The multidimensional relative poverty of rural older adults in China and the effect of the health poverty alleviation policy

Abstract

IntroductionAlthough, especially in the past decade, poverty measurement approaches have been duly developed in two paths (from unidimensional to multidimensional poverty and from absolute to relative poverty), merely a few studies have focused on the combination of both perspectives. However, with global aging, poverty among older adults simultaneously presents multidimensionality and relativity characteristics. This paper explores a multidimensional relative poverty index (MRPI) relative to the aged group in four dimensions, namely, health, social, mental, and material, and then empirically evaluates the specific effects on the MRPI of one of the key targeted anti-poverty policies, that is, the health poverty alleviation policy (HPAP), which includes public health service, medical expense reimbursement, rewarding assistance, basic medical insurance, and so on.MethodsUsing pooled cross-sectional data of poverty alleviation from 2014 to 2020 with a total of 83,521 observations aged 60+ in County J, Shaanxi Province in China, we calculate the MRPI for the older adults via a fuzzy set approach. Statistical difference testing is used to analyze the characteristics and trends of the MRPI. In policy evaluation, to address endogenous problems, the treatment effect model based on Heckman's two-stage regression and finite distributed lag model are used with a controlled township cluster structure.ResultsFrom 2014 to 2020, the MRPI shows a significant upward trend for older adults in rural China, and the health component takes the dominant MRPI position. Empirically, we find that the HPAP can significantly alleviate the MRPI of older adults. Furthermore, among the health poverty alleviation measures, basic medical insurance is the most effective anti-poverty policy to support older adults. Specifically, empirical evidence shows that there is a more statistically significant reduction in the MRPI with the HPAP for the sub-group of older adults with chronic diseases or disabilities.ConclusionBoth relativity and multidimensionality should be emphasized when analyzing poverty vis-à-vis the aging society, and for this, the MRPI is one of the effective tools. Comparing the relativity with the aged group engenders a more accurate understanding of their poverty situation. Moreover, the importance of the health component among all the four dimensions is more conducive to the detailed analysis of their poverty. The empirical analysis results show that regarding poverty reduction approaches in China, developing integrated health promotion systems is necessary and imminent, especially in the long run, such as long-term care insurance that covers typical disabled older adults with chronic diseases.

Establishment of an Index System for Multidimensional Health Poverty in Post-Poverty Alleviation Era in China: Delphi Method and Analytic Hierarchy Process

“…Studies on MHP have selected indicators of cardiovascular risk, health status, life expectancy, and malnutrition [11,12]. Studies on multidimensional poverty have included indicators of income, health, education, living conditions, social security, and social participation [48][49][50][51]. Nevertheless, a literature analysis and expert consultation revealed that MHP is not the only unhealthy state.…”

Relationship between the health poverty vulnerability and multimorbidity patterns identified with latent class analysis aged 45 years or more adults in Northwestern China: A cross-section study

“…[ 16 ] As the age group increased, HPV increased, [ 52 ] whereas the education level acted the opposite. [ 52 , 53 ] A study [ 54 ] showed that household resource endowment and labor force, such as cultivated lands [ 55 ] and livestock raised, will decrease the risk of relative poverty. [ 54 ] Registered poor households and catastrophic medical expenses increased HPV, consistent with a previous study.…”

“…[52,53] A study [54] showed that household resource endowment and labor force, such as cultivated lands [55] and livestock raised, will decrease the risk of relative poverty. [54] Registered poor households and catastrophic medical expenses increased HPV, consistent with a previous study. [16] The number of adults with chronic disease in households was a protective factor in this study, slightly different from our findings.…”

Spatial and temporal differences and convergence analysis of multidimensional relative poverty in ethnic areas

“…Subsequent scholars have expanded the definition of relative poverty and absolute poverty to continuously enrich the theoretical study of multidimensional relative poverty. In analyzing poverty in an aging society, Weihong Zeng defines relative poverty as the relative deprivation of an individual in a certain situation versus the highest situation [ 5 ]. Compared with multidimensional poverty and relative poverty, multidimensional relative poverty reflects the comprehensiveness of multidimensional poverty in measuring poverty from multiple dimensions and highlights the subjectivity of relative poverty in identifying poverty based on the average income level of society [ 6 ].…”