基于全国22省市886个县15 973位老人2002—2005年跟踪调查数据,本文应用多水平多元logit模型,对社会、经济和环境因素对老年健康和死亡的影响进行了分析。结果表明,控制了个人层面相关变量后,空气污染显著增加了老人ADL(日常生活自理能力)残障、认知功能差与累计健康亏损指数上升的可能性。降雨量的增加则显著降低了老人ADL残障和认知功能差的风险。极低的气温显著增加了老人ADL残障的风险与死亡风险,而极高的气温显著增加了老人认知功能差和累计健康亏损指数上升的可能性。居住在山区的老人ADL残障风险较低,累计健康亏损指数亦较低。此外,人均GDP、15~64岁人口的劳动参与率以及文盲率对中国老年人的生理健康、心理健康、整体健康水平以及死亡风险有显著的、作用方向不同的影响。最后,得出如下结论:保护自然环境、改善社会经济状况的干预措施将有利于改善老人健康、降低老人死亡风险。
We analyzed data from a nationally representative sample of 15,973 elderly residents from 866 coun- ties and cities in 2002 and followed up in 2005 with multilevel logistic regression models to investigate how social, eco- nomical environmental factors are associated with health outcomes and mortality risk. After control individual-level fac- tors, we found that air pollution increased the odds of disability in activities of daily living (ADLs), cognitive impair- ment, and health deficits index. More rainfall was protective, reducing the odds of ADL disability and cognitive impair- ment. Extremely low seasonal temperatures increased the odds of ADL disability and mortality. Extremely high seasonal temperatures increased the odds of cognitive impairment and health deficit index. Living in a mountain area decreased the odds of ADL disability and health deficits. The conclusion is that efforts to reduce pollution and improve socioeco- nomic conditions could significantly improve the health and survival of the elderly.