title: Regional health-care inequity in children's survival in Zhejiang Province, China.
abstract: China 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.
  
  
  
  In 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.
  
  
  
  From 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.
  
  
  
  The 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.
authors.affiliation: Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
authors.forename: Weifang
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Public Health, Zhejiang Medical College, Hangzhou, China.
authors.forename: Dingwan
authors.initials: D
authors.lastname: Chen
authors.affiliation: Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Vaderbilt University Law School, Nashville, USA.
authors.forename: Zhuopu
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Child Healthcare, Yongkang Women and Children's Hospital, Yongkang, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Ying
authors.affiliation: Department of Administration, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. zhaozy@zju.edu.cn.|Department of Child Healthcare, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. zhaozy@zju.edu.cn.
authors.forename: Zhengyan
authors.initials: Z
authors.lastname: Zhao
mesh_terms: D002648:Child; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007182:Income; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008297:Male; D012111:Residence Characteristics; D012424:Rural Population; D064890:Social Determinants of Health; D014171:Transients and Migrants; D014505:Urban Population
keywords: Children; Health-care inequality; Mortality rate; Per capita GDP; Survival