社区体育基础设施建设、中老年人健康及不平等——基于中国健康与养老追踪调查的实证分析
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摘要
体育基础设施建设是"健康中国"战略的重要组成部分。本文基于中国健康与养老追踪调查(CHARLS)数据,讨论与检验了社区体育基础设施与中老年人健康及不平等的关系。研究结果表明:第一,社区体育基础设施有利于提高中老年人的日常活动能力,并且可显著降低其抑郁程度;第二,社区体育基础设施对收入与教育水平较低、农村户籍以及年龄较大的弱势群体的健康增益效应更加明显,且相比室内设施,户外设施的健康改善作用更加有效;第三,社区体育基础设施不仅能通过增加个人体育文化活动的参与度来改善中老年人健康状况,还可以通过促进相关社团组织的建立、优化参与者的活动体验来提高健康水平,且后者发挥的中介作用更加显著;第四,不论在躯体还是心理层面,社区体育基础设施均有助于降低中老年人的健康不平等,并且能够分别解释中老年人躯体健康不平等及心理健康不平等的2.4%和5.3%。
Construction of community sports infrastructure is an important component of the"Healthy China"strategy.Based on data from the China Health and Retirement Longitudinal Study(CHARLS),this article examines and discusses the relationship among community sports infrastructure,health status,and health inequality among the middle-aged and elderly people.The results show that:firstly,community sports infrastructure is conducive to improving daily physical activities of the middle-aged and elderly people,and it also significantly reduces depression.Secondly,community sports infrastructure has a more significant health effect on people with low income and education,from rural,and being older.Outdoor facilities are more effective in improving the physical and mental health of the middle-aged and elderly,compared with indoor sports facilities.Thirdly,community sports infrastructure can improve the health status of the middle-aged and the elderly not only by increasing their participation to sports and cultural activities,but also by promoting the establishment of related community organizations and by optimizing the participants'activity experiences,of which the mediating role played is even more pronounced.Fourthly,results from quantile regressions show that community sports infrastructure can help reducing health inequalities among the middle-aged and the elderly,both physically and psychologically.The Shapley value decomposition results suggest that the community sports infrastructure can explain 2.4percent and 5.3 percent of the physical inequality and mental health inequality among the middleaged and the elderly,respectively.
Construction of community sports infrastructure is an important component of the"Healthy China"strategy.Based on data from the China Health and Retirement Longitudinal Study(CHARLS),this article examines and discusses the relationship among community sports infrastructure,health status,and health inequality among the middle-aged and elderly people.The results show that:firstly,community sports infrastructure is conducive to improving daily physical activities of the middle-aged and elderly people,and it also significantly reduces depression.Secondly,community sports infrastructure has a more significant health effect on people with low income and education,from rural,and being older.Outdoor facilities are more effective in improving the physical and mental health of the middle-aged and elderly,compared with indoor sports facilities.Thirdly,community sports infrastructure can improve the health status of the middle-aged and the elderly not only by increasing their participation to sports and cultural activities,but also by promoting the establishment of related community organizations and by optimizing the participants'activity experiences,of which the mediating role played is even more pronounced.Fourthly,results from quantile regressions show that community sports infrastructure can help reducing health inequalities among the middle-aged and the elderly,both physically and psychologically.The Shapley value decomposition results suggest that the community sports infrastructure can explain 2.4percent and 5.3 percent of the physical inequality and mental health inequality among the middleaged and the elderly,respectively.
