教育的健康回报及其队列差异——基于成长曲线模型的分析
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摘要
在我国经历巨大的经济社会变迁过程中,作为人力资本的教育对不同出生队列群体的健康回报及其演变是否一致?本研究应用队列效应与累积劣势的理论视角,采用历时16年的CHNS追踪数据和成长曲线模型,发现教育的健康回报在不同队列中有差异性。在20世纪40年代以前的出生队列中,教育对健康呈负向影响;40—50年代出生队列,教育对健康没有影响;60年代以后出生队列,教育对健康有正向影响。50年代及以后的出生队列,教育的健康回报随年龄增长而累积。本文还分性别进行了分析,发现教育对女性产生正向影响的队列比男性要晚。队列效应分析揭示了中国语境下独特的健康不平等及其演变。
This study examines how birth cohort structures the relationship between education and health through the life-course in the context of China's dramatically changing stratification system.Using longitudinal data from CHNS and growth curve models,we find strong cohort variations in educational disparities in average health and health trajectories. Unlike the nearly universal positive relationship between education and health in western societies,the effect of education on health is negative for earlier cohorts,zero for middle cohorts and positive for more recent cohorts. The age patterns in education-health relationship also vary across cohorts: for earlier cohorts,the negative association between education and health is stable across age; for cohorts born after the 1950 s,the positive effect of education strengthens across age,and this pattern is becoming stronger across successive cohorts. We also find that the very cohort of the crossover-point is more recent among women than that among men.
This study examines how birth cohort structures the relationship between education and health through the life-course in the context of China's dramatically changing stratification system.Using longitudinal data from CHNS and growth curve models,we find strong cohort variations in educational disparities in average health and health trajectories. Unlike the nearly universal positive relationship between education and health in western societies,the effect of education on health is negative for earlier cohorts,zero for middle cohorts and positive for more recent cohorts. The age patterns in education-health relationship also vary across cohorts: for earlier cohorts,the negative association between education and health is stable across age; for cohorts born after the 1950 s,the positive effect of education strengthens across age,and this pattern is becoming stronger across successive cohorts. We also find that the very cohort of the crossover-point is more recent among women than that among men.
引文
[1]LI L,GUO Y,CHEN E,CHEN J,PETO R.Epidemiology and the control of disease in China:with emphasis on the Chinese biobank study[J].Public Health,2012,126(3):210-213.
[2]YANG D.China’s education in 2003:from growth to reform[J].Chinese Education and Society,2005,389(4):11-45.
[3]LINK B G,PHELAN J C.Social Conditions as fundamental causes of disease[J].Journal of Health and Social Behavior,1995,35:80-94.
[4]BRAVEMAN P.Health disparities and health equity:concepts and measurement[J].Annual Review of Public Health,2006,27(7):167-194.
[5]MCDONOUGH P,WILLIAMS R D,HOUSE J S,DUNCAN J G.Gender and the socioeconomic gradient in mortality[J].Journal of Health&Social Behavior,1999,40(1):17-31.
[6]MIROWSKY J,ROSS E C.Education,social status,and health[M].New Brunswick,NJ:Aldine Transaction,2003:1-30.
[7]MIROWSKY J,ROSS E C.Education,learned effectiveness,and health[J].London Review of Education,2005,3(3):205-220.
[8]LYNCH S.Explaining life course and cohort variation in the relationship between education and health:the role of income[J].Journal of Health and Social Behavior,2006,47(4):324-338.
[9]DAMINE D W.Does education affect smoking behaviors?evidence using the Vietnam draft as an instrument for college education[J].Journal of Health Economics,2007,26(5):877-895.
[10]LANTZ P M,LYNCH J W,HOUSE J S,LEPKOWSKI J M,MERO R P,MUSICK M A,WILLIAMS D R.Socioeconomic disparities in health change in a longitudinal study of US adults:the role of health-risk behaviors[J].Social Science&Medicine,2001,53(1):29-40.
[11]胡安宁.教育能否让我们更健康[J].中国社会科学,2014(5):116-130.
[12]聂伟,风笑天.教育有助于改善身心健康吗?——基于江苏省的数据分析[J].人口与发展,2015(1):50-58.
[13]王甫勤.社会流动有助于降低健康不平等吗[J].社会学研究,2011(2):78-101.
