人口老龄化视域下我国农村老年人健康困境与优化路径研究

Study on Health Difficulties and Optimization Paths of Rural Elderly in China from the Perspective of Population Aging

摘要: 国内老龄化存在明显城乡倒置特征，农村老龄化程度与增速均高于城镇。城镇化持续推动青年劳动力外流，家庭养老功能不断衰退，城乡医疗资源分配不均，农村留守老人、随迁老人普遍面临生理、心理与社会融入多重健康难题。当前人口红利消退，叠加乡村振兴、健康中国战略推进，本文依托健康老龄化、积极老龄化与嵌入理论，从生理、心理、社会健康梳理农村老年群体健康问题，从制度、资源、组织、认知、数字鸿沟剖析困境成因，并立足乡村本土特质，跳出城市养老建设固有思路，从健康科普、基层医疗、多层次医保、本土化医养融合、乡村互助养老、适老化数字健康服务六方面提出优化治理对策。

Abstract: China’s aging population exhibits a distinct urban-rural inversion: rural areas register both a higher degree and faster growth rate of aging compared with urban regions. Sustained urbanization drives the outflow of young laborers, steadily weakening the family-based elderly care system. Coupled with the uneven distribution of urban and rural medical resources, left-behind elderly in rural areas and elderly migrant residents generally face multifaceted health challenges spanning physical, psychological and social integration dimensions. Against the backdrop of fading demographic dividends, alongside the advancement of the Rural Revitalization Strategy and the Healthy China Initiative, this paper draws on theories of healthy aging, active aging and embeddedness theory. It sorts out health predicaments of rural elderly groups from physical, psychological and social perspectives, and analyzes the root causes of such dilemmas covering institutional arrangements, resource allocation, organizational support, public awareness and the digital divide. Rooted in the inherent local characteristics of villages, this research breaks away from the stereotyped urban elderly care development mindset, and puts forward targeted optimized governance countermeasures in six dimensions: popularizing health science, strengthening primary medical care, developing multi-tiered medical insurance, advancing localized integrated medical-elderly care services, building rural mutual-aid elderly care systems, and delivering age-friendly digital health services.