引文
阿马蒂亚·森(2002),《以自由看待发展》,任赜、于真译,北京:中国人民大学出版社。
胡宏伟、李延宇、张楚(2017),《社会活动参与、健康促进与失能预防——基于积极老龄化框架的实证分析》,《中国人口科学》第4期,第87-96页。
连玉君、黎文素、黄必红(2015),《子女外出务工对父母健康和生活满意度影响研究》,《经济学(季刊)》第1期,第185-202页。
刘德吉(2009),《阿玛蒂亚·森的能力平等观与公共服务均等化》,《上海经济研究》第11期,第107-112页。
刘辛丹、于翠婷、吕兴洋(2017),《体育彩票公益金如何影响社区居民健康——基于体育基础设施传导视角》,《财经科学》第7期,第90-101页。
骆为祥、李建新(2011),《老年人生活满意度年龄差异研究》,《人口研究》第6期,第51-61页。
温兴祥、文凤、叶林祥(2017),《社会资本对农村中老年人精神健康的影响——基于CHARLS数据的实证研究》,《中国农村观察》第4期,第130-144页。
温忠麟、张雷、侯杰泰(2004),《中介效应检验程序及其应用》,《心理学报》第5期,第614-620页。
解垩(2009),《与收入相关的健康及医疗服务利用不平等研究》,《经济研究》第2期,第92-105页。
谢洪伟、赵克、张红艳(2011),《城市居住社区体育场地、设施有效供给的经济学分析》,《体育科学》第11期,第12-20页。
赵广川(2017),《国民健康不平等及其内在影响机制、演变过程》,《世界经济文汇》第5期,第55-74页。
郑晓冬、方向明(2017),《社会活动参与对老年人健康的影响——基于CHARLS 2011数据的考察》,《哈尔滨工业大学学报(社会科学版)》第2期,第16-23页。
Andresen,Elena,Judith Malmgren,William Carter&Donald Patrick(1994).Screening for Depression in Well Older Adults:Evaluation of a Short Form of the CES-D.American Journal of Preventive Medicine,10(2),77-84.
Collin,Christine,Derick Wade,S Davies&V Horne(1988).The Barthel ADL Index:AReliability Study.International Disability Studies,10(2),61-63.
Deaton,Angus(2013).The Great Escape:Health,Wealth,and the Origins of Inequality.Princeton:Princeton University Press.
Ekelund,Ulf,Jostein Steene-Johannessen,Wendy-J Brown,Morten-Wang Fagerland,Neville Owen,Kenneth-E Powell,Adrian Bauman,I-Min Lee,Lancet Physical Activity Series 2Executive Committe&Lancet-Sedentary-Behaviour-Working Group(2016).Does Physical Activity Attenuate,or Even Eliminate,the Detrimental Association of Sitting Time with Mortality?A Harmonised Meta-Analysis of Data from More than 1 Million Men and Women.The Lancet,388(10051),1302-1310.
Jenkins,Stephen(1995).Accounting for Inequality Trends:Decomposition Analyses for the UK,1971-86.Economica,62(245),29-63.
Lei,Xiaoyan,Xiaoting Sun,John Strauss,Peng Zhang&Yaohui Zhao(2014).Depressive Symptoms and SES among the Mid-Aged and Elderly in China:Evidence from the China Health and Retirement Longitudinal Study National Baseline.Social Science&Medicine,120C,224-232.
O'Donnell,Owen,Eddy Doorslaer,Adam Wagstaff&Magnus Lindelow(2008).Analyzing Health Equity Using Household Survey Data:A Guide to Techniques and Their Implementation.Washington D.C.:The World Bank.
Shen,Yuying(2014).Community Building and Mental Health in Mid-Life and Older Life:Evidence from China.Social Science&Medicine,107,209-216.
Shorrocks,Anthony(1982).Inequality Decomposition by Factor Components.Econometrica,50(1),193-211.
Wiggins,Richard,Paul Higgs,Martin Hyde&David Blane(2004).Quality of Life in the Third Age:Key Predictors of the CASP-19 Measure.Ageing&Society,24(5),693-708.