[14]郑莉,曾旭晖:社会分层与健康不平等的性别差异[J].社会,2016(6):209-237.
[15]ELDER G H.ROCKWELL R C.The life-course and human development:an ecological perspective[J].International Journal of Behavioral Development,1979,2(1):1-21
[16]YANG Y.Aging,cohorts,and methods[M]//BINSTOCK R H,GEORGE L K.Handbook of Aging and the Social Sciences,7th.Burlington,MA:Academic Press,2011:17-30.
[17]RYDER N B.The cohort as a concept in the study of social change[J].American Sociological Review,1965,30(6):843-861.
[18]ZHOU Xueguang,TUMA N B,MOEN P.Stratification dynamics under state socialism:the case of urban China,1949-1993[J].Social Forces.1996,74(3):759-796.
[19]CHEN MEEI-SHIA.The great reversal:transformation of health care in the People’s Republic of China[M]//COCKERHAM W C.The Blackwell Companion to Medical Sociology.MA:Blackwell Scientific Publishers,2007:456–482.
[20]HARMAN D.The aging process[J].Proceedings of the National Academy of Sciences,1981(1):7124-7128.
[21]LYNCH S.Cohort and life-course patterns in the relationship between education and health:a hierarchical approach[J].Demography,2003,40(2):309-331.
[22]HOUSE J S,LANTZ P M,HERD P.Continuity and change in the social stratification of aging and health over the life course:evidence from a nationally representative longitudinal study from 1986 to 2001/2002(Americans’Changing Lives Study)[J].The Journals of Gerontology Series B:Psychological Sciences and Social Sciences,2005,60:S15-S26.
[23]李建新,夏翠翠.社会经济地位对健康的影响:收敛还是发散——基于CFPS2012年调查数据[J].人口与经济,2014(5):42-50.
[24]LOWRY D,XIE Yu.Socioeconomic status and health differentials in China:convergence or divergence at old ages?[R/OL].Population Studies Center Research Report,University of Michigan,No.09-690,2009.http://www.psc.isr.umich.edu/pubs/pdf/rr09-690.pdf.
[25]O’RAND A M.Stratification and the life course:life course capital,life course risks,and social inequality[M]//BINSTOCK R H,GEORGE L K.Handbook of Aging and the Social Sciences,6th.Burlington,MA:Academic Press,2006:145-162.
[26]WILLSON A E,SHUEY K M,ELDER G H.Cumulative advantage processes as mechanisms of inequality in life course health[J].American Journal of Sociology,2007,112(6):1886-1924.
[27]MATTHEWS S,MANOR O,POWER C.Social inequalities in health:are there gender differences?[J].Social Science&Medicine,1999,48(1):49-60.
[28]YU Mei-Yu,SARRI R.Women’s health status and gender inequality in China[J].Social Sciense&Medicine,1997,45(12):1885-1898.
[29]RAUDENBUSH S W,BRYK A S.Hierarchical linear models:applications and data analysis methods 2nd edition[M].Sage Publications,Inc,2002:160-202.
[30]FERRARO K F,FARMER M M.Utility of health data from social surveys:is there a gold standard for measuring morbidity[J].American Sociological Review,1999,64(2):303-315.
[31]齐亚强.自评一般健康的信度和效度分析[J].社会,2014(6):196-215.
[32]CHEN Feinian,YANG Yang,LIU Guanya.Social change and socioeconomic disparities in health over the life course in China:a cohort analysis[J].American Sociological Review,2010,75(1):126-150.
[33]SINGER J D,WILLETT J B.Applied longitudinal data analysis:modeling change and event occurrence[M].New York:Oxford University Press,2002:45-75,113.
[34]李婷,张闫龙:出生队列效应下老年人健康指标的生长曲线及其城乡差异[J].人口研究,2014(2):8-35.
[35]MIYAZAKI Y,RAUDENBUSH S W.Tests for linkage of multiple cohorts in an accelerated longitudinal design[J].Psychological Methods,2000,5(1):44-63.
[36]CHEN C C.Medicine in rural China:a personal account[M].Berkeley:University of California Press,1989:177-181.
