Introduction
Methods
Ethics statement
Data collection
Variable | Southern region | Central region | Northern region | Total Anhui |
---|---|---|---|---|
Population/square kilometers | 459 | 420 | 652 | 438 |
Per capita GDP ($) | 13,001 | 2968 | 1769 | 5808 |
Per capita disposable income of rural household($) | 2835 | 2298 | 1482 | 1738 |
Numbers of medical practitioners /1000 population | 2.07 | 2.28 | 1.07 | 1.55 |
Utilization rate of city hospital beds (%) | 82.44 | 86.36 | 86.66 | 84.97 |
Utilization rate of township hospital beds (%) | 26.65 | 51.13 | 80.70 | 60.64 |
Definition of key study variables
Dependent variable
Independent variables
Variable | Southern region (n = 1245) | Central region (n = 1537) | Northern region (n = 1088) | Total Anhui (n = 3870) | |
---|---|---|---|---|---|
Gender** | Male | 42.62 | 40.45 | 36.76 | 40.27 |
Female | 57.38 | 59.55 | 63.24 | 59.73 | |
Age(y)** | 15~ | 25.31 | 28.11 | 19.58 | 24.60 |
45~ | 29.02 | 28.27 | 26.29 | 28.01 | |
55~ | 22.58 | 21.29 | 24.63 | 22.74 | |
65~ | 23.10 | 22.33 | 29.50 | 24.65 | |
Education** | No education | 42.64 | 38.63 | 52.02 | 43.99 |
Primary school | 26.04 | 27.95 | 25.55 | 26.52 | |
Middle school or higher | 31.32 | 33.41 | 22.43 | 29.49 | |
Employment status** | Subsistence farmers | 68.50 | 57.19 | 83.49 | 69.13 |
Others | 31.50 | 42.81 | 16.51 | 30.87 | |
Marital statue | Married | 88.29 | 85.70 | 85.37 | 86.64 |
Others | 11.71 | 14.30 | 14.63 | 13.36 | |
Income* | Q1 (~ 25%) | 24.06 | 24.75 | 24.36 | 24.37 |
Q2 | 24.96 | 25.22 | 24.74 | 24.99 | |
Q3 | 27.24 | 24.34 | 23.76 | 25.38 | |
Q4(75%~) | 23.73 | 25.69 | 27.15 | 25.26 | |
Household composition** | Parents and children | 26.22 | 30.44 | 19.85 | 25.79 |
Three generations | 27.33 | 19.52 | 15.17 | 21.40 | |
Elderly and children | 8.46 | 5.78 | 13.97 | 9.15 | |
Only elderly | 37.54 | 43.78 | 50.74 | 43.26 | |
Others | 0.46 | 0.48 | 0.28 | 0.41 | |
Medical insurance** | NRCMs | 96.16 | 88.51 | 98.81 | 94.44 |
Other medical insurances | 2.86 | 7.87 | 0.74 | 3.88 | |
No medical insurance | 0.98 | 3.61 | 0.46 | 1.68 | |
Social support** | Q1 (~ 25%) | 25.70 | 24.74 | 47.98 | 31.65 |
Q2 | 21.21 | 21.61 | 21.23 | 21.34 | |
Q3 | 25.11 | 27.39 | 15.90 | 23.26 | |
Q4(75%~) | 27.98 | 26.27 | 14.89 | 23.75 | |
Chronic disease** | No | 48.86 | 54.49 | 42.10 | 48.77 |
Yes | 51.14 | 45.51 | 57.90 | 51.23 | |
Clinic visit** | No | 61.99 | 57.98 | 40.00 | 54.54 |
Yes | 38.01 | 42.02 | 60.00 | 45.46 | |
Hospitalization | No | 11.05 | 11.66 | 22.50 | 14.46 |
Yes | 88.95 | 88.34 | 77.50 | 85.54 | |
Active exercise** | No | 80.29 | 68.40 | 73.40 | 74.52 |
