Hai Fang1, Jie Chen, John A Rizzo. 1. Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA. hai.fang@ucdenver.edu
Abstract
BACKGROUND: Given strict residency controls and geographic imbalances in health care resources, China may experience serious urban-rural health disparities. OBJECTIVES: To investigate urban-rural disparities in the patterns of health status and health care utilization in China and to examine the evolution of these disparities from 1997 to 2006. SUBJECTS: This study uses data from the China Health and Nutrition Survey 1997-2006 with a sample of 27,897 rural and 13,898 urban respondents aged 18 or older. MEASURES: We use self-reported health status, activity limitations due to illness, and diagnosis of serious diseases to measure health status, and physician visits for illness to measure health care utilization. RESULTS: Self-reported health status of urban residents is consistently worse than their rural counterparts (OR = 0.76; P < 0.01) based on multivariate logistic regression analysis. Urban residents are significantly more likely to have activity limitations due to illness (OR = 1.13; P < 0.01) and to have been diagnosed with a serious disease (OR = 1.69; P < 0.01). Urban residents are less likely to visit physicians for illness than are rural residents, a difference that has increased substantially since 1997. CONCLUSIONS: Urban residents appear to fare worse than rural residents in terms of overall health status and health care utilization in China. Identifying the causes of these urban-rural health disparities and developing appropriate policy responses are critical directions for researchers and policymakers.
BACKGROUND: Given strict residency controls and geographic imbalances in health care resources, China may experience serious urban-rural health disparities. OBJECTIVES: To investigate urban-rural disparities in the patterns of health status and health care utilization in China and to examine the evolution of these disparities from 1997 to 2006. SUBJECTS: This study uses data from the China Health and Nutrition Survey 1997-2006 with a sample of 27,897 rural and 13,898 urban respondents aged 18 or older. MEASURES: We use self-reported health status, activity limitations due to illness, and diagnosis of serious diseases to measure health status, and physician visits for illness to measure health care utilization. RESULTS: Self-reported health status of urban residents is consistently worse than their rural counterparts (OR = 0.76; P < 0.01) based on multivariate logistic regression analysis. Urban residents are significantly more likely to have activity limitations due to illness (OR = 1.13; P < 0.01) and to have been diagnosed with a serious disease (OR = 1.69; P < 0.01). Urban residents are less likely to visit physicians for illness than are rural residents, a difference that has increased substantially since 1997. CONCLUSIONS: Urban residents appear to fare worse than rural residents in terms of overall health status and health care utilization in China. Identifying the causes of these urban-rural health disparities and developing appropriate policy responses are critical directions for researchers and policymakers.
Authors: Hai Fang; Yinzi Jin; Miaomiao Zhao; Huyang Zhang; John A Rizzo; Donglan Zhang; Zhiyuan Hou Journal: Int J Environ Res Public Health Date: 2017-10-20 Impact factor: 3.390