(1)关于cohort effects的翻译在不同学科之间还没有统一的标准,有队列效应、同期群效应、世代效应等多种翻译。本文采用人口学界常用的队列效应的说法,对birth cohort的也采用出生队列的译法。
(2)教育可能曾经是个人向上流动的负资产,比如“文化大革命”中知识分子被称为“臭老九”,意指知识分子被非正式地排在八类社会异己分子之后。
(3)因不太健康个体(主要是老人)的死亡而不能进入调查样本,老年早期不健康者又多为经济条件较差者。因此进入样本的社会底层老人就是在本群体中健康相对较好的。
(1)CHNS最新公布的数据已到2013年,但2006年以后该数据便不再有“自评健康”这一变量,故我们的分析数据就截至2006年。由于本文的研究问题是社会变迁背景下教育对不同出生队列健康的影响,使用1991-2006年跨度达16年的数据应该不会导致结论的过时。当然我们也希望将来能使用更新的数据来研究生命历程的健康演变问题。
(2)我们也将健康视为定序变量进行了分析,使用的是多层累积logit模型(multilevel cumulative logit regression model),所得结果与将健康处理为连续变量差异不大。如有需要请与作者联系。
(1)如在美国,教育每增长一年,健康增长0.13,参见参考文献[26]。
[2]YANG D.China’s education in 2003:from growth to reform[J].Chinese Education and Society,2005,389(4):11-45.
[3]LINK B G,PHELAN J C.Social Conditions as fundamental causes of disease[J].Journal of Health and Social Behavior,1995,35:80-94.
[4]BRAVEMAN P.Health disparities and health equity:concepts and measurement[J].Annual Review of Public Health,2006,27(7):167-194.
[5]MCDONOUGH P,WILLIAMS R D,HOUSE J S,DUNCAN J G.Gender and the socioeconomic gradient in mortality[J].Journal of Health&Social Behavior,1999,40(1):17-31.
[6]MIROWSKY J,ROSS E C.Education,social status,and health[M].New Brunswick,NJ:Aldine Transaction,2003:1-30.
[7]MIROWSKY J,ROSS E C.Education,learned effectiveness,and health[J].London Review of Education,2005,3(3):205-220.
[8]LYNCH S.Explaining life course and cohort variation in the relationship between education and health:the role of income[J].Journal of Health and Social Behavior,2006,47(4):324-338.
[9]DAMINE D W.Does education affect smoking behaviors?evidence using the Vietnam draft as an instrument for college education[J].Journal of Health Economics,2007,26(5):877-895.
[10]LANTZ P M,LYNCH J W,HOUSE J S,LEPKOWSKI J M,MERO R P,MUSICK M A,WILLIAMS D R.Socioeconomic disparities in health change in a longitudinal study of US adults:the role of health-risk behaviors[J].Social Science&Medicine,2001,53(1):29-40.
[11]胡安宁.教育能否让我们更健康[J].中国社会科学,2014(5):116-130.
[12]聂伟,风笑天.教育有助于改善身心健康吗?——基于江苏省的数据分析[J].人口与发展,2015(1):50-58.
[13]王甫勤.社会流动有助于降低健康不平等吗[J].社会学研究,2011(2):78-101.
[14]郑莉,曾旭晖:社会分层与健康不平等的性别差异[J].社会,2016(6):209-237.
[15]ELDER G H.ROCKWELL R C.The life-course and human development:an ecological perspective[J].International Journal of Behavioral Development,1979,2(1):1-21
[16]YANG Y.Aging,cohorts,and methods[M]//BINSTOCK R H,GEORGE L K.Handbook of Aging and the Social Sciences,7th.Burlington,MA:Academic Press,2011:17-30.
[17]RYDER N B.The cohort as a concept in the study of social change[J].American Sociological Review,1965,30(6):843-861.
[18]ZHOU Xueguang,TUMA N B,MOEN P.Stratification dynamics under state socialism:the case of urban China,1949-1993[J].Social Forces.1996,74(3):759-796.
[19]CHEN MEEI-SHIA.The great reversal:transformation of health care in the People’s Republic of China[M]//COCKERHAM W C.The Blackwell Companion to Medical Sociology.MA:Blackwell Scientific Publishers,2007:456–482.
[20]HARMAN D.The aging process[J].Proceedings of the National Academy of Sciences,1981(1):7124-7128.