(1)来自《中国统计年鉴(2017)》,http://www.stats.gov.cn/tjsj/ndsj/2017/indexch.htm。
(2)来自http://www.xinhuanet.com/sports/2016-04/07/c_1118559597.htm。
(3)来自《第三次全国农业普查主要数据公报(第三号)》,http://www.stats.gov.cn/tjsj/tjgb/nypcgb/qgnypcgb/201712/t20171215_1563589.html。
(1)抑郁量表的10个问题包括:过去一周“我因一些小事而烦恼”;“我在做事时很难集中精力”;“我感到情绪低落”;“我觉得做任何事都很费劲”;“我对未来充满希望”;“我感到害怕”;“我的睡眠不好”;“我很愉快”;“我感到孤独”;“我觉得我无法继续我的生活”。各个问题均有相同的四个选项,分别为:很少或者根本没有(<1天);不太多(1~2天);有时或者说有一半的时间(3~4天);大多数的时间(5~7天)。在对每题赋值时,第5个问题与第8个问题的赋值方向与其余题目相反,按照选项分别赋值3~0。
(2)这里选取的是狭义的阿特金森指数,我们也采用了该指数的广义算法,发现所得结果类似。
(3)CHARLS调查的中老年人大多出生在20世纪30年代至60年代,教育程度普遍较低。因此,这里以“高中学历”为教育程度分界线进行分组。
(1)根据Barthel指数关于生活依赖的判断标准,日常活动能力得分在75~95之间,则认为生活有“轻度依赖”;根据CES-D10关于抑郁症状的判断标准,当抑郁程度分值超过10分时,则认为测试者有抑郁症状。
(1)限于篇幅,本文未报告个人与家庭特征变量结果,读者如有兴趣可向作者索取。
(1)事实上,测量误差也是计量经济学中一个常见而又难以处理的内生问题。通常认为关键指标存在系统性偏误的可能性较小,此外,本文的因变量与关键自变量均是由多个问题进行组合计算得到,因而可以认为在很大程度上避免了通常由单个问题出现的测量偏误。
(1)本文也尝试了工具变量法用以克服内生性问题。然而,寻找合适的工具变量并不容易,我们参考刘辛丹等(2017)的研究,尝试使用2011年省际体育彩票公益金、固定资产投资等指标作为工具变量进行两阶段最小二乘(2SLS)估计,通过第一阶段回归的t检验和F检验发现,以上两个工具变量均较弱。当出现弱工具变量问题时,2SLS的估计结果的偏误比OLS更严重,因此本文进行了另两种可行的稳健性检验。
(2)限于篇幅,这里并未报告多层线性回归的零模型估计结果。读者如感兴趣可向作者索取。
胡宏伟、李延宇、张楚(2017),《社会活动参与、健康促进与失能预防——基于积极老龄化框架的实证分析》,《中国人口科学》第4期,第87-96页。
连玉君、黎文素、黄必红(2015),《子女外出务工对父母健康和生活满意度影响研究》,《经济学(季刊)》第1期,第185-202页。
刘德吉(2009),《阿玛蒂亚·森的能力平等观与公共服务均等化》,《上海经济研究》第11期,第107-112页。
刘辛丹、于翠婷、吕兴洋(2017),《体育彩票公益金如何影响社区居民健康——基于体育基础设施传导视角》,《财经科学》第7期,第90-101页。
骆为祥、李建新(2011),《老年人生活满意度年龄差异研究》,《人口研究》第6期,第51-61页。
温兴祥、文凤、叶林祥(2017),《社会资本对农村中老年人精神健康的影响——基于CHARLS数据的实证研究》,《中国农村观察》第4期,第130-144页。
温忠麟、张雷、侯杰泰(2004),《中介效应检验程序及其应用》,《心理学报》第5期,第614-620页。
解垩(2009),《与收入相关的健康及医疗服务利用不平等研究》,《经济研究》第2期,第92-105页。
谢洪伟、赵克、张红艳(2011),《城市居住社区体育场地、设施有效供给的经济学分析》,《体育科学》第11期,第12-20页。
赵广川(2017),《国民健康不平等及其内在影响机制、演变过程》,《世界经济文汇》第5期,第55-74页。
郑晓冬、方向明(2017),《社会活动参与对老年人健康的影响——基于CHARLS 2011数据的考察》,《哈尔滨工业大学学报(社会科学版)》第2期,第16-23页。
Andresen,Elena,Judith Malmgren,William Carter&Donald Patrick(1994).Screening for Depression in Well Older Adults:Evaluation of a Short Form of the CES-D.American Journal of Preventive Medicine,10(2),77-84.
Collin,Christine,Derick Wade,S Davies&V Horne(1988).The Barthel ADL Index:AReliability Study.International Disability Studies,10(2),61-63.
Deaton,Angus(2013).The Great Escape:Health,Wealth,and the Origins of Inequality.Princeton:Princeton University Press.
