代际经济支持对农村老年人失能风险的影响分析

陈四维; 霍欣然; 张柠

doi:10.16766/j.cnki.issn.1674-4152.003616

代际经济支持对农村老年人失能风险的影响分析

doi: 10.16766/j.cnki.issn.1674-4152.003616

首都医科大学公共卫生学院，北京 100069

基金项目:

国家自然科学基金项目 72074159

北京市社科基金项目 22SRB008

详细信息

通讯作者:
张柠，E-mail：cufestat@163.com

中图分类号: R592 R-052
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出版历程
- 收稿日期: 2024-03-19
- 网络出版日期: 2024-11-19

Analysis of the impact of intergenerational economic support on disability risk among rural elderly in China

School of Public Health, Capital Medical University, Beijing 100069, China

摘要

摘要: 目的研究代际经济支持及其相关因素对农村老年人失能风险的影响，为提高农村老年人健康水平提供决策参考依据。方法使用中国健康与养老追踪调查数据库发布的2018年调查数据, 以常住地为农村、至少有一个子女的60岁以上老年人为研究样本，采用工具变量法，构建两阶段回归模型，分析老年人失能的影响因素。结果失能老年人人口数量为1 384人，占比27.53%，失能人口在不同性别、年龄和慢性病状况人群中的分布差异均有统计学意义(P < 0.01)；代际经济支持与老年人失能风险降低相关(β=-0.111，P < 0.01)；交互效应分析显示：男性、年龄大、患有慢性病的老年人获得的经济支持对降低失能风险的作用均减弱(P < 0.01)；异质性分析结果显示，是否饮酒和是否有医保对老年人失能的影响仅在男性老年人群体中差异均有统计学意义(P < 0.05)；是否吸烟仅在高龄老年人群体中差异有统计学意义(P < 0.05)，年龄、是否和子女同住、子女数量和收入仅在低龄老年人群体中差异有统计学意义(P < 0.05)；是否参加医保仅在患慢性病老年人群体中差异有统计学意义(P < 0.05)，是否吸烟和收入仅在无慢性病老年人群体中差异有统计学意义(P < 0.05)。结论政府宜逐步提升对农村老年人的经济支持水平，出台适宜措施，鼓励农村的子女向父母提供经济支持；进一步加强社区对农村老年人的健康宣教，强化慢性病防治工作，控制慢性病患病率。
- 代际经济支持 /
- 老年人 /
- 失能 /
- 内生性 /
- 工具变量
Abstract: Objective This study examines the impact of intergenerational economic support and related factors on the risk of disability among rural elderly, providing a decision-making reference for improving their health. Methods Using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), we focused on rural residents aged 60 and above with at least one child. A two-stage regression model with instrumental variables was constructed to analyze the factors affecting disability in the elderly. Results The number of disabled elderly was 1 384, accounting for 27.53%. Significant differences were found in the distribution of disabled population among different genders, ages, and chronic disease populations (P < 0.01). Intergenerational economic support can reduce the risk of disability in the elderly people (β=-0.111, P < 0.01). The interaction effect analysis showed that the economic support received by males, older adults, and those with chronic diseases had a diminished effect on reducing the risk of disability (P < 0.01). Heterogeneity analysis results showed the effects of drinking alcohol, and having medical insurance on disability were only significant in the male sample (P < 0.05). Smoking status has a statistically significant impact only among the oldest-old groups (P < 0.05); Age, co-residence with children, number of children, and income significantly affect only the younger elderly groups (P < 0.05). Participation in medical insurance were significant only in the elderly with chronic diseases (P < 0.05), while smoking and income were significant only in the elderly people without chronic diseases (P < 0.05). Conclusion The government should gradually increase economic support for rural elderly, encourage rural children to provide economic support to their parents, enhance health education, and strengthen chronic disease prevention efforts to control morbidity rates.
- Intergenerational economic support /
- The aged /
- Disability /
- Endogeneity /
- Instrumental variables

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表 1 被调查老年人失能状况[例(%)]

Table 1. Disability status of the surveyed elderly

项目	失能(n=1 384)	未失能(n=3 644)	χ²值	P值
性别			109.845	< 0.001
男性	539(21.05)	2 022(78.95)
女性	845(34.25)	1 622(65.75)
年龄			104.582	< 0.001
60~74岁	915(23.92)	2 911(76.08)
75岁及以上	469(39.02)	733(60.98)
患有慢性病			124.085	< 0.001
是	836(34.88)	1 561(65.12)
否	548(20.83)	2 083(79.17)

