Healthcare accessibility and subjective well-being in Xizang: evidence from a high-altitude region of China

西藏地区医疗保健可及性与主观幸福感:来自中国高海拔地区的证据

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Abstract

OBJECTIVE: Achieving universal access to healthcare is a specific target of Sustainable Development Goal 3 which seeks to promote health and well-being for all. However, the subjective well-being (SWB) in Xizang and its relationship with healthcare accessibility are inadequately understood. This study aims to assess the magnitude of SWB and examine its relationship with healthcare accessibility in Xizang, China. METHODS: Data were obtained from the 2018 Sixth National Health Service Survey in Xizang. The SWB was measured using a revised version of the Personal Well-Being Index (PWI). Healthcare accessibility was assessed based on geographical accessibility, while affordability and availability indicators were included as control variables. Descriptive statistics were used to summarize the basic characteristic of participants. After controlling for sex, age, marital status, occupation, education, household income per capita and chronic disease, multiple regression models were used to examine the relationship between SWB and geographical accessibility. RESULTS: The PWI score among the 2113 participants in 2018 was 69.04 (SD = 14.97), and the overall life satisfaction score was 7.00 (SD = 2.04). After adjusting for control variables, participants with good geographical accessibility reported significantly higher SWB (β = 1.75, 95% CI: 0.05–3.47). CONCLUSION: The SWB in Xizang fell within the normative range of China, and better geographical accessibility to healthcare was associated with higher SWB. Future research should delve into potential mechanisms between access to healthcare and SWB. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13597-6.

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