Health Equity of Rural Residents in Southwest China

Abstract

The Chinese government stresses healthcare reform to improve the health of all residents in urban and rural areas. However, much research showed that inequities still existed in health status and health services utilization in China, especially in economically disadvantaged areas. Southwest China's Yunnan Province is an ethnic frontier region with lagging economic development. This study analyzed health equity among rural residents with various socio-economic and demographic statuses in Yunnan Province. Research on this area concerns rural residents. Our study was based on a household study sample consisting of 27,395 participants from six counties in Yunnan. For all participants, data on demographic and socio-economic characteristics, and health status were collected. The chi-square test and logistic regression were used to analyze factors influencing health. The concentration index was used to evaluate health equity. For all respondents, the 2-week prevalence, the prevalence of chronic diseases, and the required hospitalization rate were 7.3, 12.8, and 9.2%, respectively. After adjusting the age proportion of the sixth population census of Yunnan Province, the 2-week prevalence was 7.1%, the prevalence of chronic disease was 10.7%, and the hospitalization rate was 8.4%. The concentration indexes (CIs) reflecting health equity among the respondents with different incomes and educational levels were negative. There was health inequity among respondents with different incomes and educational levels. The respondents with lower incomes and educational levels had worse health. The common influencing factors included gender, age, ethnicity, occupation, marriage status, and the number of family members. Females, the aged, ethnic minorities, farmers, and the divorced or widowed had worse health status than the control groups. Larger numbers of family members correlated with better health. The respondents with lower incomes or educational levels had higher chronic disease prevalences. The associations between the 2-week prevalence, required hospitalization rate, and age were U-shaped; the lowest age group and the highest age group had higher rates. In conclusion, more attention should be paid to females, the aged, ethnic minorities, farmers, the divorced or widowed, residents with low income and low educational level, and those with chronic diseases.

Keywords: Chinese healthcare reforms; disadvantaged area; health equity; household study; rural residents.