MA Yichen , DING Mingfeng , HAN Xuemei , MA Ziyuan , LI Jingyi , LUO Xiaolei , ZHANG Jiawen , JIANG Jingwen
  • 1. Institute of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;
HAN Xuemei, Email: xmhan123@163.com
Multilevel health insurance system; Neighborhood social capital; Self-rated health; Interaction
10.7507/1672-2531.202306048
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To investigate the factors that influence Chinese residents self-rated health and the effects of the multilevel health insurance system and neighborhood social capital on self-rated health. Methods Based on the 2018 China labor-force dynamics survey data, and Stata 15.0 software was used to conduct χ2 test, univariate analysis and multiple logistic regression model to analyze the influencing factors of self-rated health of Chinese residents. An interaction model was used to analyze the interactive effects of the multilevel health insurance system and the social capital of the neighborhood on self-rated health. Results A total of 10 201 people were investigated in this study, and 39.20% of them were self-rated unhealthy. After adjusting for confounders, the results of the multivariate logistic regression model showed that having social health insurance (OR=0.8, 95%CI 0.7 to 1.0) and having neighborhood social capital (OR=0.7, 95%CI 0.6 to 0.8) were more inclined to self-rated health. In addition, the results showed that being male, having a college degree or higher, having a job, and drinking alcohol increased the risk of self-rated unhealthy (P<0.05); whereas being 45-59 years of age, 60 years of age or older, in the central and western regions, exercising regularly, and having a disease or injury within two weeks decreased the risk of self-rated unhealthy (P<0.05). There was a positive multiplicative interaction between health insurance and neighborhood social capital on residents' self-rated health (univariate: OR=1.5, 95%CI 1.1 to 3.7, P<0.05; multivariate: OR=1.7, 95%CI 1.2 to 2.4, P<0.05), and negative additive interactions (RERI=−0.8, 95%CI −1.4 to −0.1; AP=−0.3, 95%CI −0.6 to −0.1; SI=0.6, 95%CI 0.5 to 0.8). Conclusion Attention should be paid to the self-rated health status of key populations through such means as health promotion and education, and healthy behavior lifestyles should be promoted. The health insurance system should be further improved, and attention should be paid to the role of social capital in the neighborhood, encouraging residents to actively build a good social neighborhood, and realizing the coordinated development of the multilevel health insurance system and the social capital in the neighborhood.