农村失能老人的性别差异及其影响机制——基于CLHLS(2014)数据的实证分析
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摘要
社会性别规制所引致的健康不平等使得不同性别老人罹患失能的概率存在很大差异,对于医疗资源匮乏、老龄化形势严峻的农村地区更是如此。基于2014年中国老年健康影响因素跟踪调查(CLHLS)数据,利用Logit模型实证分析了农村失能老人所存在的性别差异及其影响因素,并就其可能的机制进行了探讨。研究发现:农村地区老年人失能状况严重,失能概率在性别、年龄、婚姻状况等特征上存在显著的异质性;无论是自理能力、生活能力还是认知能力,农村女性老人的失能状况较农村男性老人都更加严重;家庭经济地位、自主决策权、患慢性病数量、对医疗资源的可及性等是影响农村老人失能状况的重要因素,并构成了农村女性老人失能状况较男性老人更加严重的关键致因。基于此,应将性别意识纳入与健康相关的各项政策议程中,以增强健康资源在性别间的公平分配。
Due to health inequality caused by social gender regulation,the probability of disability of the elderly has great differece between male and female elderly.That situation is more severe in the rural area which the medical resource is deficient and the aging challenge is grim.Based on the data of Chinese Longitudinal Healthy Longevity Survey(CLHLS)in 2014,this paper uses the Logistic Regression Model to explore the gender differences of elderly disability and the influence factors,and then discusses the corresponding influence mechanism.The research conclusions are as follows: rural elderly disability situation is grim,and the probability of disability has significant heterogeneity in gender,age and marital status;In terms of activities of daily,living independently ability and cognitive ability,the disability status of the female elderly is more serious than that of the male; family economic status,independence on decision-making,incidence numbers of chronic disease,accessibility of medical resources are the critical factors affecting the status of rural disabled elderly,which is the key reason why the disability of rural elderly female is more serious than that of rural elderly male.Incorporating gender consciousness into the service planning for the disabled elderly and enhancing the gender equity of health resources is a policy choice to solve the problem of rural elderly disability.
Due to health inequality caused by social gender regulation,the probability of disability of the elderly has great differece between male and female elderly.That situation is more severe in the rural area which the medical resource is deficient and the aging challenge is grim.Based on the data of Chinese Longitudinal Healthy Longevity Survey(CLHLS)in 2014,this paper uses the Logistic Regression Model to explore the gender differences of elderly disability and the influence factors,and then discusses the corresponding influence mechanism.The research conclusions are as follows: rural elderly disability situation is grim,and the probability of disability has significant heterogeneity in gender,age and marital status;In terms of activities of daily,living independently ability and cognitive ability,the disability status of the female elderly is more serious than that of the male; family economic status,independence on decision-making,incidence numbers of chronic disease,accessibility of medical resources are the critical factors affecting the status of rural disabled elderly,which is the key reason why the disability of rural elderly female is more serious than that of rural elderly male.Incorporating gender consciousness into the service planning for the disabled elderly and enhancing the gender equity of health resources is a policy choice to solve the problem of rural elderly disability.
引文
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[25]周建芳.丧偶对农村老年人口的健康影响研究[J].人口与发展,2015(4).
[26]宋璐,李树茁.代际交换对中国农村老年人健康状况的影响:基于性别差异的纵向研究[J].妇女研究论丛,2006(4).
[27]王甫勤.社会经济地位、生活方式与健康不平等[J].社会,2012(2).
[28]宋月萍,宋正亮.生育行为对老年女性健康的影响[J].人口研究,2016(4).
[29]World Economic Forum.Raising boys shortens your life-and other surprising facts about life expectancy[EB/OL].[2017-02-03].https://www.weforum.org/agenda/2017/02/raising-boys-shortens-your-life-expectancy/.
[2]民政部.三部门发布第四次中国城乡老年人生活状况抽样调查成果[EB/OL].[2016-10-09].http://www.mca.gov.cn/article/zwgk/mzyw/201610/20161000001974,shtml.
[3]贾云竹,谭琳.我国人口老龄化过程中的女性化趋势研究[J].人口与经济,2012(3).
