A Spatial-Temporal Analysis of Health Care and Mortality Inequalities in China

Two geographers specializing in China analyze that country’s health care inequality from 1990 to 2008, for the purpose of: (1) examining spatial-temporal variations of health care inequality at multiple scales (the regional, provincial, and county levels); (2) exploring whether economic growth and transition to a market economy have exacerbated the unevenness of health care; and (3) analyzing the impact of health care inequality on health outcomes, especially mortality. The authors apply GIS-based spatial statistical methods to detect spatial-temporal patterns of health care, and use multilevel regression to examine the linkages between health care, mortality, and regional economic inequality, and ultimately to assess the sensitivity of health care inequality to geographic scale and examine whether reforms implemented to date have resulted in more equitable access to health care. The paper also demonstrates how the concurrent transitions of decentralization, marketization, globalization, and urbanization in China have interactively contributed to health care inequality and mortality