[文萃]李涛 等：老年人的孤独感与保健消费

    原文标题：孤独与消费——来自中国老年人保健消费的经验发现
    作者：李涛 徐翔 张旭妍
    内容提要：中国老年人的保健消费是否受到其孤独感的影响？如果有影响，背后的作用机制是什么？本文使用中国健康与养老追踪调查数据实证回答了以上问题。考虑了内生性可能的稳健性回归结果显示，老年人的孤独感对其保健消费有着显著且稳健的正向影响，越是感到孤独的老年人，他们的保健支出的绝对水平和相对比重都会越高。产生这种影响的一个重要作用机制是社会互动，在消费保健产品和服务的过程中，老年人通过与销售人员和其他老年人进行交流，有效缓解了孤独感。据此我们建议，旨在合理规范和有效促进中国老年人保健消费的有关政策应该充分考虑到老年人孤独感的重要影响，努力实现老年人保健消费市场由情感慰藉或认知误导驱动向健康需求驱动的可持续发展方式转型。
    关键词：保健消费 孤独感 社会互动
    Loneliness and Consumption：An Empirical Investigation of the Healthcare Consumption of China’s Elderly Population
    LI Tao(a), XU Xiang(a) and ZHANG Xuyan(b)
    (a：Central University of Finance and Economics; b: China Avic Securities CO., LTD.)
    Summary：As a major component of national economy, household consumption reflects the actual living standard of a country’s citizens and is the central target of macroeconomic policies. Compared with developed countries, however, the aging consumption market of China remains underdeveloped and thus has considerable potential. In the meantime, the healthcare consumption of the Chinese aging population is increasing considerably faster than any of its other consumption types, and its healthcare expenditure has become one of the most concerning social topics in China. Both medical and healthcare expenditures are important components of household health investment. Nevertheless, healthcare expenditure is often regarded as a part of medical expenditure and has attracted less attention and systematic study. From an empirical perspective, study of the relationship between the healthcare expenditure of aging people, their emotional demands, and the underlying mechanism is very important. In this study, we examined the causal relationship between the feeling of loneliness and the healthcare expenditure of China’s aging population empirically, and investigated how healthcare expenditure was determined by controlling for other factors.
    Few studies have focused on the healthcare expenditure of the aging population. Most studies have focused on the general healthcare expenditure of households as a whole, and have basically ignored the effect of loneliness and other emotional feelings. Most foreign studies have used samples from the Organization for Economic Co-operation and Development countries and investigated the macro factors that affect healthcare expenditure. Studies by Chinese scholars have been based on Chinese datasets, but take a similar macro approach to determining the healthcare expenditure. We believe our research, conducted from the perspective of loneliness, covers the shortage in related studies to some extent.
    In this study, we used the China Health and Retirement Longitudinal Study (CHARLS) dataset in the first effort to analyze the effects of loneliness on healthcare expenditure. Our estimations implied that both health demands and emotional demands had significantly positive effects on the elderly’s healthcare expenditure. At the same time, the effects of health and emotional demands on healthcare expenditure were complementary. We also adopted several methods to test the potential endogeneity in the baseline regressions, and guaranteed the robustness of our estimations by conducting several complementary regressions. We make three contributions to the literature on healthcare consumption. First, our empirical findings suggest for the first time that the degree of loneliness has a significantly positive effect on healthcare expenditure. Elderly people who feel lonelier tend to spend more of their income in both absolute and relative terms on healthcare products, and the most probable explanation is that the elderly believe they can have more social interactions by communicating with health product sales staff and other aged people. Second, our estimations suggest that one’s physical health status has significant negative effects on their healthcare expenditure. Third, the elderly with a worse self-assessed physical health status, more severe chronic diseases, and poorer self-care ability spend more of their income on healthcare products. We also found that the aging population’s cognition, frequency of visits from children, and ability to live independently significantly affected their healthcare expenditure statistically.
    Based on our estimations, we advise the related ministries and government institutions to pay more attention to the loneliness problem of the Chinese aging population. In addition, they should consider the potential negative shocks to the healthcare expenditure market by decreasing the loneliness of the Chinese aging population as these people improve their mental health conditions. The continuous development of China’s healthcare consumption market should be based on the increasing health demand, rather than the emotional demands that immoral healthcare suppliers could take advantage of.
    Keywords：Health Care Consumption; Loneliness; Social Interaction
    作者简介：李涛、徐翔（通讯作者），中央财经大学经济学院；张旭妍，中航证券有限公司。
    致谢：感谢国家社科基金重大项目（批准号：12&ZD028,16ZDA005）、霍英东教育基金会、中央财经大学青年科研创新团队和青年教师发展基金的资助。感谢匿名审稿人的宝贵建议，当然文责自负。
    期刊责任编辑：林一；校对：曹帅
    

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