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<section style="box-sizing: border-box;font-style: normal;font-weight: 400;text-align: justify;font-size: 16px;" data-mpa-powered-by="gulangu"><section style="margin: 30px 0% 0px;text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;width: 95%;vertical-align: top;border-style: solid;border-width: 1px;border-radius: 0px;border-color: rgb(24, 54, 118);padding: 10px;box-sizing: border-box;"><section style="margin: -30px 0% 0px;box-sizing: border-box;" powered-by="gulangu"><section style="text-align: justify;font-size: 24px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><span style="background-color: rgb(255, 255, 255);box-sizing: border-box;"><em style="box-sizing: border-box;"><strong style="box-sizing: border-box;">导读</strong></em></span></p></section></section><section style="text-align: justify;font-size: 15px;color: rgb(95, 156, 239);line-height: 1.6;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">春节是中国最盛大、最热闹、最重要的传统节日，我们与家人同欢聚、共此时。值此新春佳节之际，“”祝大家新春快乐，鼠年大吉！在这个春节里，肚子吃饱了，也别忘了补充精神食粮哦~春节期间，我们特别推出规划人专“SHU”新春好礼——2019年会宣讲论文精选，以飨读者。</p></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 52%;padding: 0px 10px 0px 0px;box-sizing: border-box;"><section style="margin: 0px 0%;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;width: 100%;border-width: 0px 1px;border-style: solid dotted solid none;border-left-color: rgb(160, 160, 160);border-right-color: rgb(152, 152, 152);padding: 5px 0px 5px 10px;border-bottom-left-radius: 0px;border-top-right-radius: 0px;box-sizing: border-box;"><section style="text-align: justify;font-size: 14px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">本文字数：</strong><span style="color: rgb(95, 156, 239);box-sizing: border-box;">9043字</span></p></section><section style="text-align: justify;font-size: 14px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">阅读时间：</strong><span style="color: rgb(95, 156, 239);box-sizing: border-box;">25分钟</span></p></section></section></section></section><section style="display: inline-block;vertical-align: middle;width: 30%;padding: 0px;border-width: 0px;box-sizing: border-box;"><section style="font-size: 24px;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: top;border-width: 2px;border-style: dashed;border-color: transparent;border-radius: 100%;box-sizing: border-box;"><section style="width: 3em;height: 3em;border-radius: 100%;background-position: 0% 0%;background-repeat: no-repeat;background-size: 100%;background-image: url("http://mmbiz.qpic.cn/mmbiz_jpg/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bTlXRhZj5GciaXIhcP8CCoGtO3AhJ8ha6VCDGtMMiackJet4WsWFZWjLw/640?wx_fmt=jpeg");overflow: hidden;box-sizing: border-box;"><section style="height: 100%;overflow: hidden;line-height: 0;vertical-align: middle;max-width: 100%;box-sizing: border-box;"> <img data-ratio="1" data-w="1024" src="http://mmbiz.qpic.cn/mmbiz_jpg/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bTlXRhZj5GciaXIhcP8CCoGtO3AhJ8ha6VCDGtMMiackJet4WsWFZWjLw/640?wx_fmt=jpeg" style="width: 100%;height: 100%;opacity: 0;box-sizing: border-box;" width="100%" data-type="jpeg"  /></section></section></section></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;width: 100%;border-width: 0px 0px 0px 3px;border-style: solid;border-left-color: rgb(15, 60, 143);border-right-color: rgb(15, 60, 143);padding: 0px 10px;box-sizing: border-box;"><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">作者：</strong><strong style="box-sizing: border-box;">甘霖、王雅捷、加雨灵</strong></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">北京市城市规划设计研究院</p></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="margin-top: 