RESUMO
BACKGROUND: Although China has eliminated absolute poverty, the effects of sickness still pose a threat to the prospect of returning to poverty in western rural areas. However, poverty governance extends beyond solving absolute poverty, and should enhance the family's ability to resist risks, proactively identify the existence of risks, and facilitate preventive measures to reduce the probability of falling into poverty again. This study aimed to assess the health poverty vulnerability of rural households in western China and decompose its determinants. METHODS: Based on survey data from 2022, the three-stage feasible generalized least squares method was used to calculate the health poverty vulnerability index. Then, Anderson's health behavior theory model was extended to analyse various influencing factors using binary logistic regression, and the contribution of each influencing factor was decomposed using the Shapley index. Finally, Tobit regression and the censored least absolute deviations estimation (clad) method were used to test the model's robustness. RESULTS: A total of 5455 families in the rural Ningxia region of western China were included in the study. The health poverty vulnerability index of the sample population in 2022 was 0.3000 ± 0.2223, and families with vulnerability ≥0.5 accounted for 16.9% of the sample population. From the Anderson behavioral model, the three models including propensity, enabling, and demand factors had the best fit, and the AIC and BIC values were the smallest. The Shapley decomposition showed that the dimensions of the propensity factor, number of residents, age and educational level of the household head, and dependency ratio were the most important factors influencing vulnerability to health poverty. Tobit regression and the clad method proved the reliability of the constructed model through a robustness test. CONCLUSION: Rural areas still face the risk of becoming poor or falling into poverty owing to residents' health problems. Health poverty alleviation should gradually change from a focus on treatment to prevention, and formulate a set of accurate and efficient intervention policies from a forward-looking perspective to consolidate the results of health poverty alleviation and prevent widescale poverty return.
Assuntos
Características da Família , Pobreza , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários , China/epidemiologia , População RuralRESUMO
Prevalece na comunicação de massa a abordagem da doença com ênfase nos fatores de risco da contemporaneidade. O trabalho que fundamenta este artigo objetivou analisar a divulgação do estresse na mídia impressa a partir das perspectivas teóricas do risco, dos níveis de prevenção de doença, da vulnerabilidade e promoção de saúde. Trata-se de uma pesquisa qualitativa conduzida por meio de análise de conteúdo. Um percurso histórico-teórico, analisando notícias de jornais e estudos científicos, foi realizado a partir das categorias analíticas previamente definidas: estresse e risco em saúde; estresse e prevenção de doenças; estresse e vulnerabilidade; estresse e promoção de saúde. Constatou-se que a prevenção de doença ligada ao risco tem maior visibilidade na mídia impressa que a promoção de saúde relacionada à vulnerabilidade. Propõem-se ações que impulsionem as políticas públicas e mudanças estruturais para garantir direitos à saúde e combate ao estresse, fomentadas por meio da divulgação midiática com perspectiva crítica relativa ao entendimento das vulnerabilidades sociais e das potencialidades da promoção da saúde.
The approach of the disease with emphasis on contemporary risk factors prevails in the mass media. This article bases on a study to analyze the dissemination of stress in print media from the theoretical perspectives of risk, levels of disease prevention, vulnerability and health promotion. The study is a qualitative research using the content analysis. A historical and theoretical trajectory, analyzing printing news and scientific studies was carried out from these previously defined analytical categories: stress and health risk; stress and disease prevention; stress and vulnerability; stress and health promotion. It was found that risk-related disease prevention has greater visibility in the print media than health promotion related to vulnerability. We propose that actions promoting public policies and structural changes to ensure health rights and a fight against stress, fomented by means of media coverage, adopting a critical perspective on the understanding of social vulnerabilities and the potentialities of health promotion.
Prevalece en los medios de comunicación de masas el abordaje de la enfermedad con énfasis en los factores de riesgo de la contemporaneidad. Este artículo es basado en trabajo que ha tenido el objetivo de analizar la divulgación del estrés en los diarios impresos a partir de las perspectivas teóricas del riesgo, de los niveles de prevención de la enfermedad, de la vulnerabilidad y de la promoción de salud. Se trata de una investigación cualitativa utilizando el análisis de contenido. Una trayectoria histórico-teórica, analizando noticias de periódicos y estudios científicos, fue realizado a partir de las categorías analíticas previamente definidas: estrés y riesgo en salud; estrés y prevención de enfermedades; estrés y vulnerabilidad; estrés y la promoción de la salud. Se constató que la prevención de enfermedad relacionada con el riesgo tiene mayor visibilidad en los medios de comunicación impresos que la promoción de la salud relacionada con la vulnerabilidad. Proponemos acciones que permitam avanzar las políticas públicas y los cambios estructurales para asegurar los derechos a la salud y el combate al estrés, fomentados por medio de la divulgación mediática, con perspectiva crítica para el entendimiento de las vulnerabilidades sociales y de las potencialidades de la promoción de la salud.
