The Measurement Of The Vulnerability Of Health Poverty In Rural Elderly And Its Heterogeneity

Objective:Based on the analysis of domestic and foreign literature,theory and health poverty alleviation policies,the status quo and influencing factors of rural poverty in rural areas are sorted out,and the existing literature is used to define the connotation of rural elderly population health and poverty vulnerability and personal characteristics from rural elderly population.And the four dimensions of medical and health services,the level of security system,disease prevention and control,and the evaluation index system of rural elderly population health and poverty vulnerability,and measure the vulnerability of rural elderly population health and poverty from time and space characteristics.Heterogeneity,in turn,provides a forward-looking scientific basis for accurately identifying poor rural elderly populations and optimizing accurate health and poverty alleviation policies.Methods:Based on the analysis of literature and status quo,the orientation of health poverty alleviation policy and the influencing factors of health and poverty vulnerability,the evaluation index system framework of rural elderly population health and poverty vulnerability is determined.According to the CHARLS database,the evaluation index system of rural elderly population health and poverty vulnerability is preliminarily constructed.Using two rounds of Delphi expert consultation method,invite experts in the professional field to score,use SPSS 23.0 to analyze the reliability of the consultation results,eliminate the indicators according to the standard with a comprehensive coefficient less than 7.5,and modify and improve the contents of the indicators according to expert opinions.The fuzzy comprehensive evaluation method determines the weights of various indicators and the scheme of assigning points*The descriptive analysis of CHARLS data in 2011,2013 and 2015 was carried out,and the regression model was measured based on STATA 14.0 using a three-stage feasible generalized least squares method.Based on GeoDa-1.12.1.59 software,ESDA-GIS spatial analysis method was used to analyze the health and poverty vulnerability of rural elderly population,and the differences of health and poverty vulnerability of rural elderly population in different provinces were explored.Based on SPSS 23.0,the time series model was used to treat rural elderly population health poverty.Vulnerability analysis and prediction.Results:(1)Construction of the evaluation index system of rural elderly population poverty vulnerability:According to the scores of two rounds of Delphi expert consultation method,the mean,standard deviation,coefficient of variation and comprehensive coefficient of each index are calculated separately.The positive coefficients of the two rounds of expert consultation are respectively For 92.31%and 100%,the judgment degrees are 0.888 and 0.896 respectively,the familiarity is 0.883 and 0.892,the authority levels are 0.886 and 0.894,the importance values are 0.407 and 0.427,respectively,and the operability values are 0.414 and 0.421,respectively.Sensitivity values were 0.468 and 0.474,respectively.After two rounds of expert consultation,an index system for assessing the health and poverty vulnerability of the elderly population in rural areas was constructed,including four first-level indicators(personal characteristics of rural elderly population,health and poverty alleviation services,level of protection system,disease prevention and control),11 Level indicators,24 level indicators.(2)Rural elderly population health and poverty vulnerability measurement:When the poverty line standard is 2300?yuan/year,1.25 US dollars/day and 2 US dollars/day,the poverty vulnerability of rural elderly population in China in 2015 was 0.6135,0.6602,0.7548,respectively.The personal characteristics of the rural elderly population and the level of the security system are the main factors affecting their annual income.(3)Spatial heterogeneity of rural elderly population health and poverty vulnerability:The global autocorrelation results show that the distribution of health and poverty vulnerability of rural elderly population in China showed local spatial agglomeration characteristics in 2015,and local autocorrelation showed that in the 28 provinces of the sample A total of 6 provinces presented meaningful clusters,and Guizhou Province,Sichuan Province and Yunnan Province(where Yunnan Province showed high concentration under the standard line of 2300 yuan/year)showed high accumulation,presented in Zhejiang,Shanghai and Jiangsu Provinces.Low and low concentration.(4)Time heterogeneity of rural elderly population health and poverty vulnerability:Based on the original data,the health and poverty vulnerability of rural elderly population in China in 2017-2023 is predicted,and the results show a downward trend,at 2300 yuan/year.Under the standard,the health and poverty vulnerability of rural elderly population in China will fall to 0.4865 in 2021,lower than 50%.Conclusion:(1)The health and poverty vulnerability of rural elderly population is high,and there is spatial heterogeneity.There are differences in the health and poverty vulnerability of rural elderly population in different provinces.(2)The health and poverty vulnerability of the rural elderly population is related to the economic level.The rural areas in the western region have higher health and poverty vulnerability than the rural elderly population.(3)The health and poverty vulnerability of the rural elderly population is temporally heterogeneous and shows a downward trend.(4)It is necessary to improve the rural elderly population health poverty evaluation index system,accurately identify the rural elderly poor population,improve the medical and health facilities in rural areas,promote the fairness of medical and health resource allocation,establish and improve the multiple security mechanisms for rural elderly population,and implement accurate Health poverty alleviation policy.