International Journal for Equity in Health
Volume 15, Issue 1, 2016, Pages 1-9

Regional health-care inequity in children's survival in Zhejiang Province, China (Article) (Open Access)

Zhang W. , Chen D. , Zhou H. , Xu Y. , Xu Z. , Ying Y. , Zhao Z.*
  • a Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
  • b Department of Public Health, Zhejiang Medical College, Hangzhou, China
  • c Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
  • d Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
  • e Vaderbilt University Law School, Nashville, United States
  • f Department of Child Healthcare, Yongkang Women and Children's Hospital, Yongkang, China
  • g Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China, Department of Child Healthcare, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China

Abstract

Background: China is now under a period of social transition, and inequity is evident in the field of health care. We aimed to investigate regional health-care inequalities in children's survival in Zhejiang Province, China. Methods: In our study, monitoring data of Zhejiang Province from 2005 to 2014 was collected. The flow of data collection of community-district-city for urban areas or village-township-county rural areas was followed. The factors affecting equity was analyzed including regional economical level and household registry. We adopted standard measures of concentration curve and concentration index to evaluate degree of income-related inequity and the trend of mortality changes. Results: From 2005 to 2014, overall mortality rate in children under five decreased, and regional disparity reduced markedly, and with a reduced disparity of mortality rate among children from urban and rural areas. In 2014, the mortality rate in children from urban and rural areas was similar. In contrast, the mortality rate in the children from migrant population was more than two folds of that in the children from native residency (7.82 ‰ vs. 3.89 ‰). The mortality rates of newborns (rs = −0.396, P < 0.001), infants (rs = −0.553, P < 0.001) and children under five (rs = −0.568, P < 0.001) were all negatively correlated with per capita GDP in different regions. CI in the newborns, infants and children under 5 years was −0.105, −0.107 and −0.118, respectively. The concentration curve was near to equity curve. The concentration curve was near to equity curve. The mortality rate of children was negatively related with economical level in this study. Conclusions: The survival status was near to equity. Regional economical development can improve children's survival but it was not the only social determinant. Migrant population will be the future monitor focus for reducing disparity on healthcare and increase equity in children's survival. © 2016 The Author(s).

Author Keywords

Health-care inequality Per capita GDP Mortality rate Children Survival

Index Keywords

urban population urban area China rural area household demography survival health disparity Health Status Disparities human epidemiology trends rural population social aspect social determinants of health priority journal regional pattern socioeconomic status family size Gross Domestic Product Family Characteristics Residence Characteristics income Humans migrant economic development Infant, Newborn male female preschool child Infant Child, Preschool newborn spatiotemporal analysis population research child health Article health care migration equity Infant Mortality age distribution Transients and Migrants childhood mortality Child Mortality Healthcare Disparities health care disparity mortality Zhejiang Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84995493632&doi=10.1186%2fs12939-016-0470-1&partnerID=40&md5=71038e71c06c2f1d91723c8ceb5fa7b1
DOI: 10.1186/s12939-016-0470-1
ISSN: 14759276
Cited by: 2
Original Language: English