Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach

Abstract Background In recent decades, China has experienced tremendous economic growth and also witnessed growing socioeconomic-related health inequality. The study aims to explore the potential causes of socioeconomic-related health inequality in urban and rural areas of China over the past two decades. Methods This study used six waves of the China Health and Nutrition Survey (CHNS) from 1991 to 2006. The recentered influence function (RIF) regression decomposition method was employed to decompose socioeconomic-related health inequality in China. Health status was derived from self-rated health (SRH) scores. The analyses were conducted on urban and rural samples separately. Results We found that the average level of health status declined from 1989 to 2006 for both urban and rural populations. Average health scores were greater for the rural population compared with those for the urban population. We also found that there exists pro-rich health inequality in China. While income and secondary education were the main factors to reduce health inequality, older people, unhealthy lifestyles and a poor home environment increased inequality. Health insurance had the opposite effects on health inequality for urban and rural populations, resulting in lower inequality for urban populations and higher inequality for their rural counterparts. Conclusion These findings suggest that an effective way to reduce socioeconomic-related health inequality is not only to increase income and improve access to health care services, but also to focus on improvements in the lifestyles and the home environment. Specifically, for rural populations, it is particularly important to improve the design of health insurance and implement a more comprehensive insurance package that can effectively target the rural poor. Moreover, it is necessary to comprehensively promote the flush toilets and tap water in rural areas. For urban populations, in addition to promoting universal secondary education, healthy lifestyles should be promoted, including measures such as alcohol control

Socioeconomic Differences and Trends in the Place of Death among Elderly People in China

China is facing a dramatic aging of its population. Little is known about the factors that influence the place of death and the trends in the place of death for elderly people in China. The purposes of this study were: (1) to examine the impact of the socioeconomic status (SES) on place of death for elderly Chinese residents; and (2) to assess temporal trends in the place of death over the last 15 years. Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998–2012). Place-of-death as an outcome was dichotomized into either death at home or death outside the home. Logistic regression analyses were used to examine the impact of SES on place of death. The results showed that, of the 23,098 deaths during the study period, 87.78% occurred at home. The overall trend in home death has increased since 2005. SES was shown to be an important factor affecting place of death. The elderly with higher SES were more likely to die where health resources were concentrated, i.e., in a hospital or other type of institution. Our finding suggests that the trend towards a greater emphasis on death at home may call for the development of more supportive home care programs in China. Our finding also suggests that the socioeconomic differences in the place of death may be related to the availability of or access to health care services

Determinants of and socio-economic disparities in self-rated health in China

Abstract Background Self-rated health (SRH) is not only used to measure health status and health inequalities, but also as a strong predictor of morbidity and mortality. The purpose of this study was to: 1) evaluate the factors that account for variations in self-rated health among Chinese citizens; and to 2) explore the process through which socio-economic status may impact self-rated health. Methods Data were derived from the Chinese General Social Survey (CGSS) (2013). Determinants of self-rated health were analyzed along four main dimensions: demographic characteristics, socio-economic status, lifestyle, and psychosocial factors. Multivariate odds ratios for good self-rated health were calculated for different variables in order to analyze the determinants. Binary logistic regression analysis was performed to assess the extent to which lifestyle and psychosocial factors explained the association between socio-economic status and self-rated health. Results About 65% of the survey respondents reported good self-rated health. Women, the elderly, married or single respondents and residents of Western China were less likely to report good self-rated health. Respondents who were engaged in work, had higher household income, reported high social class and higher socio-economic status compared with peers were more likely to report good self-rated health. Normal weight and physically active respondents along with those reporting a happy life, no depression, and good relationships with families and friends were related to good self-rated health. We also found the effect of socio-economic status on self-rated health was partly explained by lifestyle and psychosocial factors. Conclusion The present findings support the notion that both socio-economic status and lifestyle as well as psychosocial factors were related with good self-rated health. The interventions targeting these factors could improve the health status of the population. The depression was the most influential predictor of self-rated health, especially for the women and the elderly. Although lifestyle and psychosocial factors explained partly the the association between socio-economic status and health, the reason why socio-economic difference exists in health must be further explored. What’s more, it needs to be further studied why the same determinant has different influence strengths on the health of different groups of people

Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada

The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed. A total of 181 caregivers were interviewed biweekly over the course of the palliative care trajectory, yielding a total of 994 interviews. The propensity and intensity of health service use were examined using logistic regression and negative binomial regression, respectively. The results demonstrated that both the propensity and intensity of home-based nurse and PSW visits fell with socioeconomic status. The use of home-based palliative care services was not concentrated in high socioeconomic status groups. The common predictors of health service use in the three service categories were patient age, the Palliative Performance Scale (PPS) score and place of death. These findings may assist health service planners in the appropriate allocation of resources and service packages to meet the complex needs of palliative care populations

