Page 214 - 《社会》2026年第1期

“看中医”与健康的教育梯度

or maintaining health. Although previous studies have explored the mechanisms
underlying the “educational gradient in health” from individual，family，and social
perspectives，findings based on the Western medical paradigm have largely
overlooked the potential influence of TCM preferences in healthcare behavior. Using
data from the Chinese General Social Survey and an ordered chain mediation model，
this study finds that the behavior of“seeking TCM”（i.e.，a stronger preference for
TCM over Western medicine） can serve as a mediating variable between educational
attainment and self鄄rated health. This result remains robust after conducting both
robustness and endogeneity tests. Regarding the explanatory mechanisms，the self鄄
assessed perception of health among Chinese people，coupled with the increasingly
sensitive physical awareness associated with higher education levels，makes highly
educated individuals more prone to perceive themselves as unhealthy and to engage
in healthcare鄄seeking behaviors. Compared to Western medicine，TCM’s philosophy
of “preventing illness before it occurs” and its relational model of collaborative
patient鄄doctor care can more effectively address self鄄assessed health concerns.
Therefore，individuals with higher levels of education are more likely to choose
TCM，and ultimately experience an improvement in their self鄄rated health due to the
effective response to self鄄diagnosis. The research results provide empirical support
for the formulation of health policies tailored to China’s context to promote high
quality national health.
Keywords：education gradient in health，self鄄rated health，“seeing a TCM doctor”，
ordered chain model

一、 问题的提出

国民健康的高质量发展是建设现代化国家的重要标志， 对于促进
国民的健康水平、 充分理解影响健康的差异化机制十分重要。 通常来
说，健康水平在不同受教育程度的群体之间呈现一定的梯度，即受教育
程 度 越 高 的 人 健康 水 平 越 高 ， 这 一 现 象 被 称 为 “健 康 的 教 育 梯 度 ”
（ education gradient in health）。 健康的教育梯度及其形成机制被医学社
会学、健康经济学、公共卫生及流行病学等多个学科所关注（叶华、石
爽，2015）。其重要意义在于，在生活环境、医疗卫生条件、保障政策等客
观影响因素之外，将健康获得拉回到更加观照主体的影响机制，为通过
提升教育水平促进个体健康发展提供实证支持。

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