10px;margin-bottom: 10px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="padding-left: 1em;padding-right: 1em;display: inline-block;text-align: center;box-sizing: border-box;"><span style="display: inline-block;padding: 0.3em 0.5em;border-radius: 0.5em;background-color: rgb(15, 60, 143);color: rgb(255, 255, 255);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">摘要</strong></p></span> </section><section style="border-width: 1px;border-style: solid;border-color: rgb(192, 200, 209);margin-top: -1em;padding: 20px 10px 10px;background-color: rgb(239, 239, 239);text-align: center;box-sizing: border-box;"><section style="text-align: justify;line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">城市化的最终目标是促进所有人的健康与发展，后工业化时代城市应回归为公众健康而规划的初衷，重视健康公平。研究从健康平等与健康公平的概念甄别出发，梳理国内外行动共识和研究共识；继而借助2018年北京市居民健康问卷调查展开健康公平性评价，运用集中指数识别出存在健康不平等风险的4类脆弱群体；最后针对底层弱势群体（老年/低学历/低收入）、边缘化人群（低学历/低收入/外来人口）、青年高知（青年/高学历）、中年中产（中青年/中高收入/中高学历/外地人和新北京人）4类群体，分别分析造成健康不公平的关键要素，探讨通过规划促进健康公平的可行策略。研究认为，健康公平视角下的脆弱群体不限于社会分层中的底层和边缘化人群，还涉及潜在高风险人群，任何一项规划的实施都可能影响到不同人群在健康方面的“机会可及性”，关注并持续改善健康公平的规划导向不仅关乎城市利贫与包容，更关乎城市的社会资本、劳动力和可持续发展。</p></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="margin-top: 10px;margin-bottom: 10px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="padding-left: 1em;padding-right: 1em;display: inline-block;text-align: center;box-sizing: border-box;"><span style="display: inline-block;padding: 0.3em 0.5em;border-radius: 0.5em;background-color: rgb(15, 60, 143);color: rgb(255, 255, 255);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">关键词</strong></p></span> </section><section style="border-width: 1px;border-style: solid;border-color: rgb(192, 200, 209);margin-top: -1em;padding: 20px 10px 10px;background-color: rgb(239, 239, 239);text-align: center;box-sizing: border-box;"><section style="text-align: justify;line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">健康公平；健康公平性评价；集中指数；脆弱群体</p></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;box-sizing: border-box;"><section style="width: 2.6em;height: 2.6em;display: inline-block;vertical-align: middle;line-height: 2.6em;border-radius: 50%;background-color: rgb(15, 60, 143);box-sizing: border-box;"><section style="width: 1.8em;height: 1.8em;line-height: 1.8em;border-radius: 50%;margin: 0.36em 0px 0.35em 0.44em;background-color: rgb(255, 255, 255);box-sizing: border-box;"><section style="width: 100%;height: 100%;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="margin: -0.5em auto 0.3em;width: 0px;border-top: 1.1em solid rgb(15, 60, 143);box-sizing: border-box;height: 1px;line-height: 0;border-left: 1em solid transparent !important;border-right: 1.12em solid transparent !important;"><br  /></section><section style="border-top: 2px solid rgb(15, 60, 143);display: inline-block;font-size: 21px;padding: 1px 5px 0px;color: rgb(15, 60, 143);letter-spacing: 2px;box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">引  言</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">现代城市规划起源于对公共健康问题的关注。工业化带来19世纪欧洲城市人口剧增，工业革命早期居民健康并没有因国民财富的积累而得到改善，反而因城市卫生环境恶化数次爆发大规模传染病，死亡率居高不下。直到1848年英国《公共卫生法案》颁布，城市规划作为政府干预公共卫生问题的手段得到重视。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">可以说，城市规划从诞生之始所秉承的终极目标就是促进人的健康和发展。</span></strong></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">过去、今天和未来的城市如何规划，始终深刻地影响着城市居民的寿命、健康和生产力。在工业化与城市化快速推进的进程中，健康并没有在规划中得到足够的重视。今天在城市系统高效运转的同时，出现了环境污染、交通安全、社会分层等一系列危机，引致不健康饮食、缺乏体力活动、非正规住房等都市危机，带来持续性增长的慢性疾病与城市问题。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;">毋庸置疑，后工业化阶段城市发展应以健康促进为导向，回归为公众健康而规划的初衷。在这一背景下，有必要充分评估既往规划实施对于公共健康的影响，特别是对于脆弱群体的影响，以“人人享有健康”为目标，重塑面向所有人的健康公平。