农村留守老人健康关爱的主体缺陷与改进策略

农村留守老人是一个人数众多、分布广泛的弱势群体，提升农村留守老人的健康关爱水平既是一个民生问题，也是一个发展问题。农村留守老人存在政府、家庭、社会、社区以及老人自身五个健康关爱主体，但各关爱主体在农村留守老人健康关爱的实践中均存在缺陷，其中，家庭方面的主体责任未能凸显，精神慰藉聊胜于无；政府方面的健康关爱制度短缺，健康公共服务供给不足；市场介入的动力不足，自发行为未成常态；社区的责任主体被动缺位，骨干作用未能发挥；留守老人自身的健康意识淡薄，健康投入有所顾忌。提升农村留守老人健康关爱水平，家庭应该不避责任，主动承载；政府则组织领导，保驾护航；社会各方积极协同；社区方面需激活各类组织，倡行孝亲文化；留守老人自身亦需转变观念，并抱团取暖，共同构建“五位一体”的健康关爱体系。

The Main Defects and Improvement Strategies for a Health and Care System for the Left-behind Elderly in Rural Areas

The left-behind elderly in rural areas are a large and widely distributed vulnerable group,and improving the health and care for them is not only a livelihood issue,but also a developmentone.There are five health care subjects for the left-behind elderly in rural areas:the government,the family,the society,the community and the elderly themselves,but each subject has defects in the actual action,among which family responsibility and spiritual comfort are particular.Other defects are seen in the shortage of health and care system of the government,the insufficient supply of health public services,the lack of motivation of market intervention,the abnormal spontaneous behavior,the absence of the main body of responsibility of the community,the weak health awareness of the left-behind elderly,and the stagnant health investment.To improve health and care for the left- behind elderly in rural areas,the families should take the initiative to bear the burden,the government should act as the organizer and leader,the society should cooperate with all sectors,the communities should activate all organizations,and the left-behind elderly also need to change their ideas.In this way,a "five-in-one" health and care system could be established together.