Examining multidimensional health poverty and determining factors among rural women of childbearing age in ningxia, china.

BACKGROUND: The multidimensional health poverty afflicting rural women of reproductive age bears profound implications for the sustainable development of families, societies, and healthy villages. Elucidating vulnerable groups at risk of multidimensional health poverty and delineating its determinants can inform refinements and implementation of health-poverty alleviation policies. METHODS: Based on the 2022 "Health Status and Health Service Utilization" survey data in rural Ningxia, China, this study analyzes the dimension of health status, capacity for health service utilization, health expenditure and security using the A-F dual-threshold method, logit model, and probit model. It comprehensively evaluates multidimensional health poverty and analyzes its determining factors among rural women of childbearing age. RESULTS: With k set at 0.3, the health multidimensional poverty index, incidence, and intensity among rural women of reproductive age were 0.021, 0.053, and 0.392, respectively. Chronic illness, capacity for free gynecological examination utilization, health examination utilization, and borrowing due to illness contributed significantly to multidimensional health poverty. Risk factors for multidimensional health poverty among rural women of childbearing age include age, unemployment, family size, and lack of sanitary toilets. Protective factors include being married, educational level, non-farm or student occupation, receiving government support, separate housing and kitchen, owning a television and computer. CONCLUSIONS: Even with the elimination of absolute poverty, the multidimensional health poverty situation among rural women remains important from a gender perspective. It is recommended to strengthen economic assistance and health service support for these groups, improve the level of rural health services from a gender perspective, and enhance housing structure and sanitation toilet usage in rural areas. Efforts should be made to narrow the digital divide in rural areas and promote digital health education. Pre-interventions on multidimensional health poverty can provide new pathways for the development, empowerment, and well-being of rural women of childbearing age.

Association between sanitary toilets and health poverty vulnerability among rural western Chinese adults aged 45 years and older: A cross-sectional study.

This study aimed to investigate the association between sanitary toilets and health poverty vulnerability among rural western Chinese adults aged 45 years and older. Using data from the 'Rural Household Health Inquiry Survey' conducted in 2022, a three-stage feasible generalized least squares method was employed to calculate health poverty vulnerability. Propensity score matching (PSM) and mediation effect analysis were used to assess the association between sanitary toilets and health poverty vulnerability among rural western Chinese adults aged 45 years and older and the mechanisms underlying this impact. This study revealed that the use of sanitary toilets was significantly associated with decreased health poverty vulnerability in adults over 45 years of age. Heterogeneity analysis revealed that this effect was more pronounced among males (ß = -0.0375, P<0.05), those aged 60-74 years (ß = -0.0476, P<0.05), and households with middle income (ß = -0.0590, P<0.01). Mediation effect analysis identified total household income (a×b = -0.0233, P<0.05), household size (a×b = -0.0181, P<0.01), number of household laborers (a×b = -0.0107, P<0.01), and registered poor households (a×b = -0.0081, P<0.01) as the mediating factors between sanitary toilets and health poverty vulnerability. The provision of sanitary toilets has been instrumental in mitigating health-related poverty among middle-aged and elderly people residing in rural areas. By improving household livelihood capital, the vulnerability of these individuals to health-related poverty can be significantly reduced.

Association between cooking with solid fuels and depressive symptoms among middle-aged and older adults in China: The mediating effect of the residential environment.

BACKGROUND: Depression is a common issue among elderly people in both developing and developed countries. Existing research indicates that cooking with solid fuels has a negative impact on the mental health of middle-aged and elderly people (aged 45 and older). However, the potential role of the residential environment in this process is not yet clear. Clarifying this issue may help identify effective interventions to improve public health for elderly people. This study aimed to explore the association between cooking with solid fuels and depressive symptoms, as well as the potential mediating role of the residential environment in this relationship. METHOD: This study utilized cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) for 2020, involving approximately 19,000 respondents aged 45 years and older. Propensity score matching (PSM) was used to explore the association between cooking with solid fuels and depressive symptoms. Additionally, a range of potential covariates were adjusted, and the Sobel test was applied to assess the potential mediating effect of the residential environment on this relationship. RESULTS: According to the fully adjusted model, cooking with solid fuels was significantly associated with an increased risk of depressive symptoms in middle-aged and older adults (ß = 0.315, P < 0.001), and this finding was confirmed through robustness tests using different propensity score matching methods. Heterogeneity analysis revealed that this association was particularly significant among men (ß = 0.318, P < 0.001), those aged 60-74 (ß = 0.347, P < 0.001), and individuals with a middle school education (ß = 0.353, P < 0.001). Mediation effect analysis revealed that indoor cleanliness (ß = 0.0090, P < 0.001), indoor broadband coverage (ß = 0.0077, P < 0.001), and the installation of indoor air purifiers (ß = 0.0010, P < 0.1) mediated the relationships between cooking with solid fuels and depressive symptoms. CONCLUSION: Given the growing attention given to improving indoor environments and enhancing mental health, the findings of this paper highlight that improving indoor cleanliness, increasing broadband coverage indoors, and installing air purifiers can effectively intervene in and prevent depressive symptoms caused by cooking with solid fuels.

A study on the factors influencing the vulnerability of women of childbearing age to health poverty in rural western China.

The health of women of childbearing age in rural areas is crucial for the development of individuals, families, and society. Research on the identification and influencing factors of health vulnerability in impoverished and disadvantaged groups is important for adjusting and implementing health poverty alleviation policies. However, there is limited research on the health vulnerability of women of childbearing age in rural Western China. Based on panel data from the Rural Residents' Family Health Status Survey in 2019 and 2022, the vulnerability to health poverty of women of childbearing age in rural areas was constructed using the three-stage feasible generalized least squares method. Variables from four dimensions-physical capital, financial capital, social capital, and human capital-were included in the sustainable livelihood analysis framework for analysis. The Tobit model was used to analyze the influencing factors of vulnerability to health poverty among women of childbearing age in rural Western China, and the contribution rates of various factors were studied using the Shapley value decomposition method. In 2019 and 2022, under the poverty line standards of $1.90 and $2.15, respectively, the vulnerability to health poverty among rural women of childbearing age exceeded 20%. Tobit regression analysis revealed that the type of drinking water being well water significantly increased the vulnerability to health poverty of rural women of childbearing age (P < 0.05), whereas the separation of housing and kitchen, registered poor households, household loans, annual per capita household income, expenditures on social interactions, educational level, self-assessed health status, respondent age, and the utilization of hospital services significantly reduced the vulnerability to health poverty of rural women of childbearing age (P < 0.05). Shapley's decomposition shows that annual per capita household income, expenditures on social interactions, respondent age, and household loans are the factors contributing most to the vulnerability to health poverty of rural women of childbearing age, while other variables have a smaller contribution rate. The health poverty situation of women of childbearing age in rural Western China is not optimistic. Preintervention for health poverty should be strengthened among rural women of childbearing age, early warning mechanisms for the risk of falling back into poverty due to illness should be established, the precise identification of highly vulnerable rural women of childbearing age should be improved, and the medical insurance system for rural women of childbearing age should be enhanced to help improve their current health poverty situation.