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;box-sizing: border-box;"><section style="width: 2.6em;height: 2.6em;display: inline-block;vertical-align: middle;line-height: 2.6em;border-radius: 50%;background-color: rgb(15, 60, 143);box-sizing: border-box;"><section style="width: 1.8em;height: 1.8em;line-height: 1.8em;border-radius: 50%;margin: 0.36em 0px 0.35em 0.44em;background-color: rgb(255, 255, 255);box-sizing: border-box;"><section style="width: 100%;height: 100%;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">1</strong></p></section></section></section><section style="margin: -0.5em auto 0.3em;width: 0px;border-top: 1.1em solid rgb(15, 60, 143);box-sizing: border-box;height: 1px;line-height: 0;border-left: 1em solid transparent !important;border-right: 1.12em solid transparent !important;"><br  /></section><section style="border-top: 2px solid rgb(15, 60, 143);display: inline-block;font-size: 21px;padding: 1px 5px 0px;color: rgb(15, 60, 143);letter-spacing: 2px;box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">研究背景</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">1.1基本概念：健康平等与健康公平</strong></p></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">1996年世界卫生组织和瑞典国际开发合作署发布了《健康与卫生服务的公平性》，在这份倡议书中明确指出公平（equity）不等于平等（equality），由此引发“健康平等”与“健康公平”概念的甄别。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">基于既有研究共识，健康不平等（health inequalities）是指不同社会经济特征的人群之间健康状况的差异性，它在不同国家和不同地区之间普遍存在。这种差异性能够通过可观测的健康数据来衡量，但并非所有不平等都能定义为不公平[[1]]。因为健康不公平（health inequities）意味着存在不合理、可避免或不公正的健康差异，是一个伦理上的概念。与之相对的“健康公平”强调每一位社会成员均享有相等的机会达到其最佳的健康状态，其本质是“健康可及机会”的公平[[2]]。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">由此可见，“健康平等”强调的是缩小不同群体之间的健康差异，“健康公平”强调的是破除健康差异背后的机会分配不均。因此，<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">面向健康公平的规划研究重点应关注健康状态和健康决定因素的分布在不同人群中的差异，聚焦年龄、收入、社会地位等固有差异造成的资源可及性影响，在此基础上思考以城市规划来促进全民健康的可行干预路径。</span></strong></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">1.2理念演进：面向健康公平的城市发展观</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">早在几十年前的《阿拉木图宣言》和《渥太华宪章》中，国际社会既已认识到健康是一项基本人权，而健康公平是社会公平的重要方面[[3]]。通过梳理四十余年来具有标志性意义的若干共识性文件与共同行动，能够发现对健康公平的倡导和促进已由最初的部门之责演进为面向可持续发展的全球性城市共识。<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">在这一历程中，平等、充分参与、赋权、跨部门协作、跨地区共同行动等理念不断更新，城市规划在促进健康公平方面的关键性作用也一步步明晰。</span></strong></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="1.5231481" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0b1pljGye3k4oo75NPOklSbl9yYUFibm2gyiaLhfCJ0mLrlezg8HHqPxFA/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">表1国内外有关健康公平的共识性文件与共同行动中的关键性理念演进</p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">当前全球城市对于健康促进的普遍共识体现为WHO提出的“寓健康于万策(Health in All Policies，HIAPs)”，强调政府所有部门将健康作为制定政策的重要考量，这其中城市规划的关键性角色不言而喻。正如《健康城市上海共识》所明确的：“我们已认识到可持续发展目标3(人人享有健康)和可持续发展目标11(建设包容、安全、具抵御灾害能力、可持续发展的城市和人居环境)之间的紧密联系——充分发挥城市潜能，促进健康与福祉、消除健康不公平，共同推动这两个可持续发展目标的实现。”<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">城市对于健康的环境支持作用已得到全球普遍关注，而城市规划能够通过对空间资源的分配影响所有人的机会可及性，是塑造益于健康的城市环境最重要的力量。</span></strong></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">1.3研究共识：社会公平衍生的健康公平问题</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">对健康公平的研究普遍建立在一个共识之上，即造成健康不平等的原因不能单独通过服务覆盖不均等来解释，而是与社会因素具有密不可分的关系[[4]]。20世纪80年代英国发布《布莱克报告》（Black Report)），揭示健康服务覆盖率的提高并未使不同阶层间的死亡率差异减少，将健康不平等的根源归结为经济收入的不平等，并提供了虚假相关论、自然或社会选择论、唯物主义论、文化行为论四种解释[[5]]。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">事实上，影响健康公平的社会性因素不仅限于收入，而是建立在综合而广泛的社会分层结构之上。</span></strong>最具代表性的研究是分别于1967-1977年、1985-2008年开展的两期白厅研究（Whitehall Study and Whitehall Study II）。这一研究通过公务员健康调查证实职业阶层与健康有着非常重要的相关性，较高的死亡率和患病率倾向于发生在职位较低的公务员中，这一阶级倾斜现象与工作压力、岗位所能获得的支持、自身能力和信心、生活满意度等密切相关，揭示与工作有关的“可控感”对健康存在潜在影响[[6]]。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">城市规划领域中，健康公平研究普遍关注那些在社会经济属性中处于劣势的典型群体和典型地区，建立健康不平等在老人、女性、低收入人群、外来移民等群体中的人群印证，以及在城乡结合部、老城、乡村等地区中的空间印证。