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Spatial variations and social determinants of life expectancy in China, 2005-2020: A population-based spatial panel
Wei Wang1, Yunning Liu1, Pengpeng Ye1
1National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
The Lancet Regional Health. Western Pacific
|April 25, 2022
Summary
Social determinants of health significantly impact life expectancy disparities in China. Factors like GDP and healthcare access influence local and neighboring regions, highlighting the need for integrated policies to improve health equity.
Area of Science:
- Public Health
- Spatial Epidemiology
- Health Economics
Background:
- Social determinants of health (SDOH) are known to cause life expectancy (LE) disparities.
- Limited research exists on the spatial associations between SDOH and LE in China over time.
- This study quantifies the relationship between SDOH and LE from a spatial perspective in China.
Purpose of the Study:
- To determine the existence of associations between SDOH and LE in China.
- To quantify the magnitude of these associations.
- To interpret the spatial spillover effects of SDOH on LE disparities.
Main Methods:
- Provincial-level LE data from 2005-2020 were analyzed using mortality records.
- A spatial panel Durbin model was employed to investigate LE-associated SDOH proxies.
- Spatial spillover effects were incorporated to analyze direct and indirect impacts of SDOH on LE.
Main Results:
- Nationwide LE increased from 73.1 to 77.7 years between 2005 and 2020.
- Significant spatial clustering of LE was observed, with high LE in coastal and low LE in western regions.
- SDOH proxies like GDP, Gini index, healthcare beds, and population growth rate were positively associated with LE, exhibiting spatial spillover effects.
Conclusions:
- Significant spatial variations in LE exist across Chinese provinces.
- SDOH related to socioeconomic factors, healthcare, and population characteristics influence LE locally and regionally.
- Policy interventions addressing SDOH externalities and promoting equitable socioeconomic environments are crucial for reducing health disparities and enhancing LE.
Keywords:
AIC, Akaike Information CriterionCI, confidence intervalChinaDSPs, Disease Surveillance Points systemLE, life expectancyLM test, Lagrange Multiplier testLR, Likelihood ratioLife expectancyNMSS, National Mortality Surveillance SystemOLS, ordinary least squarePopulation strategySBIC, Schwarz's Bayesian Information CriterionSD, standard deviationSDOH, social determinants of healthSPAR, spatial panel autoregressive regression modelSPDM, spatial panel Durbin modelSPEM, spatial panel error modelSocial determinants of healthSpatial spillover effectsSpatial variationsMore Related Videos
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