Abstract: Exploring regional differences in mortality levels and their evolutionary trends is an important way to understand China's mortality and health transition. By using provincial mortality data from the third to the seventh censuses as revised by the Log-Quad Model and provincial statistics from various sources, this study analyzes variations in mortality levels and their driving mechanisms across age groups in China by space-time framework. It is found that firstly, the life expectancy gap between different regions in China has continued to show a pattern of being higher in the east and lower in the west, while the gap in infant mortality rates has narrowed and the gap in elderly mortality rates has increased. Secondly, with the shift in the epidemiological pattern of mortality, the driving mechanism behind the decline in mortality rates in China has shifted from medical facility investment to socio-economic development. The regional differences in mortality rates are largely driven by the stage-specific differences in the driving mechanisms of different regions. Given that socio-economic development has increasingly become the main driving force behind the convergence of regional mortality rates in China, efforts should be made to improve the socio-economic level of different regions, while consolidating existing medical investment.

Keywords: Mortality Level, Medical Investment, Socio-economic Development, Health Transition

摘要： 探索分地区死亡水平差异及其演变趋势是理解中国死亡和健康转变的重要手段。借助经对数二项法修订后的第三次至第七次全国人口普查分省死亡数据以及各来源分省统计数据，考察中国分时段、分地区不同年龄段死亡水平的变化过程及其动力机制。研究发现，近40年中国的死亡水平持续呈现东低西高的态势，地区间婴儿死亡水平差异趋于缩小、老年死亡水平差异趋于扩大；随着流行病学死亡模式的转变，中国死亡水平下降的动力机制已由以医疗设施投入为主要推动力转向以社会经济发展为主要推动力，地区间死亡水平差异在很大程度上是由各地区动力机制变迁的阶段性差异所导致。考虑到社会经济发展日益成为推动中国地区间死亡水平收敛的主要力量，未来应在巩固已有医疗设施投入成果的基础上，着力提高各地区社会经济发展水平。

关键词: 死亡水平, 医疗设施投入, 社会经济发展, 健康转变