</span></strong>例如陈曦和冯建喜[[7]]通过污染物暴露分布与年龄结构分布的交叉分析，评估南京面向不同年龄人群的健康空间公平性；Corburn和Sverdlik[[8]]针对亚非拉地区若干城市贫民窟升级案例，揭示贫民窟改造中对综合健康效益的考虑能够为促进健康与社会公平提供机遇；Yuqi Z等[[9]]通过集中指数、集中曲线、逻辑斯蒂回归等定量研究方法比较了2010年和2014年中国各收入群体健康自评状况变化，证明在一系列健康促进措施下低收入人群健康不公平程度降低。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">目前健康公平视角下的城市研究刚刚兴起，研究成果多针对某类特定的弱势群体，关注社会公平衍生的健康公平问题。<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">从规划实施评估与应用的角度看，未来更需要综合考虑市民的多重社会属性，不仅关注既定的弱势群体，也发现潜在的健康脆弱群体，从全民公平角度挖掘城市健康的风险与抵御。</span></strong></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;box-sizing: border-box;"><section style="width: 2.6em;height: 2.6em;display: inline-block;vertical-align: middle;line-height: 2.6em;border-radius: 50%;background-color: rgb(15, 60, 143);box-sizing: border-box;"><section style="width: 1.8em;height: 1.8em;line-height: 1.8em;border-radius: 50%;margin: 0.36em 0px 0.35em 0.44em;background-color: rgb(255, 255, 255);box-sizing: border-box;"><section style="width: 100%;height: 100%;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">2</strong></p></section></section></section><section style="margin: -0.5em auto 0.3em;width: 0px;border-top: 1.1em solid rgb(15, 60, 143);box-sizing: border-box;height: 1px;line-height: 0;border-left: 1em solid transparent !important;border-right: 1.12em solid transparent !important;"><br  /></section><section style="border-top: 2px solid rgb(15, 60, 143);display: inline-block;font-size: 21px;padding: 1px 5px 0px;color: rgb(15, 60, 143);letter-spacing: 2px;box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">健康公平性评价的技术框架</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">研究基于2018年北京市居民健康问卷调查[1]数据展开健康公平性评价，在评价基础上发现当前存在的健康不平等风险，其技术框架涉及<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">健康指标的选择、社会层组的划分、测算方法的选择</span></strong>三个关键环节。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="1.0212963" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bNpWwHRBMH0yKC9DVYaK43MlVkdaqYJY91cLNcBCdnnR7dv9sib4xy5Q/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">2.1综合健康量表构建<br style="box-sizing: border-box;"  /></p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;">针对上述13个指标，分别设置区分相对健康和相对不健康的量化标准，如“不久坐”这一指标，量化的标准为每天连续坐着的时间不超过3小时，满足这一标准为相对健康，否则为相对不健康。所有指标的相对健康样本赋值为1，相对不健康样本赋值为0，保持指标数值的同向性。居民健康水平和生活方式的最终得分即所对应指标0/1赋值的加和，得分高代表综合健康水平相对较高。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">2.2社会层组划分</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;">结合相关研究结论[[10]][[11]][[12]]，提取4个影响健康公平的一般社会属性：年龄、收入、户籍、学历。根据这四个社会属性分别对1063个调查样本进行分组，并按照从低到高的顺序计算样本累计百分比。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="0.6037037" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bzIq3VT61jUx9HVghNoiac6PWsuEQI1Vp0CmpnCS94W5yJE8MCyHoOwA/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">表3：调查样本社会层组划分<br style="box-sizing: border-box;"  /></p><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">2.3集中指数与集中曲线</strong></p></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">常用于测度健康公平性的方法主要有极差法、洛伦兹曲线、基尼系数、集中指数、差别指数[13][14][15]等，本次选取集中指数(Concentration Index, CI)和集中曲线（Concentration Curve）作为评价工具。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;">集中指数[[16]]能够衡量与社会经济状况相联系的健康不公平程度，原理是根据健康水平在不同组别的分布绘制集中曲线。集中曲线横轴为根据社会经济地位排序的人数累计百分比，纵轴为各分组所对应的各项健康分值总和的累计百分比[3]。集中指数的数值等于集中曲线和公平线之间的面积的两倍，指数介于-1到1之间，绝对值越大表示不平等程度越高。