探究社會養老保險對老年人的健康影響與配偶效果：以中國大陸?例

Abstract

改善老年人的健康是所有國家在面對老齡化社會時的重要議題，而影響老年人健康狀況的因素有很多，其中之一便是收入安全。很多國家透過實施社會養老保險政策來保障老年人的收入安全，這種社會養老保險通常會給予未參保勞工保險的老年人每個月一定的養老金收入，例如中國大陸于2009年所開始推行的新型農村養老保險政策。 本研究以中國大陸新農保政策?依託，探究這種社會養老保險政策對老年人的健康影響，而蒐集相關研究後發現，過往對於配偶擁有新農保是否也會對自身健康產生影響探討較少，在夫妻關係中，新農保政策的效果?何仍待回答，因此本研究藉助互賴理論的框架進一步探究這種配偶效果。 在研究方法上，本研究利用「中國健康與養老追蹤調查」資料庫，篩選出擁有農村戶口的夫妻樣本，利用差異中之差異法估計新農保政策對在有開展村中的老年人之健康影響，同時利用工具變數法估計新農保政策對擁有新農保收入的老年人之健康影響，以及配偶擁有新農保收入對老年人自身的健康影響。 本研究發現，在當地開展新農保政策後，農村老人相比之下在日常生活活動中需要他人幫助的機率更低，發生抑鬱情緒的頻率也更低，同時身體質量指標狀況相比之下更好。擁有新農保收入的參保老人同樣得到了身體狀況和精神健康上的改善。對於新農保政策的配偶效果，本研究發現，配偶擁有新農保收入增加了老年人自身日常生活活動需要他人幫助的機率，同時字詞回憶能力有所下降，然字詞回憶能力代表的是短期的記憶能力，對長期的記憶力狀況解釋力有限。這些政策效果也都存在不同的地區差異和性別差異。 本研究認?，透過保障老年人收入安全能有效改善其健康，只是需要考慮到其中的配偶效果，儘管本研究發現的配偶效果是負面的，但其中的機制仍未可知，建議未來研究可進一步探討其中的機制。

Improving the health of the elderly is an important issue for all countries in the face of an aging society, and one of the many factors that affect the health status of the elderly is income security. Many countries have implemented social pension insurance policies to ensure the income security of the elderly, which typically provide a monthly pension income to the elderly who are not covered by labor insurance, such as the New Rural Pension Scheme(NRPS) in mainland China, which was introduced in 2009. This thesis explores the health effects of social pension on the elderly based on the New Rural Pension Scheme in mainland China and discovers that there has been little research on whether partner’s social pension income also affects their health. What effect the NRPS will have on a husband and wife's relationship remains to be answered, thus this thesis also explores the partner effects of NRPS based on the interdependency theory. In terms of research methodology, this thesis screens a sample of couples with rural hukou using the China Health and Retirement Longitudinal Study database, and use difference-in-difference methods to estimate the health effects of the NRPS on the elderly by comparing villages that did and did not implement NRPS. In addition, instrumental variable methods are used in this thesis to estimate the health effects of NRPS on the insured elderly with pension income. The health effects of partner's pension income on the elderly are also estimated using instrumental variable methods. This thesis concludes that after the NRPS was implemented, rural elderly were less likely to require assistance with daily living activities, were less likely to be depressed, and had a higher BMI. Those with pension income experienced the same physical and mental health improvements. Regarding the partner effects of the NRPS, this thesis concludes that partner’s pension income increased the likelihood of requiring assistance in activities of daily living and weakened word recall ability; however, word recall ability is difficult to explain the long-term memory status because it represents short-term memory capacity. The effects of NRPS differ depending on region and gender. This thesis suggests that income security for the elderly is effective in improving their health, but the partner effects should be taken into account. Although the partner effects found in this thesis are negative, the mechanisms are still unknown, and it is suggested that future studies may further explore the mechanisms.