经济学院知识库

健康是人民幸福与社会发展的基础，尤其是21世纪以来，随着我国老龄化进程加快、人均预期寿命延长和人均收入水平的提高，健康问题日益受到普遍重视，人们不但追求健康长寿，而且更加关注健康公平性。本研究以黄河流域71个地级行政单元为研究对象，采用熵值法从身体健康水平、健康生活环境和健康医疗条件三个维度综合评价该流域60岁及以上老年人健康水平，利用空间自相关等模型分析其时空演变规律，基于Grossman健康生产函数构建黄河流域老年人健康水平影响因素指标体系。

研究结果表明：（1）2005-2020年黄河流域各市（州）老年人健康水平指数，从流域整体来看，黄河流域老年人健康水平指数由0.5447提高至0.6165，增速为13.29%，整体呈上升趋势。从市（州）尺度来看，省会城市老年人总体健康水平较高。从流域尺度来看，上游地区老年人健康水平始终低于黄河流域整体老年人健康水平，但上游地区年人健康水平增速最快，下游次之，中游增速最慢；（2）2005-2020年，黄河流域老年人健康水平在空间上呈集聚分布的特征。该流域上游地区的果洛藏族自治州、甘南藏族自治州、阿坝藏族羌族自治州、玉树藏族自治州、黄南藏族自治州、海南藏族自治州等藏区为稳定性冷点区，内蒙段为稳定性热点区，表明黄河流域老年人健康水平具有一定的空间锁定特征，并形成一定时间的稳定性空间分布格局；（3）黄河流域老年人健康水平受经济增长水平、受教育水平、居住环境与自然环境的影响。经济增长水平与受教育水平的提升会显著改善该流域老年人健康水平，并且存在空间溢出效应。拥有厨房比例与年均气温直接正向作用于该流域老年人健康水平，且对周围地区老年人健康水平无显著影响。平均海拔对该市（州）老年人健康水平有显著负向影响，但空间溢出效应并不明显。

Health is the foundation of people's happiness and social development,  especially since the 21st century, with the acceleration of China's aging process, the increase of average life expectancy and the increase of per capita income level, health has been paid more and more attention, and people not only pursue health and longevity, but also pay more attention to health equity. Therefore, taking 71 prefecture-level administrative units in the Yellow River Basin as the research object, this paper comprehensively evaluates the health level of the elderly aged 60 and above in the Yellow River Basin from three dimensions: physical health level, healthy living environment and healthy medical conditions, analyzes the temporal and spatial evolution law of the elderly based on spatial autocorrelation and other models, and constructs the index system of influencing factors of the health level of the elderly in the Yellow River Basin based on the Grossman health production function. 

The results show as followed:(i) From 2005 to 2020, the health level index of the elderly in the Yellow River Basin City, from the overall perspective of the river basin, the health level index of the elderly in the Yellow River Basin increased from 0.5447 to 0.6165, with a growth rate of 13.29%, showing an overall upward trend. From the perspective of prefecture and city, the overall health level of the elderly in provincial capitals is relatively high. From the perspective of river basin scale, the health level of the elderly in the upstream area is always lower than the overall health level of the elderly in the Yellow River Basin.(ii) From 2005 to 2020, the health level of the elderly in the Yellow River Basin was spatially agglomerated. The upper reaches of the Yellow River Basin, such as Goluo Tibetan Autonomous Prefecture, Gannan Tibetan Autonomous Prefecture, Aba Tibetan and Qiang Autonomous Prefecture, Yushu Tibetan Autonomous Prefecture, Huangnan Tibetan Autonomous Prefecture, Hainan Tibetan Autonomous Prefecture and other Tibetan areas, are stable cold spots, and the Inner Mongolia section is a stable hot spot, indicating that the health level of the elderly in the Yellow River Basin has certain spatial locking characteristics and forms a certain spatial distribution pattern of temporal stability.(iii) The health level of the elderly in the Yellow River Basin is affected by the level of economic growth, education level, living environment and natural environment. The increase in economic growth and education level will significantly improve the health level of the elderly in the basin, and there is a spatial spillover effect. The proportion of kitchen ownership and the average annual temperature directly and positively affect the health level of the elderly in the basin, and have no significant impact on the health level of the elderly in the surrounding areas. The average altitude had a significant negative impact on the health level of the elderly in the city, and there was no obvious spatial spillover effect.