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;box-sizing: border-box;"><section style="width: 2.6em;height: 2.6em;display: inline-block;vertical-align: middle;line-height: 2.6em;border-radius: 50%;background-color: rgb(15, 60, 143);box-sizing: border-box;"><section style="width: 1.8em;height: 1.8em;line-height: 1.8em;border-radius: 50%;margin: 0.36em 0px 0.35em 0.44em;background-color: rgb(255, 255, 255);box-sizing: border-box;"><section style="width: 100%;height: 100%;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">3</strong></p></section></section></section><section style="margin: -0.5em auto 0.3em;width: 0px;border-top: 1.1em solid rgb(15, 60, 143);box-sizing: border-box;height: 1px;line-height: 0;border-left: 1em solid transparent !important;border-right: 1.12em solid transparent !important;"><br  /></section><section style="border-top: 2px solid rgb(15, 60, 143);display: inline-block;font-size: 21px;padding: 1px 5px 0px;color: rgb(15, 60, 143);letter-spacing: 2px;box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">健康不平等的测度结果</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">3.1不同维度的健康不平等判别</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">研究采用stata分析软件对综合健康量表中7个领域分别计算集中指数与集中曲线，并检验CI不等于0的显著性，将P值小于0.05作为判别存在健康不平等的判据。根据集中指数的数值与集中曲线在不同组别的斜率，能够初步判读健康不平等的影响人群和影响程度。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">（1）与年龄有关的健康不平等体现在身体健康和心理健康2个健康领域，以及工作、饮食、锻炼3项生活习惯上。</span></strong>其中，身体健康的集中指数显示高龄组处于劣势，心理健康和生活习惯均显示中青年组处于劣势。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="0.4861111" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bia28iaccEapqM2esO3iaREX6M521wnr5x80hHLxkOB16GcWp30dO1yQFw/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">图1 与年龄有关的健康不平等现状（集中曲线和集中指数）</p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">（2）与学历有关的健康不平等体现在身体健康、心理健康、健康认知3个健康领域，以及工作、饮食2项生活习惯上。</span></strong>其中，身体健康和健康认知两项中低学历组处于明显劣势，而心理健康以及工作、饮食习惯两项中高学历组反而处于劣势。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"> </p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="0.4861111" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bCJAfXI4heCPxG8QoG6YwQ8CxWnenNFwO9oU79QnENPhbwlBMdr0wzw/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">图2 与学历有关的健康不平等现状（集中曲线和集中指数）<br style="box-sizing: border-box;"  /></p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">（3）与收入有关的健康不平等主要体现在健康认知与生活习惯上，身体健康与心理健康2项并不存在显著不平等。</span></strong>其中低收入组在健康认知方面处于劣势，而中等收入以上组别在生活习惯方面处于劣势。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="0.4842593" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bwe4X5d06QyiamVab2nnEUko17ecxVHm2XpG5UTQPkov8wiaQZbK9rJMQ/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">图3 与收入有关的健康不平等现状（集中曲线和集中指数）</p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">（4）与户籍有关的健康不平等同样体现为健康认知与生活习惯。</span></strong>其中，健康认知的劣势主要集中在外来人口组，与定期体检覆盖率低有关；生活习惯不健康问题主要集中在外来人口和新北京人，主要体现为加班、久坐、依赖外卖三项。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="0.4861111" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bVvwOuMJzic7SS3gbkT38SBboa2VHTiaZzOWqE86ywMKZu9BS5uLe56nw/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">图4 与户籍有关的健康不平等现状（集中曲线和集中指数）</p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">3.2脆弱群体与健康风险识别</strong></p></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;">从健康不平等的初步判读结果可以发现，如果以综合健康的视角来看，健康不平等不仅存在于老年人、低学历、低收入、外来人口等通常认知中的弱势群体，新北京人、青年高知、中年中产等群体也面临某一方面或某些方面的健康风险，成为城市化后期大都市生活中的潜在高风险人群。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;box-sizing: border-box;" powered-by="gulangu"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"><img data-ratio="0.5675926" data-w="1080" src="http://mmbiz.qpic.cn/mmbiz_png/3rV5DOkGgCbVviblLmr3JJ1LnZykoIq0bzZZylPcGovImfic5noqQPKQMFiaPAbSLBibzfic1CvRnnWLEr2ljh45iaAw/640?wx_fmt=png" style="vertical-align: middle;max-width: 100%;box-sizing: border-box;" data-type="png"  /></section></section><section style="text-align: center;line-height: 2;font-size: 14px;color: rgb(160, 160, 160);box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">表4 十三项健康指标的集中指数表</p></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;">表4显示各项健康指标的集中指数表，其中显示数字的是在95%显著水平上存在健康不平等的条目，蓝色代表典型弱势群体处于劣势，红色代表存在其他潜在高风险群体。