Ekelund,Ulf,Jostein Steene-Johannessen,Wendy-J Brown,Morten-Wang Fagerland,Neville Owen,Kenneth-E Powell,Adrian Bauman,I-Min Lee,Lancet Physical Activity Series 2Executive Committe&Lancet-Sedentary-Behaviour-Working Group(2016).Does Physical Activity Attenuate,or Even Eliminate,the Detrimental Association of Sitting Time with Mortality?A Harmonised Meta-Analysis of Data from More than 1 Million Men and Women.The Lancet,388(10051),1302-1310.
Jenkins,Stephen(1995).Accounting for Inequality Trends:Decomposition Analyses for the UK,1971-86.Economica,62(245),29-63.
Lei,Xiaoyan,Xiaoting Sun,John Strauss,Peng Zhang&Yaohui Zhao(2014).Depressive Symptoms and SES among the Mid-Aged and Elderly in China:Evidence from the China Health and Retirement Longitudinal Study National Baseline.Social Science&Medicine,120C,224-232.
O'Donnell,Owen,Eddy Doorslaer,Adam Wagstaff&Magnus Lindelow(2008).Analyzing Health Equity Using Household Survey Data:A Guide to Techniques and Their Implementation.Washington D.C.:The World Bank.
Shen,Yuying(2014).Community Building and Mental Health in Mid-Life and Older Life:Evidence from China.Social Science&Medicine,107,209-216.
Shorrocks,Anthony(1982).Inequality Decomposition by Factor Components.Econometrica,50(1),193-211.
Wiggins,Richard,Paul Higgs,Martin Hyde&David Blane(2004).Quality of Life in the Third Age:Key Predictors of the CASP-19 Measure.Ageing&Society,24(5),693-708.
(1)来自《中国统计年鉴(2017)》,http://www.stats.gov.cn/tjsj/ndsj/2017/indexch.htm。
(2)来自http://www.xinhuanet.com/sports/2016-04/07/c_1118559597.htm。
(3)来自《第三次全国农业普查主要数据公报(第三号)》,http://www.stats.gov.cn/tjsj/tjgb/nypcgb/qgnypcgb/201712/t20171215_1563589.html。
(1)抑郁量表的10个问题包括:过去一周“我因一些小事而烦恼”;“我在做事时很难集中精力”;“我感到情绪低落”;“我觉得做任何事都很费劲”;“我对未来充满希望”;“我感到害怕”;“我的睡眠不好”;“我很愉快”;“我感到孤独”;“我觉得我无法继续我的生活”。各个问题均有相同的四个选项,分别为:很少或者根本没有(<1天);不太多(1~2天);有时或者说有一半的时间(3~4天);大多数的时间(5~7天)。在对每题赋值时,第5个问题与第8个问题的赋值方向与其余题目相反,按照选项分别赋值3~0。
(2)这里选取的是狭义的阿特金森指数,我们也采用了该指数的广义算法,发现所得结果类似。
(3)CHARLS调查的中老年人大多出生在20世纪30年代至60年代,教育程度普遍较低。因此,这里以“高中学历”为教育程度分界线进行分组。
(1)根据Barthel指数关于生活依赖的判断标准,日常活动能力得分在75~95之间,则认为生活有“轻度依赖”;根据CES-D10关于抑郁症状的判断标准,当抑郁程度分值超过10分时,则认为测试者有抑郁症状。
(1)限于篇幅,本文未报告个人与家庭特征变量结果,读者如有兴趣可向作者索取。
(1)事实上,测量误差也是计量经济学中一个常见而又难以处理的内生问题。通常认为关键指标存在系统性偏误的可能性较小,此外,本文的因变量与关键自变量均是由多个问题进行组合计算得到,因而可以认为在很大程度上避免了通常由单个问题出现的测量偏误。
(1)本文也尝试了工具变量法用以克服内生性问题。然而,寻找合适的工具变量并不容易,我们参考刘辛丹等(2017)的研究,尝试使用2011年省际体育彩票公益金、固定资产投资等指标作为工具变量进行两阶段最小二乘(2SLS)估计,通过第一阶段回归的t检验和F检验发现,以上两个工具变量均较弱。当出现弱工具变量问题时,2SLS的估计结果的偏误比OLS更严重,因此本文进行了另两种可行的稳健性检验。
(2)限于篇幅,这里并未报告多层线性回归的零模型估计结果。读者如感兴趣可向作者索取。