与收入相关的健康不平等扩大了吗

引致健康不平等原因在很大程度上可追溯到收入不平等。本文利用中国营养与健康调查数据，采用建立在追踪调查样本上的集中系数，对1990-2006年间与收入相关健康不平等进行了测度和分解。结果显示：（1）城市和农村都存在着亲富人的健康不平等且累积效应不断深化，初始收入不平等是健康不平等加剧的重要原因；（2）居民平均健康水平有所降低，穷人的健康变动度大于富人，农村的健康不平等大于城市；（3）农村收入不平等扩大带来了健康不平等上升，而城市相关医疗卫生服务水平的提高，使收入不平等扩大对健康不平等的负效应有所减弱。因此，提升公共服务均等化水平、缩小城乡健康差距，是缓解健康不平等的有效途径。

Whether the Income-related Health Inequality has Increased

Factors caused health inequality could be mainly attributed to income inequality. This paper uses China Health Nutrition Survey data, and adopts concentration index based on longitudinal samples to measure and decompensate the income-related health inequality from 1990-2006. Results show that: (1) Both in urban areas and rural areas, it exists deepening health inequality which favors to the wealth, the initial income inequality is an important reason of deepening health inequality. (2) The average health level has a little decrease, the poor’s variability of health is larger than the wealthy, and the health inequality in rural areas is deeper than that in urban areas. (3) The increasing of income inequality in rural area leads to more health inequality. However, due to some related medical and health services has improved in urban areas, such negative effect from income inequality to health inequality has weakened. In fact, establishing equal access to publics service and narrowing healthy gaps between urban and rural areas would be an effective channel to hold health inequality.