Spatial variations and macroeconomic determinants of life expectancy and mortality rate in China: a county-level study based on spatial analysis models.

Objectives: The life expectancy and mortality rate always exhibit remarkable spatial variations. Their spatial distribution patterns and economic determinants in China were explored.

Methods: Four indexes including lifespan expectancy at birth (LEB), infant mortality rate (IMR), under-5 mortality rate (U5MR) and crude mortality rate (CMR) at county level in China were calculated. The spatial distribution patterns of these indexes were illustrated. Meanwhile, spatial regressive model was applied to explore the relations between major macroeconomic determinants and these indexes.

Results: Spatial dependence of these four indexes in China was identified, and the positive spatial autocorrelation indicated a clustering feature rather than stochastic distribution. Additionally, local Moran's I statistics revealed opposite local spatial clusters of LEB and IMR, U5MR in China, that LEB showed that high value clusters in the southwest and low value clusters in the eastern part and northern Xinjiang, and IMR/U5MR exhibited that low value clusters in the east and high value clusters in the west. The spatial regression revealed that income per capita influenced positively on LEB and CMR, and GDP per capita was associated positively with IMR and U5MR.

Conclusions: Geographical factors should be highly considered, and the L-L LEB or H-H IMR/U5MR clustered areas need to be integrated as a whole to formulate public health and economic development plans.