian statistical technology to carry out empirical analysis of the health of the elderly in China.Based on the individual level and macro level,this paper will systematically explore the socioeconomic factors affecting the prevalence of chronic diseases and depression among the elderly in China and the East,middle and west regions by controlling individual living habits,physiological functions and regional environment.The prevalence of chronic diseases and depression among the elderly in 338 cities in China from 2011 to 2018 was statistically inferred for the first time,and the spatial distribution pattern of diseases was presented.At the same time,the temporal and spatial evolution characteristics are further described.Through a series of studies,this paper finds that:(1)The prevalence rate of chronic diseases of the elderly increased in 2011,2013,2015 and 2018 in the whole country,eastern,central and western regions of China.It increased from 75.92%,74.49%,74.78% and 78.45% in 2011 to 88.22%,85.70%,89.27%and 89.66% in 2018,respectively.The prevalence rate of depression was stable at 40%to 50%,but the regional difference is obvious: the depression rate is the highest in the western region,the second in the middle,and the lowest in the east.(2)From an individual socioeconomic perspective,the factors such as smoking and other living habits,daily behavior ability and other physiological functions are controlled,the empirical results reveal the important impact of the socio-economic characteristics of the elderly on their health.Except that the social characteristics of women and old age are the common risk factors of chronic diseases and depression in the elderly,the effects of other socio-economic characteristics on the health of the elderly are different.For example,the risk of depression in the elderly living with their spouses and participating in social communication is lower,otherwise it is not significant for the prevalence of chronic diseases;Owning wage income significantly reduced the risk of chronic disease or depression among the elderly in the eastern and central regions,and the regression coefficient values were about 0.55 and 0.74;The risk of chronic diseases and depression of the elderly in the western region was significantly correlated with pension monthly income;In the central and western regions,the risk of depression of the elderly with children's financial support is 0.85 and 0.77 times higher than that of the elderly without children's financial support.In addition,smoking,low ADL score,poor audio-visual status and sleep quality are risk factors for the elderly.Family support plays a positive role in reducing the risk of depression.(3)From the macro socioeconomic perspective and the control of environmental factors such as air pollution,the empirical analysis shows that the role of regional socioeconomic factors on the health of the elderly can not be ignored.Medical and health expenditure is of great significance to the health of the elderly.In particular,the support of health expenses to health-related personnel and facilities,such as "health,social security and social welfare practitioners" and "the number of beds in hospitals and health centers",will have a direct impact on the prevalence of chronic diseases and depression of the elderly.The participation rate of medical insurance plays a certain role in reducing the incidence of chronic diseases among the elderly,and the participation rate of endowment insurance is an effective factor in reducing the incidence of depression among the elderly,with the sub-regional regression coefficients ranging from-0.34 to-0.14 and from-0.17 to-0.10,respectively.And the prevalence of depression among the elderly in the western region is also affected by the participation rate of medical insurance.The participation rate of medical insurance increases by 1%,and the prevalence rate of depression among the elderly decreases by about 0.14%.In addition,environmental factors such as the improvement of centralized sewage treatment level have reduced the prevalence of chronic diseases and depression among the elderly in the region to a certain extent;The green coverage rate has a significant effect on alleviating the depression of the elderly;PM2.5 concentration significantly increased the risk of chronic diseases in the elderly.(4)The temporal and spatial inference and evolution results of the prevalence of chronic diseases and depression among the elderly in 338 cities in China from 2011 to2018 show that the prevalence of chronic diseases among the elderly in China has increased year by year,from 76.14% in 2011 to 86.72% in 2018;The prevalence of depression fluctuated and decreased from 44.89% to 42.58%.At the same time,the spatial pattern of the prevalence of chronic diseases and depression among the elderly is roughly similar.The prevalence of the elderly in central and western cities,especially in western provinces such as Guangxi,Sichuan,Yunnan,Gansu,Guizhou and Ningxia,is more widespread,while the prevalence of the elderly in most eastern cities is more optimistic.The spatial relative risk and local variation trend further confirm that the prevalence of chronic diseases and depression among the elderly in Western China is particularly serious.The cities with the spatial relative risk of chronic disease and depression prevalence greater than 1.0 in the western region are wider than those in the middle and eastern regions,especially in most cities in the southwest region,such as Guangxi,Guizhou and Yunnan;At the same time,different from the significant downward trend of the prevalence of depression among the elderly in eastern and central cities,the local trend of depression among the elderly in western cities is increased or slightly decreased.This shows the prevalence of the disease among the elderly in western cities in China. |
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