《保险研究》20220701-《人口老龄化下的寿命延长伴随健康水平下降吗？》（王晓军、黄子航、秦澄莹）

［摘   要］本文基于2010年和2020年人口普查提供的老年人死亡率和健康自评数据,采用预期余寿、健康预期余寿和自理预期余寿度量人口的综合健康水平,比较老年人在年龄、性别和城乡维度上健康水平的差距及其随时间的变化,并通过因素分解,挖掘影响差距和变化的原因,寻找老年人生命长度与生命质量变化的关系,回答老年人在寿命增长中是否伴随着健康期压缩的问题。研究发现:10年间我国60岁以上人口预期余寿的增加伴随着完全健康生存期的大幅提升、基本健康生存期的小幅改善、不健康但生活能自理生存期的缩短以及生活不自理生存期的微弱提升,存在不健康期和不自理期的压缩现象；同龄老年人口健康预期余寿和自理预期余寿的提升速度高于预期余寿,生命质量的提升快于生命长度的延长速度；城市老年人口的预期余寿、自理预期余寿和健康预期余寿高于乡村；女性自理预期余寿高于男性,但健康预期余寿呈现交叉特征,女性尤其是乡村女性有较长的不健康生存期。

［关键词］预期余寿；健康预期余寿；自理预期余寿；城乡差距；因素分解

［基金项目］本文受到教育部哲学社会科学研究重大课题攻关项目“健康中国2030背景下的健康老龄化体系优化研究”的支持。

［作者简介］王晓军，中国人民大学应用统计科学研究中心、中国人民大学统计学院教授；黄子航，中国人民大学统计学院博士研究生；秦澄莹(通讯作者)，中国人民大学统计学院硕士研究生。

Is Longer Life Expectancy Accompanied by a Decline in Health in an Aging Population?

WANG Xiao-jun,HUANG Zi-hang,QIN Cheng-ying

Abstract：Based on the mortality and self-evaluation data of the elderly from the sixth and seventh national population censuses,this paper used life expectancy,healthy life expectancy and disability-free life expectancy to measure the overall health level of the population,and compared the health level gap of the elderly in terms of age,gender and urban and rural dimensions and their changes over time.Through factor decomposition,the factors affecting the gap and change were explored to find the relationship between life length and life quality change of the elderly,and to answer the question whether the increase of life span of the elderly was accompanied by health compression.The results show that the increase of life expectancy of the elderly in China during the past 10 years is accompanied by a significant increase in the completely healthy survival period,a small improvement in the basic healthy survival period,a shortening of the unhealthy but self-supporting survival period and a slight increase in the non-self-supporting survival period,and there is a compression phenomenon of the unhealthy period and the non-self-supporting survival period.For the elderly of the same age,the speed of improvement in terms of the healthy life expectancy and the disability-free life expectancy is higher than the life expectancy,and the improvement of life quality is faster than the extension of life length.Life expectancy,disability-free life expectancy and healthy life expectancy of the same age elderly population are higher in urban areas than in rural areas.The disability-free life expectancy of females is higher than that of males,but the healthy life expectancy shows crossover characteristics.Females,especially rural females,experience a longer period of unhealthy life.

Key words：life expectancy;healthy life expectancy;disability-free life expectancy;gap between urban and rural areas；factor decomposition method