Yes | 19.71 | 31.60 | 26.60 | 25.46 | |
Smoke** | No | 78.09 | 77.98 | 83.61 | 79.60 |
Yes | 21.91 | 22.02 | 16.39 | 20.40 | |
Drink** | No | 76.58 | 77.51 | 86.21 | 79.59 |
< 3 times/week | 8.56 | 7.31 | 5.15 | 7.24 | |
≥3 times/week | 14.77 | 15.18 | 8.64 | 13.18 |
Active exercise
Smoking status
Drinking status
Statistical analysis
Results
Characteristics of the sampled regions and participants
Individual and family traits and health
Characteristic | Southern region | Central region | Northern region | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Poorest | Poor | Good | Best | Poorest | Poor | Good | Best | Poorest | Poor | Good | Best | ||
Gender | Male | 21.27** | 20.48 | 26.84 | 31.41 |
25.19
|
20.00
|
25.19
|
29.62
|
46.25
|
20.75
|
16.50
|
16.50
|
Female | 27.09 | 22.37 | 27.76 | 22.78 | 26.08 | 22.11 | 25.06 | 26.76 | 48.98 | 21.51 | 15.55 | 13.95 | |
Age(y) | 15~ | 10.86** | 16.00 | 31.14 | 42.00 | 10.54** | 16.97 | 27.76 | 44.73 | 25.35** | 16.90 | 22.54 | 35.21 |
45~ | 18.18 | 23.58 | 28.13 | 30.11 | 21.75 | 25.56 | 25.34 | 27.35 | 42.66 | 21.33 | 19.58 | 16.43 | |
55~ | 35.85 | 24.53 | 23.40 | 16.23 | 33.14 | 18.44 | 25.65 | 22.77 | 51.12 | 24.25 | 14.55 | 10.07 | |
65~ | 39.93 | 23.38 | 25.54 | 11.15 | 40.00 | 23.10 | 21.41 | 15.49 | 65.11 | 21.50 | 9.35 | 4.05 | |
Education | No education | 35.34** | 24.74 | 26.40 | 13.51 | 36.64** | 21.37 | 23.51 | 18.47 | 57.07** | 21.55 | 12.90 | 8.48 |
Primary school | 28.45 | 22.99 | 25.86 | 22.70 | 22.50 | 24.25 | 24.50 | 28.75 | 44.24 | 22.30 | 16.55 | 16.91 | |
Middle school or higher | 9.38 | 16.83 | 29.81 | 43.99 | 13.51 | 18.50 | 27.65 | 40.33 | 31.15 | 19.26 | 22.13 | 27.46 | |
Employment status | Subsistence farmers | 28.87** | 23.38 | 27.32 | 20.42 | 29.53** | 22.79 | 24.41 | 23.27 | 47.91** | 22.69 | 16.19 | 13.22 |
Others | 19.25 | 19.25 | 27.48 | 34.02 | 17.36 | 17.77 | 26.65 | 38.22 | 48.33 | 13.89 | 14.44 | 23.33 | |
Marital status | Married | 22.77** | 21.65 | 27.84 | 27.74 | 24.39** | 21.08 | 25.50 | 29.03 | 46.23** | 21.34 | 16.27 | 16.16 |
Others | 36.52 | 21.35 | 24.72 | 17.42 | 35.56 | 22.22 | 22.22 | 20.00 | 57.86 | 20.75 | 13.84 | 7.55 | |
Income | Q1 (~ 25%) | 45.66** | 21.86 | 21.22 | 11.25 | 40.38** | 22.22 | 20.05 | 17.34 | 65.09** | 18.18 | 12.00 | 4.73 |
Q2 | 23.30 | 25.89 | 26.86 | 23.95 | 28.53 | 22.01 | 24.73 | 24.73 | 49.65 | 25.18 | 13.83 | 11.35 | |
Q3 | 16.61 | 20.27 | 30.56 | 32.56 | 19.47 | 20.43 | 25.96 | 34.13 | 42.52 | 21.65 | 17.32 | 18.50 | |
Q4(75%~) | 12.94 | 19.09 | 30.74 | 37.22 | 16.09 | 19.84 | 29.22 | 34.85 | 34.19 | 19.85 | 20.59 | 25.37 | |