[21]LYNCH S.Cohort and life-course patterns in the relationship between education and health:a hierarchical approach[J].Demography,2003,40(2):309-331.
[22]HOUSE J S,LANTZ P M,HERD P.Continuity and change in the social stratification of aging and health over the life course:evidence from a nationally representative longitudinal study from 1986 to 2001/2002(Americans’Changing Lives Study)[J].The Journals of Gerontology Series B:Psychological Sciences and Social Sciences,2005,60:S15-S26.
[23]李建新,夏翠翠.社会经济地位对健康的影响:收敛还是发散——基于CFPS2012年调查数据[J].人口与经济,2014(5):42-50.
[24]LOWRY D,XIE Yu.Socioeconomic status and health differentials in China:convergence or divergence at old ages?[R/OL].Population Studies Center Research Report,University of Michigan,No.09-690,2009.http://www.psc.isr.umich.edu/pubs/pdf/rr09-690.pdf.
[25]O’RAND A M.Stratification and the life course:life course capital,life course risks,and social inequality[M]//BINSTOCK R H,GEORGE L K.Handbook of Aging and the Social Sciences,6th.Burlington,MA:Academic Press,2006:145-162.
[26]WILLSON A E,SHUEY K M,ELDER G H.Cumulative advantage processes as mechanisms of inequality in life course health[J].American Journal of Sociology,2007,112(6):1886-1924.
[27]MATTHEWS S,MANOR O,POWER C.Social inequalities in health:are there gender differences?[J].Social Science&Medicine,1999,48(1):49-60.
[28]YU Mei-Yu,SARRI R.Women’s health status and gender inequality in China[J].Social Sciense&Medicine,1997,45(12):1885-1898.
[29]RAUDENBUSH S W,BRYK A S.Hierarchical linear models:applications and data analysis methods 2nd edition[M].Sage Publications,Inc,2002:160-202.
[30]FERRARO K F,FARMER M M.Utility of health data from social surveys:is there a gold standard for measuring morbidity[J].American Sociological Review,1999,64(2):303-315.
[31]齐亚强.自评一般健康的信度和效度分析[J].社会,2014(6):196-215.
[32]CHEN Feinian,YANG Yang,LIU Guanya.Social change and socioeconomic disparities in health over the life course in China:a cohort analysis[J].American Sociological Review,2010,75(1):126-150.
[33]SINGER J D,WILLETT J B.Applied longitudinal data analysis:modeling change and event occurrence[M].New York:Oxford University Press,2002:45-75,113.
[34]李婷,张闫龙:出生队列效应下老年人健康指标的生长曲线及其城乡差异[J].人口研究,2014(2):8-35.
[35]MIYAZAKI Y,RAUDENBUSH S W.Tests for linkage of multiple cohorts in an accelerated longitudinal design[J].Psychological Methods,2000,5(1):44-63.
[36]CHEN C C.Medicine in rural China:a personal account[M].Berkeley:University of California Press,1989:177-181.
(1)关于cohort effects的翻译在不同学科之间还没有统一的标准,有队列效应、同期群效应、世代效应等多种翻译。本文采用人口学界常用的队列效应的说法,对birth cohort的也采用出生队列的译法。
(2)教育可能曾经是个人向上流动的负资产,比如“文化大革命”中知识分子被称为“臭老九”,意指知识分子被非正式地排在八类社会异己分子之后。
(3)因不太健康个体(主要是老人)的死亡而不能进入调查样本,老年早期不健康者又多为经济条件较差者。因此进入样本的社会底层老人就是在本群体中健康相对较好的。
(1)CHNS最新公布的数据已到2013年,但2006年以后该数据便不再有“自评健康”这一变量,故我们的分析数据就截至2006年。由于本文的研究问题是社会变迁背景下教育对不同出生队列健康的影响,使用1991-2006年跨度达16年的数据应该不会导致结论的过时。当然我们也希望将来能使用更新的数据来研究生命历程的健康演变问题。
(2)我们也将健康视为定序变量进行了分析,使用的是多层累积logit模型(multilevel cumulative logit regression model),所得结果与将健康处理为连续变量差异不大。如有需要请与作者联系。
(1)如在美国,教育每增长一年,健康增长0.13,参见参考文献[26]。