Decomposition analysis of health inequalities between the urban and rural oldest-old populations in China: Evidence from a national survey

Yuan, Lei; Yu, Boyang; Gao, Lei; Du, Maolin; Lv, Yipeng; Liu, Xu; Sun, Jing

doi:10.1016/j.ssmph.2022.101325

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…To be consistent with previous studies [26,28,[30][31][32][33][34][35][36][37], four categories of variables were used in this research: (i) location characteristics reflecting the geographical advantages; (ii) neighborhood characteristics representing the surrounding environment; (iii) income characteristics affected by regional development and the strength of the economy; and (iv) population characteristics considering the health needs of various groups. The specific indicators are summarized in Table 1.…”

Section: Identification Of Determinants To Healthcare Accessibilitymentioning

confidence: 99%

“…Heavy traffic, especially at peak times, increases the travel cost to healthcare services, influencing the accessibility of healthcare facilities in the city center [32]. It has also been shown that public transport (PT) [33], income [34], the population distribution [35,36], and demographic statuses [37] affect access to public services. To evaluate the equity of access to healthcare services, it is essential to analyze whether and to what degree the difference in healthcare accessibility aligns with variations in both spatial and non-spatial factors [38][39][40][41][42].…”

Section: Introductionmentioning

confidence: 99%

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Exploring Equity in a Hierarchical Medical Treatment System: A Focus on Determinants of Spatial Accessibility

Du,

Liu,

Luo

2023

IJGI

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It is essential to understand the spatial equity of healthcare services to achieve the Sustainable Development Goals. Spatial and non-spatial factors affect access to healthcare, resulting in inequality in the hierarchical medical treatment system. Thus, to provide a comprehensive equity evaluation, it is indispensable to investigate the extent to which spatial accessibility to healthcare services varies due to various factors. This study attempted to analyze the determinants of healthcare accessibility under multi-trip modes and integrate them into Theil index, as a demand index to evaluate spatial equity in the system. The results reveal an inadequate and inequitable distribution of healthcare resources. While access to primary hospitals is limited (47.37% of residential locations cannot access them on foot), 96.58% of residential locations can access general and tertiary hospitals via public transport or driving. Furthermore, inequitable access to the three-tiered medical system was evaluated on a more granular scale, with primary hospitals being closest to achieving equity (inequitable for only 48.83% of residential locations), followed by general and tertiary hospitals (82.01% and 89.20%, respectively). The unequal residential locations brought on by an abundance of medical resources are far from those with a shortage of resources (66.86% > 5.34%). It is thus suggested that services be expanded or resources be transferred to move toward a more equitable system. Our findings provide policymakers with insights into how to increase accessibility to public health.

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Section: Identification Of Determinants To Healthcare Accessibilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring Equity in a Hierarchical Medical Treatment System: A Focus on Determinants of Spatial Accessibility

Du,

Liu,

Luo

2023

IJGI

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“…According to China’s seventh national census, in 2020, 191 million individuals were aged 65 years and older, accounting for 13.50% of the total population [ 1 ], and the proportion of people aged 65 and above in rural is 6.6% higher than in urban [ 2 ]. In addition, China’s long-standing urban-rural dual structure has resulted in inequality in economic, medical, and educational development, leading to significant differences in the health status of China’s urban and rural older populations [ 3 , 4 ]. Relevant studies have found that, urban residents have a higher survival rate [ 5 ], better self-assessed health status and better self-assessed self-care ability than rural dwellers [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping

Zhang,

Lin,

et al. 2024

BMC Psychiatry

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Background Studies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship. Methods Data were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping. Results Approximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028). Conclusions Anxiety and negative coping were important mediating factors for rural older adult’s childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality.

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“…However, farmers still comprise a substantial proportion (34.8%) [ 5 ]. While health issues among urban residents and the elderly have garnered widespread scholarly attention [ 6 – 8 ], a notable disparity persists between rural and urban areas, encompassing infrastructure, healthcare, environmental pollution, food safety, and economic conditions. Consequently, the health of farmers, as crucial component of the primary industry's human capital, warrants increased consideration.…”

Section: Introductionmentioning

confidence: 99%

Exploring factors influencing farmers’ health self-assessment in China based on the LASSO method

Wu,

Zeng

2024

BMC Public Health

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As the main force and practice subject of rural revitalisation, farmers' health is intricately linked to agricultural production and the rural economy. This study utilizes open data from the 2015 China Nutrition and Health Survey and employs the Least Absolute Shrinkage and Selection Operator (LASSO) method to explore the factors influencing farmers' self-assessment of health. The findings reveal that education level, proactive nutrition knowledge seeking, healthy dietary preferences and habits, and the use of clean cooking fuel positively impact farmers' health self-assessment. Conversely, age, history of illness or injury, and participation in medical insurance negatively affect their self-assessment. Furthermore, factors influencing farmers' health self-assessment exhibit heterogeneity across regions. Our findings suggest that promoting health education, disseminating nutritional dietary knowledge, and enhancing rural household infrastructure play an important role in improving farmers' self-evaluation of health. Therefore, policymakers should design more targeted health interventions and infrastructure improvement plans based on farmers' self-assessment of health and the level of regional economic development.

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Decomposition analysis of health inequalities between the urban and rural oldest-old populations in China: Evidence from a national survey

Cited by 10 publications

References 29 publications

Exploring Equity in a Hierarchical Medical Treatment System: A Focus on Determinants of Spatial Accessibility

Exploring Equity in a Hierarchical Medical Treatment System: A Focus on Determinants of Spatial Accessibility

The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping

Exploring factors influencing farmers’ health self-assessment in China based on the LASSO method

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