Household composition | Parents and children | 17.15** | 20.84 | 25.07 | 36.94 | 17.37** | 21.84 | 23.33 | 37.47 | 35.19** | 17.59 | 18.52 | 28.70 |
Three generations | 20.16 | 19.75 | 28.40 | 31.69 | 21.67 | 20.00 | 29.05 | 29.29 | 36.97 | 20.61 | 18.79 | 23.64 | |
Elderly and children | 25.00 | 20.83 | 31.94 | 22.22 | 30.00 | 17.69 | 20.00 | 32.31 | 44.08 | 27.63 | 15.13 | 13.16 | |
Only elderly | 31.93 | 23.30 | 27.89 | 16.88 | 33.80 | 22.01 | 24.78 | 19.41 | 57.07 | 21.20 | 14.31 | 7.43 | |
Others | 33.33 | 0.00 | 33.33 | 33.33 | 0.00 | 57.14 | 14.29 | 28.57 | 100.00 | 0.00 | 0.00 | 0.00 | |
Medical insurance | NRCMs | 24.68** | 22.87 | 27.22 | 25.23 |
26.05
|
20.84
|
25.03
|
28.08
| 48.00** | 21.40 | 15.91 | 14.70 |
Other medical insurances | 20.41 | 14.29 | 26.53 | 38.78 | 18.18 | 29.55 | 25.00 | 27.27 | 37.50 | 0.00 | 12.50 | 50.00 | |
No medical insurance | 35.56 | 6.67 | 33.33 | 24.44 | 13.33 | 33.33 | 33.33 | 20.00 | 60.00 | 20.00 | 20.00 | 0.00 | |
Social support | Q1 (~ 25%) | 38.06** | 21.67 | 24.44 | 15.83 | 35.42** | 21.30 | 21.30 | 21.99 | 61.09** | 19.94 | 10.93 | 8.04 |
Q2 | 26.86 | 24.03 | 26.50 | 22.61 | 26.97 | 21.72 | 23.63 | 27.68 | 48.03 | 23.03 | 16.12 | 12.83 | |
Q3 | 18.55 | 22.01 | 29.56 | 29.87 | 20.96 | 20.40 | 25.21 | 33.43 | 42.11 | 26.32 | 16.12 | 15.46 | |
Q4(75%~) | 12.68 | 18.66 | 29.58 | 39.08 | 16.52 | 21.32 | 31.83 | 30.33 | 34.32 | 11.24 | 24.26 | 30.18 | |
Chronic disease | No | 11.95** | 17.99 | 31.12 | 38.94 | 11.58** | 16.78 | 27.96 | 43.68 | 25.11** | 22.49 | 24.24 | 28.17 |
Yes | 40.04 | 25.93 | 22.93 | 11.11 | 39.19 | 25.45 | 22.39 | 12.98 | 64.60 | 20.32 | 9.84 | 5.24 | |
Clinic visit | No | 13.29** | 18.88 | 30.91 | 36.92 | 15.07** | 18.65 | 28.13 | 38.15 | 24.19** | 22.56 | 24.42 | 28.84 |
Yes | 40.46 | 25.43 | 22.93 | 11.18 | 42.96 | 25.60 | 19.93 | 11.51 | 63.88 | 20.16 | 10.39 | 5.58 | |
Hospitalization | No | 20.55** | 22.11 | 28.99 | 28.35 | 22.63** | 21.09 | 26.01 | 30.27 | 42.89** | 21.98 | 18.40 | 16.73 |
Yes | 56.25 | 18.06 | 16.67 | 9.03 | 50.30 | 22.49 | 17.16 | 10.06 | 65.84 | 18.52 | 7.41 | 8.23 | |
Active exercise | No |
25.30
|
21.38
|
28.38
|
24.94
| 27.73** | 21.04 | 24.47 | 26.75 |
46.59
|
21.34
|
16.92
|
15.15
|
Yes | 23.39 | 22.37 | 25.96 | 28.28 | 17.28 | 21.93 | 27.24 | 33.55 | 51.92 | 20.91 | 13.24 | 13.94 | |
Smoke | No | 26.27** | 22.95 | 27.00 | 23.78 | 27.14** | 21.78 | 24.54 | 26.55 | 50.17** | 21.82 | 15.06 | 12.96 |
Yes | 19.12 | 16.91 | 29.41 | 34.56 | 20.30 | 19.70 | 26.57 | 33.43 | 37.29 | 18.08 | 20.34 | 24.29 | |
Drink | No | 27.25** | 22.38 | 26.74 | 23.63 | 29.14** | 21.07 | 24.13 | 25.66 | 50.43** | 22.49 | 14.39 | 12.69 |