从中可总结出几点结论：（1）在身体健康方面，健康不平等的劣势显著叠加于老年、低学历、低收入三类典型弱势群体之上；（2）在心理健康方面，青年高知人群值得特别关注，这一群体在精力匮乏、情绪低落、焦虑三方面均处于相对劣势，是城市化后期大都市生活带来的潜在健康高风险人群；（3）在健康认知方面，市民对于自身健康的评价不存在显著差异，但是在每年定期体检这项中，低学历、低收入、外地人的机会可及性较差，意味着城市医疗资源存在普惠性不足、成本门槛和户籍排斥；（4）在生活习惯方面，中青年、中高收入、中高学历、外地人或新北京人四类属性对应着更为不健康的生活方式，这一群体是当前北京城市生活中“沉默的大多数”，其健康危机集中表现为加班、久坐、依赖外卖、缺乏运动等不健康的生活方式。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;box-sizing: border-box;"><section style="width: 2.6em;height: 2.6em;display: inline-block;vertical-align: middle;line-height: 2.6em;border-radius: 50%;background-color: rgb(15, 60, 143);box-sizing: border-box;"><section style="width: 1.8em;height: 1.8em;line-height: 1.8em;border-radius: 50%;margin: 0.36em 0px 0.35em 0.44em;background-color: rgb(255, 255, 255);box-sizing: border-box;"><section style="width: 100%;height: 100%;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">4</strong></p></section></section></section><section style="margin: -0.5em auto 0.3em;width: 0px;border-top: 1.1em solid rgb(15, 60, 143);box-sizing: border-box;height: 1px;line-height: 0;border-left: 1em solid transparent !important;border-right: 1.12em solid transparent !important;"><br  /></section><section style="border-top: 2px solid rgb(15, 60, 143);display: inline-block;font-size: 21px;padding: 1px 5px 0px;color: rgb(15, 60, 143);letter-spacing: 2px;box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">影响健康公平的关键性规划要素及改善方向</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">如上所述，健康不平等一部分来源于人群的固有属性（例如老年人面临更高的慢性病发病率等），一部分可溯源到背后的不公平因素。<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">面向公共健康的城市规划应致力于减少因不公平而产生的健康差异，</span></strong>以上文分析得出的四类健康脆弱群体为例，首先应明确健康不公平性的可能来源以及影响因素，进一步得出面向健康脆弱群体的规划要点。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">4.1面向底层弱势群体：把握老旧贫弱社区的更新机遇</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">“底层弱势群体”的社会属性是老年、低学历、低收入为主，面临的健康风险主要是身体健康，如慢性病、超重肥胖、活动受限等。这一群体天然处于资源利用和机会分配的劣势，<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">而加剧其健康不公平的因素之一，是城市发展过程中被滞留在老旧、低成本、更新缓慢的“剩余空间”内。</span></strong>六普分街乡人口结构数据和城乡低保公示数据显示，北京老龄、贫困、低学历比重最高的地区是老城、远郊村和单位大院集中的近郊地区，多数面临着住房条件衰败、公共空间和服务设施短缺、街区封闭导致低步行可达性等特征。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">面向此类人群的健康促进规划重点是把握城市更新机遇，在更新改造程序中引入健康影响评估</span></strong>（health impact assessment, HIA）[[17]]，充分分析改造方案和实施政策对健康的影响，以及这些影响在人群中的分布，优先满足弱势群体的健康需求。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">4.2面向边缘化人群：正视空间覆盖背后的制度隔离</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">“边缘化人群”的社会属性是低学历、低收入、外来人口为主，三者面临的共同健康风险主要体现为定期体检机会受限导致的低水平健康感知，埋下较高的突发疾病风险。这一群体大多属于低就业技能的城市贫民和流动人口，绝大多数被排斥在社会保障体系之外，不能获得基本公共服务。<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">造成这类人群健康不平等的因素主要是锚固于户籍制度之上的医疗服务，从规划的角度进一步挖掘，能够溯源到基于户籍人口测算基本公共服务配套指标的合理性，以及设施可达性评估中对于制度性隔离的忽视。</span></strong></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">面向此类人群的规划改善要点是重视跨部门合作及制度输出，充分认识到健康促进是一个综合治理目标，需要在所有可能影响健康的公共政策中秉承“寓健康于万策”的原则。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">4.3面向青年高知：回应小众人群的健康需求</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">“青年高知”主要指城市中年轻的高学历人群，面临的健康风险主要集中在心理健康层面。北京每年吸引大量高校毕业生流入，但城市对于青年高知人群的核心吸引力主要是就业机会而非城市环境。传统规划很少思考什么构成了一个“青知友好”城市的必要素质，事实上，不同的社会属性决定了迥异的空间与设施利用偏好，在问卷调查的一些回答中可见端倪：在锻炼地点的选择中，超过50%的青年高学历受访对象选择了工作地周边而不仅仅在居住地周边；在锻炼场所的选择中，青年高学历受访对象选择最多的是上下班路上（40%），其次是公园（33%）和健身房（30%），选择小区建设器材仅占8%；对于需要补充的健身设施，49%的青年高学历受访对象建议增加操场跑道。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;">由此可见，<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">传统的围绕居住小区配置健身设施和广场绿地的规划手法并未给青知阶层提供一个鼓励体力活动的日常环境。