灾后重建中的资源再分配与健康不平等:基于三期汶川地震重建调查

基于2008年至2011年间三期汶川灾区调查数据,本文假定应急救灾、恢复重建和重建结束三个阶段政府的再分配能力存在差异,进而分析这一时段不同职业和教育群体之间的健康差异变化情况。研究发现,首先,在自评健康上,2011年呈现显著的教育梯度,而2008和2009年则无显著的教育差异。其次,在心理健康上,2011年存在显著的教育梯度,2009年存在较弱的教育梯度,2008年未呈现系统性教育梯度。第三,在自评和心理健康上各年份均未呈现系统性的职业阶层梯度。第四,稳健性比较分析表明灾区健康差异模式存在独特性。本文认为,在应急救灾阶段政府再分配能力骤增,提升了弱势阶层的医疗资源可及性,进而降低了阶层健康不平等。但该模式不具有可持续性,一旦重建结束、外部资源减少,不平等会回到常态社会水平。

Resource Redistribution and Health Inequality in Post-Disaster Recovery: On Three Surveys of Wenchuan Earthquake Recovery (2008-2011)

This paper examines the relationship between the state resource redistribution and the change in health inequality in post-earthquake Wenchuan. Three Wenchuan disaster recovery surveys from 2008 to 2011 constitute the base of this study. The government resource distribution is examined in sequent phases of emergency relief,recovery,and post-recovery against its possible effect on the health of different occupational and educational groups during the period. The data analysis shows a significant gradient in 2011 on self-rated health among different educational groups,a phenomenon nonexistent in 2008 and 2009. Similarly,on mental health,the year of 2011 also shows the most noticeable degree of gradient. However,no systematic occupational gradients present in all three years on either self-rated health or mental health. In addition,a comparative analysis between disaster areas and surrounding areas and between pre-disaster and post-disaster period indicates a unique pattern of health inequality in disaster areas:a decline of inequality during the emergency relief period and a climb back in the post-recovery period. It is argued that the decline is due to the fact that at the initial stage of the concerted relief effort,the disadvantaged groups have direct access to the medical and health resources distributed by the state. However,the gain is only temporary. With the dramatic reduction of aids in the post-recovery period and the lack of a good redistribution mechanism,health inequality quickly bounces back to the normal level.