Regional health-care inequity in children’s survival in Zhejiang Province, ChinaReport as inadecuate

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International Journal for Equity in Health

, 15:188

First Online: 17 November 2016Received: 26 May 2016Accepted: 31 October 2016DOI: 10.1186-s12939-016-0470-1

Cite this article as: Zhang, W., Chen, D., Zhou, H. et al. Int J Equity Health 2016 15: 188. doi:10.1186-s12939-016-0470-1


BackgroundChina is now under a period of social transition, and inequity is evident in the field of health care. We aimed to investigate regional health-care inequalities in children’s survival in Zhejiang Province, China.

MethodsIn our study, monitoring data of Zhejiang Province from 2005 to 2014 was collected. The flow of data collection of community-district-city for urban areas or village-township-county rural areas was followed. The factors affecting equity was analyzed including regional economical level and household registry. We adopted standard measures of concentration curve and concentration index to evaluate degree of income-related inequity and the trend of mortality changes.

ResultsFrom 2005 to 2014, overall mortality rate in children under five decreased, and regional disparity reduced markedly, and with a reduced disparity of mortality rate among children from urban and rural areas. In 2014, the mortality rate in children from urban and rural areas was similar. In contrast, the mortality rate in the children from migrant population was more than two folds of that in the children from native residency 7.82 ‰ vs. 3.89 ‰. The mortality rates of newborns rs = −0.396, P < 0.001, infants rs = −0.553, P < 0.001 and children under five rs = −0.568, P < 0.001 were all negatively correlated with per capita GDP in different regions. CI in the newborns, infants and children under 5 years was −0.105, −0.107 and −0.118, respectively. The concentration curve was near to equity curve. The concentration curve was near to equity curve. The mortality rate of children was negatively related with economical level in this study.

ConclusionsThe survival status was near to equity. Regional economical development can improve children’s survival but it was not the only social determinant. Migrant population will be the future monitor focus for reducing disparity on healthcare and increase equity in children’s survival.

KeywordsHealth-care inequality Survival Children Mortality rate Per capita GDP AbbreviationsCCConcentration curve

CIConcentration index

GDPGross domestic product

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Author: Weifang Zhang - Dingwan Chen - Huan Zhou - Yanhua Xu - Zhuopu Xu - Ying Ying - Zhengyan Zhao


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