</span></strong>体育锻炼只是其中一个侧面，综合来看，青知阶层在承担超大城市就业生活的压力之外，很少能够从城市环境、步行体验、社区氛围中汲取积极生活的愉悦感，这才是这一群体心理健康风险背后急需干预的环境要素，要求更加精细化和人性化的规划引导，根据亚人群的需求细化健康城市的实施要求。</p><p style="margin: 0px;white-space: normal;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;vertical-align: middle;width: 5%;box-sizing: border-box;"><section style="margin-top: 10px;margin-bottom: 10px;font-size: 13px;text-align: left;box-sizing: border-box;" powered-by="gulangu"><section style="width: 0.6em;display: inline-block;vertical-align: middle;box-sizing: border-box;"><span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.2;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 0.6;margin: 2px 0px;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> <span style="width: 0.6em;height: 0.6em;display: block;opacity: 1;background-color: rgb(15, 60, 143);box-sizing: border-box;"></span> </section><section style="display: inline-block;vertical-align: middle;font-size: 10px;padding-left: 5px;color: rgb(15, 60, 143);box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section></section></section><section style="display: inline-block;vertical-align: middle;width: 95%;box-sizing: border-box;"><section style="color: rgb(15, 60, 143);padding: 0px;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">4.4面向中年中产：促进体能活动和健康生活的规划设计</strong></p></section></section></section><section style="line-height: 2;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;">“中年中产”是对中青年、中高收入、中高学历、外地或新北京人的一个泛称，这一群体数量可观，是构成当前城市社会资本和人力资本的主体，所面临的共同健康风险是以加班久坐、依赖外卖、缺乏锻炼为主要表现的生活方式不健康。其背后存在的健康不公平要素涉及到效率主导的大都市运转模式、竞争性筛选的市民权分配、国民健康素养和健康意识不足等，将加班、久坐、吃外卖等不利行为作为习惯甚至文化广泛而长期地固化下来。</p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">处于全球城市竞争金字塔尖的很多大城市已开始认识到超大城市所附带的健康危机，</span></strong>北京并非个例。2010年纽约发布城市公共健康空间设计导则，鼓励市民选择步行、骑行等积极出行方式，提倡将体能锻炼融入日常生活的健康生活方式。2013年洛杉矶颁布健康城市建设手册，针对引发慢性病的源头提出了积极出行、健康饮食和社区营造三个健康策略。<strong style="box-sizing: border-box;"><span style="color: rgb(139, 0, 0);box-sizing: border-box;">借鉴其经验，北京应尽快制定相应的健康城市规划设计导则，促进体能活动、健康饮食和健康工作，倡导积极健康的现代城市生活方式。</span></strong></p><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="font-size: 14px;color: rgb(160, 160, 160);line-height: 1.6;box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">参考文献</strong>（向下滑动查看）</p></section><section style="text-align: center;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;width: 100%;height: 240px;vertical-align: top;overflow-y: auto;box-sizing: border-box;-webkit-overflow-scrolling: touch;"><section style="overflow-x: hidden;box-sizing: border-box;"><section style="margin: 20px 0% 0px;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;border-width: 2px;border-style: solid;border-color: rgba(213, 209, 209, 0);padding: 0.1em 0.3em;color: rgb(160, 160, 160);font-size: 14px;text-align: left;box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[1] 北京市居民健康线上问卷调查为《北京市健康城区规划纲要研究》课题开展的面向北京市民的线上调查，于2018年9月通过问卷星网站在线发放，回收有效问卷1063份，采集了身体健康、心理健康、生活方式等方面综合信息。</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[2] 按照问卷获取的家庭可支配收入分组</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[3] 集中曲线类似于洛伦兹曲线，分配完全均等的情况下呈现为一条直线，若实现完全的健康公平，则集中曲线与公平线重合；若较低组别处于健康劣势，集中曲线将位于公平线以下；若较高组别处于健康劣势，集中曲线位于公平线以上。</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[1]] Whitehead M. The concepts and principles of equity and health[J]. International Journal of Health Services,1992, 22(3):429-445.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[2]] Braveman P, Gruskin S. Defining equity in health[J]. Journal of epidemiology and community health, 2003,57(4):254-258.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[3]] 杨玉洁, 雷海潮. 国外健康城市建设的新进展与启示[J]. 医学与社会, 2016, 29(8).</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[4]] 郭岩, 谢铮. 