ArticleInternational journal for equity in health2021
Income-related health inequality among Chinese adults during the COVID-19 pandemic: evidence based on an online survey.
Article in International journal for equity in health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed.
- Regional disparities, dynamic evolution, and convergence of China's resident health service development levels.BMC health services research · 2026Article
- Research on the equity of health manpower resource allocation in the Yangtze River Delta region.Frontiers in public health · 2025Article
- The Relationship between Family Functioning, Emotional Intelligence, Loneliness, Social Support, and Depressive Symptoms among Undergraduate Students.Behavioral sciences (Basel, Switzerland) · 2024Article
- A person-centered approach to capture health disparities and multidimensional impact of COVID-related stressors.The American psychologist · 2023Article
- The Effect of Ecological Management on Regional Health Inequality.International journal of environmental research and public health · 2023Article
- Estimating Income-Related Health Inequalities Associated with Tobacco and Alcohol Consumption in Namibia.International journal of environmental research and public health · 2023Article
- Can Mobile Payment Increase Household Income and Mitigate the Lower Income Condition Caused by Health Risks? Evidence from Rural China.International journal of environmental research and public health · 2022Article
- Refining index to measure physical activity inequality: which group of the population is the most vulnerable?International journal for equity in health · 2022Article
- Income-related health inequality among rural residents in western China.Frontiers in public health · 2022Article
- Influences of relative deprivation on health inequality of rural residents in China: A moderated mediation model.Frontiers in psychology · 2022Article
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Abstract
backgroundPartial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic.
methodsThe 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities.
resultsMost participants reported their health status as "very good" (39.0%) or "excellent" (42.3%). CCI of SRH and mental health were - 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%), p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health).
conclusionsPer capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups.
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