Multidimensional poverty and health: an analysis of multidimensional poverty and its influencing factors among rural residents in Western China from a health ecology perspective

多维贫困与健康:基于健康生态学视角对中国西部农村居民多维贫困及其影响因素的分析

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Abstract

BACKGROUND: Although absolute poverty in rural China has been systematically eradicated, rural residents continue to suffer deprivation in terms of education, healthcare and living conditions, which has become an urgent obstacle to China's goal of rural revitalisation and common prosperity. In addition, the impact of health on multidimensional poverty remains unclear. METHODS: This study constructs four periods of balanced panel data on the basis of baseline survey data from 2012 and follow-up survey data from 2015, 2019 and 2022 to conduct a longitudinal study of multidimensional poverty among rural residents. The Alkire-Foster method was used to measure the multidimensional poverty of the rural population. A fixed-effects logit model with panel data and health ecology theory is used to analyse the impact of health-related factors on multidimensional poverty. RESULTS: From 2012 to 2022, the Multidimensional Poverty Index (M₀) of rural residents decreased from 0.288 to 0.093, and the multidimensional poverty incidence (H) decreased from 58.0% to 20.2%. Among them, the contribution rate of the education dimension to multidimensional poverty always ranked first. The contribution rate of the health dimension increased significantly from 14.7% to 32.9%. The results of the fixed effects model show that increasing age (OR 2.123/4.350, 95% CI 1.802 to 2.501/3.411 to 5.547), chronic diseases (OR 1.969, 95% CI 1.757 to 2.206), catastrophic health expenditure (OR 1.446, 95% CI 1.262 to 1.658) could significantly increase the risk of multidimensional poverty in rural residents. Using outpatient health services (OR 0.632, 95% CI 0.542 to 0.738), using inpatient health services (OR 0.599, 95% CI 0.525 to 0.684), being married (OR 0.553, 95% CI 0.418 to 0.732) could significantly reduce the risk of multidimensional poverty. CONCLUSION: In the past decade, the multidimensional poverty of rural residents in Western China has been significantly improved, but the impact of the health dimension continues to expand. Increasing investment in medical infrastructure in rural areas and improving residents' utilisation of health services are important ways to reduce multidimensional poverty in rural areas. Meanwhile, attention should be paid to the vulnerable position of patients with chronic diseases and families incurring catastrophic health expenditures in multidimensional poverty.

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