用一代人时间弥合差距——健康社会决定因素理论及其国际经验[J]. 北京大学学报(医学版), 2009, 41(2):125-128.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[5]] 李鲁.社会医学[M].人民卫生出版社,2012:128-132</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[6]] Marmot M G, Smith G D, Stansfeld S, et al. Health inequalities among British civil servants: the Whitehall II study.[J]. Lancet, 1991, 337(8754):1387-1393.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[7]] 陈曦, 冯建喜, Plaut P . 基于暴露视角的城市健康空间公平性研究——以南京为例[J]. 城乡规划, 2018(03):31-37.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[8]] Corburn J, Sverdlik A. Slum Upgrading and Health Equity[J]. International Journal of Environmental Research & Public Health, 2017, 14(4):342-355.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[9]] Yuqi Z , Xi Y , Weiyan J . Improving health equity: changes in self-assessed health across income groups in China[J]. International Journal for Equity in Health, 2018, 17(1):94-107</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[10]] 黄聚云 . 上海地区户籍与非户籍人口健康压力的比较研究[J]. 中国卫生事业管理, 2018.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[11]] 张蕾. 精神健康与生活质量——城市弱势群体的社会学关注[J]. 武汉大学学报（哲学社会科学版）, 2007, 60(2):292-297.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[12]] 陈春, 陈勇, 于立, 等. 为健康城市而规划:建成环境与老年人身体质量指数关系研究[J]. 城市发展研究, 2017(04):13-19.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[13]] 孙祺, 饶克勤, 郭岩. 选用不同的健康指标对健康公平指数的影响[J]. 中国卫生统计, 2003, 20(4).</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[14]] 陈家应, 严非, 舒宝刚,等. 差别指数用于居民健康公平性评价[J]. 中国卫生资源, 2001, 4(4):161-163.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[15]] 王敏. 四川省城市居民健康公平性探讨[D]. 四川大学, 2005.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[16]] 饶克勤, 姚岚, 秦立轩. 健康公平的测量方法[J]. 中国卫生经济, 1998(12):30-32.</p><p style="margin: 0px;padding: 0px;box-sizing: border-box;">[[17]] 刘吉祥, 周江评. 迈向健康导向的城市规划:来自美国健康影响评估的启示[J]. 城乡规划, 2018(03):10-16.</p></section></section></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;margin: 0px 0%;box-sizing: border-box;" powered-by="gulangu"><section style="display: inline-block;width: 140px;height: 70px;vertical-align: top;overflow: hidden;background-image: url("http://mmbiz.qpic.cn/mmbiz_gif/BbJk29Kd4m0pqomeI4h7KI25ymxF05hVjFH1FTNkTtYsHibGYdVIC2kY67uTYIljCW40esnhkU8hD92wTt8SR2g/640?wx_fmt=gif");background-position: 50% 50%;background-repeat: no-repeat;background-size: contain;background-attachment: scroll;box-sizing: border-box;"><section style="margin: 20px 0% 0px;box-sizing: border-box;" powered-by="gulangu"><section style="color: rgb(255, 255, 255);font-size: 18px;box-sizing: border-box;"><p style="margin: 0px;padding: 0px;box-sizing: border-box;"><strong style="box-sizing: border-box;">END<br style="box-sizing: border-box;"  /></strong></p></section></section></section></section><section style="box-sizing: border-box;" powered-by="gulangu"><p style="white-space: normal;margin: 0px;padding: 0px;box-sizing: border-box;"><br style="box-sizing: border-box;"  /></p></section><section style="text-align: center;padding-top: 0.65em;box-sizing: border-box;" powered-by="gulangu"><section style="width: 100%;height: 1px;background-color: rgb(15, 60, 143);box-sizing: border-box;line-height: 0;"><br  /></section><section style="margin-top: -0.65em;box-sizing: border-box;"><section style="display: inline-block;vertical-align: top;height: 1.3em;line-height: 1.3em;padding: 1px 8px 0px;border-left: 3px solid rgb(15, 60, 143);border-right: 3px solid rgb(15, 60, 143);background-color: rgb(255, 255, 255);border-top-color: rgb(15, 60, 143);border-bottom-color: rgb(15, 60, 143);box-sizing: 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