Research On The Decomposition And Production Mechanism Of Health Inequality Among The Elderly In Urban And Rural Areas In China

In the course of the rapid social development,health inequality has been gradually exposed,and there are differences in the distribution of health outcomes among groups with different socio-economic characteristics.The health inequality of the elderly stands out.The health of the elderly is not only a matter of everyone’s well-being in old age,but also a matter of social equity and justice.The data over 60 years old used in this paper comes from the 2018 Chinese Longitudinal Healthy Longevity Survey(CLHLS).We use self-rated health as an indicator to measure the health status of older people,exploring the factors that affect the health of elderly people in urban and rural areas from four dimensions:demographic characteristics variables,family support variables,social security variables and health behavior variables.We calculate concentration indices and decomposed them.In addition,we use the Oaxaca-Blinder decomposition method to analyse the health inequality between urban and rural residents.The results show that pro-rich health inequality exists in urban and rural areas.Elderly people with high economic status have better health conditions than those with low economic status,and compared to urban elderly people,health inequalities among rural elderly are more serious.Within urban and rural areas,economic status,alcohol consumption,and exercise are factors that influence the health of urban older people.Economic status,number of children,caregivers(spouses),smoking,drinking alcohol,and exercise are factors that affect the health of rural older people.Economic status and exercise behavior are the main factors that cause health inequality among urban and rural elderly,as well as between urban and rural elderly.Health inequality outcome for older people is shaped by a combination of structural causes,institutional causes and self motivated efforts.On the one hand,health practices are both constrained by socially structured positions and individual characteristics.Class habitus distinguishes social status groups and individuals in certain class structures unable to fully control or choose their own behavior.On the other hand,institutional mechanisms of allocation(granting of power and market exchange)and non-institutional mechanisms of distribution(social networks)redistribute social interests and resources.In the process of the game of interests,the advantaged groups have an advantage in the distribution of income and social resources,reinforcing the sense of relative deprivation of the disadvantaged groups.The differences in social stratification,residential segregation,social capital,and social networks caused by the different social status of older social members restrict people’s choices of healthy behavior or lifestyle,leading to differences in health outcomes.However,individual behavioral factors such as lifestyle and healthy behavior significantly enhance the prevention of health problems.In the course of life,conscious and planned physical activity can reduce the cumulative disadvantages that socio-economic conditions bring to the health level of the elderly.Therefore,individuals can still alleviate health inequalities through learning health knowledge,cultivating healthy lifestyles,and long-term physical exercise.