Additional file 1: of Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach

The mathematical process of RIF regression decomposition method. (DOCX 34 kb

Preparation of Ta/W Composite by CVD

The Ta/W composites with 10%W, 13%W and 18%W were prepared by chemical vapor deposition (CVD). The properties of Ta/W composites were investigated by optical microscopy (OM), scanning electron microscopy (SEM ) and tensile test. The results show that it is possible to prepare Ta/W composites with different W volume fractions by CVD, and the actual densities of the composites are more than 99.4% of the theoretical density. Both Ta and W layers have columnar grain structures, and the more close to the interface, the more fine the grains are. The mechanical properties of CVD Ta/W are better than those of CVD Ta or CVD W. After hot treatment(1600 ℃×2 h),the diffused layers of the composites have become more wider and the mechanical properties are increased remarkably, and the tensile strength of the CVD Ta/W composite with 18%W is 660 MPa

Growth of hafnium dioxide thin films via metal-organic chemical vapor deposition

Metal-organic chemical vapour deposition (MOCVD) is a key technique for depositing thin solid film materials for use in important technological applications. To obtain thin films of the desired standard, it is essential to design volatile, reactive and thermally stable precursors. A metal-organic precursor consisting of Hf with excellent vaporization characteristics and low decomposition temperature has been reported. Hafnium dioxide thin films on a Mo substrate were obtained via thermal MOCVD using Hafnium(IV) acetylacetonate(Hf(acac) _4 ) in a horizontal cold-wall reactor. The Hf(acac) _4 precursor was synthesized from HfCl _4 and Hthd in methanol. Hf(acac) _4 was characterized using elemental analysis and infrared spectroscopy. The thermal decomposition properties were studied using thermogravimetric analysis under a nitrogen atmosphere. The results showed that Hf(acac) _4 was completely volatised at 245 °C. The thin films products were investigated using x-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). The results from these measurements revealed that the main crystalline phase was the monoclinic phase, the surface consists of hafnium and oxygen and the morphology was densely packed and composed of visible grains

Interfacial structure and mechanical properties of the Ta/Re layered composites prepared by chemical vapor deposition

A novel Ta/Re layered composites with high temperature resistance, low cost, light weight, and excellent mechanical properties has been prepared by chemical vapor deposition, for improving the comprehensive service performance of the aerospace engine nozzle materials. The interface structure, element distribution, and mechanical properties of the Ta/Re layered composites have been studied with scanning electron microscopy, energy dispersive spectroscopy, x-ray diffraction, and tensile testing machine. The results show that the structure of the Ta/Re layered composites is flat and smooth, uniform, and dense. Further, the interface joint is a serrated meshing structure, which tremendously improves the interface bonding properties. The high temperature (1600 °C) tensile strength of the heat-treated Ta/Vol. 30% Re layered composites is 125 MPa, which is 2.8 times and 56.3% higher than the commonly used nozzle materials C103 and Nb521, respectively, whereas the raw material cost is only about 46% of that of pure rhenium. The heat treatment process enhances the mutual diffusion behavior of the atoms in the interface diffusion layer, and increases the thickness of the diffusion layer, besides changing the mechanical properties of the material. When the heat treatment process is at 1800 °C × 1 h, the highest tensile strength at room temperature is 739.61 MPa, which is 42.76% higher than that in a deposited state. This work can provide a reference for the further research of the Ta/Re layered composites

Exploring the Impact of Zirconium Doping on the Mechanical and Thermodynamic Characteristics of Pt-40Rh Alloy through First-Principles Calculations

Zirconium (Zr) element doping has proven to be an effective strategy for reinforcing the strength and toughness of Pt-Rh alloys. However, the incorporation of Zr into Pt-Rh alloy in solid solution form renders its microstructural observation challenging through experimental means, thus complicating the elucidation of its underlying mechanisms. Therefore, this study employs density functional theory-based first-principles calculations to investigate the mechanical and thermodynamic properties of Pt-40Rh-xZr (x = 0, 0.1, 0.5, 1.0) alloys. The results reveal that with an increasing Zr weight percentage, Young’s modulus, and hardness of Pt-40Rh-xZr alloys exhibit a trend of an initial decrease followed by a subsequent increase. Notably, at a Zr weight percentage of 1.0 wt.%, the alloy Pt-40Rh-1.0Zr demonstrates the highest Young’s modulus (329.119 GPa) and hardness (10.590 GPa). Concurrently, thermodynamic calculations indicate that as Zr content increases, the crystal thermal stability of Pt-40Rh-xZr alloys initially decreases before rising again. More specifically, the coefficient of thermal expansion for Pt-40Rh-1.0Zr is merely 89.518% of that observed in Pt-40Rh. These results imply that incorporating 1.0 wt.% Zr results in the most substantial enhancement in the comprehensive mechanical properties of the Pt-40Rh-xZr alloy. Consequently, this study offers theoretical insights that can guide the extended application of Pt-Rh alloys