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表 2 老年人失能影响因素的两阶段回归分析结果

Table 2. Two-stage regression analysis results on factors affecting disability in the elderly

变量	第一阶段			第二阶段
变量	系数	P值	SE	系数	P值	SE
子女平均教育年限	0.138	< 0.001	0.014
是否有儿子(否=0)	0.833	< 0.001	0.151
是否有女儿(否=0)	1.233	< 0.001	0.115
经济支持				-0.111	< 0.001	0.031
性别(女性=0)	-0.057	0.583	0.104	-0.230	< 0.001	0.050
年龄	0.006	0.388	0.007	0.021	< 0.001	0.003
户口(非农户=0)	0.262	0.071	0.145	-0.038	0.601	0.072
教育程度	0.007	0.586	0.013	-0.009	0.153	0.006
婚姻(非在婚=0)	0.257	0.007	0.095	-0.044	0.344	0.047
与子女同住(否=0)	-1.172	< 0.001	0.083	-0.095	0.087	0.055
子女数	0.280	< 0.001	0.029	0.060	< 0.001	0.016
慢性病种类数	-0.001	0.989	0.037	0.186	< 0.001	0.018
15岁前身体状况(不佳=0)	-0.188	0.029	0.086	-0.075	0.071	0.042
吸烟(否=0)	-0.272	0.007	0.101	-0.083	0.104	0.051
饮酒(否=0)	0.114	0.225	0.094	-0.060	0.202	0.047
收入	0.000	0.026	0.000	0.000	0.003	0.000
医疗保障(无=0)	0.442	0.034	0.208	-0.190	0.052	0.098
社会活动(未参与=0)	0.438	< 0.001	0.080	-0.020	0.626	0.042

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表 3 老年人失能影响因素的交互效应分析结果

Table 3. Interaction effect analysis results on factors affecting disability in the elderly

变量	(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)
经济支持	-0.111^a	-0.240^a	-0.115^a	-0.169^a	-0.247^a	-0.298^a	-0.171^a	-0.302^a
性别^*经济支持	/	0.235^a	/	/	0.235^a	0.232^a	/	0.231^a
年龄^*经济支持	/	/	0.034^a	/	0.037^b	/	0.034^a	0.036^a
慢性病^*经济支持	/	/	/	0.076^a	/	0.078^a	0.075^a	0.077^a
控制变量和常量	控制	控制	控制	控制	控制	控制	控制	控制
样本量	5 028	5 028	5 028	5 028	5 028	5 028	5 028	5 028
注：“*”表示两变量的交互项。^aP < 0.01, ^bP < 0.05；“/”表示该变量在回归模型中未被包含。(1)~(8)代表模型。

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表 4 老年人失能影响因素的异质性分析结果

Table 4. Heterogeneity analysis results on factors affecting disability in the elderly

变量	性别分组		年龄分组		慢性病分组
变量	男性	女性	60~74岁	75岁及以上	患慢性病	无慢性病
经济支持	-0.082	-0.123^a	-0.109^a	-0.133^b	-0.115^a	-0.096
性别(女性=0)	/	/	-0.227^a	-0.251^b	-0.229^a	-0.231^a
年龄	0.016^a	0.026^a	0.022^a	0.014	0.017^a	0.026^a
户口(非农户=0)	-0.146	-0.021	-0.028	-0.036	-0.035	-0.092
教育程度	-0.007	-0.010	-0.012	-0.002	-0.014	-0.005
婚姻(非在婚=0)	-0.027	-0.066	0.015	-0.173	-0.083	-0.009
与子女同住(否=0)	-0.031	-0.127	-0.141^b	0.024	-0.102	-0.072
子女数	0.047	0.047^b	0.082^a	0.023	0.082	0.030
慢性病种类数	0.187^a	0.196^a	0.194^a	0.155a	0.110^a	/
15岁前身体状况(不佳=0)	-0.068	-0.072	-0.061	-0.095	-0.094	-0.051
吸烟(否=0)	-0.111	0.016	-0.025	-0.237^b	-0.003	-0.153^b
饮酒(否=0)	-0.131^b	0.080	-0.099	0.075	-0.038	-0.080
收入	-0.000	-0.000^a	-0.000^b	-0.000	-0.000	-0.000^a
医疗保障(无=0)	-0.409^b	-0.085	-0.208	-0.155	-0.336^b	-0.091
社会活动(未参与=0)	-0.052	0.010	-0.000	-0.053	0.043	-0.105
常数项	-0.797	-1.397^a	-0.163	-0.133^b	-0.503	1.518^a
注：^aP < 0.01, ^bP < 0.05；“/”表示该变量未包含于回归模型中。

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