< 3 times/week | 16.48 | 20.88 | 19.78 | 42.86 | 8.27 | 20.30 | 27.07 | 44.36 | 35.71 | 10.71 | 28.57 | 25.00 | |
≥3 times/week | 15.87 | 17.99 | 34.39 | 31.75 | 18.06 | 22.47 | 29.07 | 30.40 | 30.85 | 14.89 | 23.40 | 30.85 | |
Region** | 24.74 | 21.61 | 27.39 | 26.27 | 25.70 | 21.21 | 25.11 | 27.98 | 47.98 | 21.23 | 15.90 | 14.89 |
Strong social support positively impact good health
Better physical health consistent with better SRH
Health lifestyles positively impact good health
Determinants of SRH in rural regions
Variable | Model 1a | Model 2 b | Model 3 c | Model 4d | Model 5 e | Model 6 f |
---|---|---|---|---|---|---|
SRH(ref: Poorest) | ||||||
Poor | 2.873** | 4.967** | 3.038** | 2.433** | 4.827** | 3.447** |
Good | 1.331* | 1.776** | 1.061 | 0.844 | 1.479* | 1.045 |
Best | 0.384** | 0.536** | 0.315** | 0.249** | 0.387** | 0.270** |
Region (ref: Southern) | ||||||
Central | 0.994 | 0.948 | 0.999 | 0.993 | 0.962 | 0.957 |
Northern | 2.557** | 2.139** | 2.276** | 2.278** | 1.992** | 1.932** |
Gender (ref: Male) | ||||||
Female | 1.184* | 1.236** | 1.255** | 1.217* | 0.879 | |
Age (y) (ref: 15~) | ||||||
45~ | 1.825** | 1.765*** | 1.782** | 1.413** | 1.472** | |
55~ | 2.663** | 2.190*** | 2.155** | 1.525** | 1.562** | |
65~ | 3.899** | 2.655*** | 2.578** | 1.727** | 1.772** | |
Education (ref: No education) | ||||||
Primary school | 0.776** | 0.811** | 0.836* | 0.896 | 0.859 | |
Middle school or higher | 0.501** | 0.546** | 0.576** | 0.655** | 0.661** | |
Income (ref: Q1) | ||||||
Q2 | 0.613** | 0.647** | 0.696** | 0.706** | ||
Q3 | 0.497 | 0.507** | 0.555** | 0.554** | ||
Q4 | 0.447** | 0.475** | 0.498** | 0.499** | ||
Household composition (ref: Parents and children) | ||||||
Three generations | 0.868 | 0.874 | 0.871 | |||
Elderly and children | 0.784 | 0.775 | 0.767 | |||
Only elderly | 1.118* | 0.995* | 0.988* | |||
Others | 2.114 | 2.032 | 2.291 | |||
Social support (ref: Poorer) | ||||||
Poor | 0.792** | 0.833* | 0.620** | |||
Good | 0.701** | 0.730** | 0.735** | |||
Better | 0.608** | 0.599** | 0.836* | |||
Chronic disease (ref: No) | ||||||
Yes | 2.303** | 2.235** | ||||
Clinic visit (ref: No) | ||||||
Yes | 1.794** | 1.807** | ||||
Hospitalization (ref: No) | ||||||
Yes | 2.220** | 2.126** | ||||
Smoke (ref: No) | ||||||
Yes | 0.745** | |||||
Drink (ref: No) | ||||||
< 3 times/week | 0.685** | |||||
≥3 times/week | 0.627** | |||||
Chi-square | 203.772 | 739.745 | 835.445 | 864.839 | 1374.133 | 1409.634 |
df | 2 | 9 | 17 | 22 | 25 | 29 |
Sig. | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 |