Previously submitted to: JMIR Public Health and Surveillance (no longer under consideration since Sep 22, 2025)
Date Submitted: Oct 15, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Healthcare Access and Subjective Well-being at High Altitudes: Evidence from Tibet, China
ABSTRACT
Background:
Achieving universal access to healthcare is a specific target of Sustainable Development Goals 3 which seeks to promote health and well-being for all. However, the SWB in Tibet and its relationship with healthcare access are inadequately understood.
Objective:
This study aims to assess the magnitude of subjective well-being (SWB) and examine the its relationship with healthcare access in Tibet, China.
Methods:
Data was obtained from the 2018 Sixth National Health Service Survey in Tibet. The SWB was measured using a revised version of Personal Well-Being Index (PWI), and healthcare access was assessed using geographical accessibility, affordability, and availability. Descriptive statistics were used to summary the basic characteristic of respondents. After controlling for sex, age, marital status, occupation, education, household income per capita and chronic disease, multiple regression model was used to examine the relationship between SWB and healthcare access.
Results:
The PWI score among the 2113 respondents in 2018 was 69.04 (SD=14.97) and the overall life satisfaction was 7.00 (SD=2.04). After adjusting for control variables, the residents with good geographical accessibility reported higher SWB (β= 2.90, 95% CI: 1.32–4.47). Basic and supplementary health insurance coverage showed no significant association with SWB. Regarding availability, the number of physicians per 1,000 populations was significantly positively correlated with SWB (β=2.38, 95% CI: 1.00–3.76).
Conclusions:
The SWB in Tibet fell in normative range of China and good healthcare access could promote SWB. Future research should delve into potential mechanisms between access to healthcare and SWB.
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