| Objective:To understand the health status of the minority residents in the border areas,analyze the influencing factors of health,and evaluate the residents’ health equity and explore the determinants of health inequities.Then to provide the evidence for making the health polices to improve the minority residents’ health for the goal of"Health Yunnan 2030".Methods:A total of 1424 residents of Yi,Lahu and Blang nationality in 584 households were selected using a multi-stage stratified sampling method.The respondents aged 16 years and above,lived in Dali,Zhaotong and Pu’er of Yunnan Province.Household surveys were conducted.Mean,rate and frequency were used to describe the data.Chi-square test and Wilcoxon rank sum test were used in univariate analysis;Logistic regression was used to analyze the influencing factors of the respondents’ health.Hurdle counting model was used to appraise the influencing factors of the frequencies of two-week prevalence.The Concentration Index,Concentration Curve and Theil Index were used to measure health equity.Concentration Index decomposition method was used to analyze the determinants of health inequity.Results:1.The two-week prevalence rate was 13.20%.The average number of days in two-week prevalence lasted 1.2 days,the average bed rest days were 0.2 days,and the average number of rest days were 0.2 days.The two-week prevalence of the Yi respondents(9.25%)was lower than the Lahu’s(15.93%)and the Blang’s(19.05%)(P<0.001).There was no significant difference in the two-week prevalence rate between the Lahu and the Blang nationality(P>0.05).Multivariate Logistic regression analysis showed that age,ethnicity,occupation,family size,and chronic disease were influencing factors of two-week prevalence.The elderly,the Lahu,the Blang,and those who suffered from chronic disease were the risk factors of two-week prevalence.On the contrary,other occupations and family sized more than 4 were protective factors of two-week prevalence.2.The rate of chronic disease prevalence was 13.90%.The average rest days in bed for patients with chronic diseases in the last year were 1.7 days,and the average number of rest days was 7.1 days.There was no significant difference in the chronic disease ’prevalence among three ethnic minorities(P>0.05).Multivariate Logistic regression analysis showed that gender and age were influencing factors of chronic disease prevalence.Female and the elderly were the risk factors of chronic disease.The three highest rates of chronic diseases prevalence were hypertension(2.95%),rheumatism(2.39%)and kidney stones(0.63%).The main chronic diseases were hypertension(21.21%)and rheumatism(17.17%).3.The required hospitalization rate was 11.52%.There was no significant difference in the required hospitalization rates among three ethnic minorities(P>0.05).The main causes of non-hospitalization were financial difficulties(50.0%),mild illness(40.0%)and lack of time(10.0%).Multivariate Logistic regression analysis showed that marital status and chronic disease were influencing factors of required hospitalization.The ethnic minorities who were married,divorced and widowed,suffered from chronic disease were risk factors of required hospitalization.4.There existed pro-poor inequity of two-week prevalence as the Concentration Index(CI)of two-week prevalence(-0.0807)and the Horizontal Inequity(HI,-0.0745)were negative.After removing the influencing of "required variables",the inequity of two-week prevalence had been reduced.The main contributors of inequity were attributed to annual per-capita income(-178.39%)and family size(-25.03%).With the increase of annual income per capita and family size,the poverty-prone inequity of the two-week prevalence was reduced.The CIs of two-week prevalence among the Yi,the Lahu and the Blang were-0.0327,-0.1306 and 0.1454,respectively.Two-week prevalence among the Yi and the Lahu respondents were in favor of lower income respondents,while among the Blang respondents it was skewed to those with higher income.5.The CI of chronic disease prevalence was-0.1004,and the HI was-0.0351.After removing the influencing of "required variables",the pro-poor inequity of chronic disease prevalence had been reduced.The main contributions of inequity were attributed to the annual per-capita income(-88.10%),age(80.75%),marital status(-25.32%)and gender(-15.74%).The poverty-prone inequity of the chronic disease was reduced by the increase in annual income per capita,the married and male.However,the poverty-prone inequity of the chronic disease was increased by the increase in age.The CIs of chronic disease prevalence among the Yi,the Lahu and the Blang were-0.1536,-0.0413 and-0.0756,respectively.In total,the chronic disease of three ethnic minorities was skewed to those with lower income.6.The CI of required hospitalization prevalence was 0.0439,and the HI was 0.0236.After removing the influencing of "required variables",the pro-rich inequity of required hospitalization had been reduced.The main contributions to inequity were attributed to the annual per-capita income(150.54%),marital status(55.48%)and those who suffered from chronic disease(46.21%).The pro-rich inequity of the required hospitalization was enlarged by the increase in annual income per capita,the married and those with chronic disease.The CIs of required hospitalization among the Yi,Lahu and Blang were 0.0889,0.0364 and-0.0763,respectively.The required hospitalization of the Yi and Lahu respondents were skewed to those with higher income,while among the Blang respondents it was in favor of those with lower income.Conclusions:1.The ethnic minority residents in border areas had general health status,and the demands for health services were not high.2.Female,the elderly,farmers,the married,the divorced and widowed,people with chronic disease were the risk factors of health status.It would be necessary to strengthen them to their concept of disease prevention and control,and to keep a healthy diet.3.There was a poverty-prone inequity in two-week prevalence.The Blang respondents had the highest pro-poor inequity,and the Yi respondents had the lowest inequity.4.There was a poverty-prone inequity in chronic disease.The Yi respondents had the highest pro-poor inequity,and the Lahu respondents had the lowest inequity.5.There was a richness-prone inequity in required hospitalization.The Yi respondents had the highest pro-poor inequity,and the Lahu respondents had the lowest inequity.6.The annual per capita income was the greatest contributing factors to health inequity.With the increase of the annual per capita income,the inequities of two-week disease and chronic disease decreased,while the inequity of required hospitalization increased.Family size,age,marital status,gender and chronic disease were the primary contributing factors of health inequity. |
PDF Full Text Request