[4]联合国人口基金会.2014年世界人口状况报告[R/OL].[2014-01-31].https://www.unfpa.org/sites/default/files/pub-pdf/EN-SWOP14-Report_FINAL-web.pdf.
[5]张车伟主编.中国人口年鉴(2015)——全国分年龄、性别的人口数[M/OL].[2015-12-01].http://navi.cnki.net/KNavi/YearbookDetail?pcode=CYFD&pykm=YZGRK&bh.
[6]穆光宗.银发中国:从全面二孩到成功老龄化[M].北京:中国民主法制出版社,2016:39-72.
[7]张文娟,魏蒙.中国老年人的失能水平和时间估计——基于合并数据的分析[J].人口研究,2015(5).
[8]Katz S,Ford A B,Moskowitzet R W,et al.Studies of Illness in the Aged,the Index of ADL:A Standardized Measure of Biological and Psychosocial Function[J].Journal of the American Medical Association,1963,185(12):914-919.
[9]Takeda K,Mizusim S,Tochikubo O,et al.Relationship between Activities of Daily Living and Rresidential Environment for Patients Receiving Home Oxygen Therapy[J].Japanese Journal of Public Health,2002,49(7):683-693.
[10]Perkins J M,Lee H Y,James K S,et al.Marital Status,Widowhood Duration,Gender and Health Outcomes:A Cross-sectional Study among Older Adults in India[J].BMC Public Health,2016,16(1):1032.
[11]Demure S,Satto S,Minami M.Gender and Age Difference in Basic ADL Ability on the Elderly Comparison between the Independent and the Dependent Elderly[J].Journal of Physiological Anthropology and Applied Human Science,2003,22(1):19-27.
[12]Bella J K.Another ‘futile quest’?A Simulation Study of Yang and Land’s Hierarchical Age-Period-Cohort Model[J].Demographic Research,2014,30(11):333-360.
[13]Frank W P,Helen B M.Regional Differences in Functional Status among the Aged[J].Social Science & Medicine,2002,54(8):1181-1198.
[14]赵向红.城市失能老人长期照料问题的应对之策[J].贵州社会科学,2012(10).
[15]丁建定,樊晴晴.SWOT分析视角下城镇失能老人医养结合服务模式研究[J].社会保障研究,2017(4).
[16]刘二鹏,张奇林.失能老人子女照料的变动趋势与照料效果分析[J].经济学动态,2018(6).
[17]宋新明,周勇义,郭平,等.中国老年人慢性病的致残作用分析[J].人口与发展,2016(3).
[18]潘金洪,帅友良,孙唐水,等.中国老年人口失能率及失能规模分析——基于第六次全国人口普查数据[J].南京人口管理干部学院学报,2012(10).
[19]张文娟,魏蒙.中国老年人的失能水平到底有多高?——多个数据来源的比较[J].人口研究,2015(3).
[20][22]曾毅.中国老年健康影响因素跟踪调查(1998—2012)及相关政策研究综述[J].老龄科学研究,2013(1).
[21]陆杰华,李月.中国大陆轻度认知障碍老人死亡风险的影响因素研究[J].人口学刊,2015(5).
[23]孙菊,宋月萍.城市人口健康的性别差异及影响因素的实证分析[J].医学与哲学,2008(10).
[24]Wannamethees S G,Shaper A G,Walker M.Changes in Physical Activity,Mortality,and Incidence of Coronary Heart Disease in Older Men[J].Lancet,1998,351(9116):1603-1608.
[25]周建芳.丧偶对农村老年人口的健康影响研究[J].人口与发展,2015(4).
[26]宋璐,李树茁.代际交换对中国农村老年人健康状况的影响:基于性别差异的纵向研究[J].妇女研究论丛,2006(4).
[27]王甫勤.社会经济地位、生活方式与健康不平等[J].社会,2012(2).
[28]宋月萍,宋正亮.生育行为对老年女性健康的影响[J].人口研究,2016(4).
[29]World Economic Forum.Raising boys shortens your life-and other surprising facts about life expectancy[EB/OL].[2017-02-03].https://www.weforum.org/agenda/2017/02/raising-boys-shortens-your-life-expectancy/.