Research on the Mechanism of Influence of Socioeconomic Factors on Public Health Outcomes and Policy Optimization: An Analysis of Regional Heterogeneity Based on China's Provincial-Level Data

Background Public health equity is a core objective of the national health security system, yet structural socioeconomic disparities are a key driver of imbalanced public health outcomes. Income gap and educational attainment are pivotal socioeconomic factors shaping public health, and China’s regional development heterogeneity implies their impacts may vary across regions. This underscores the need to explore their influence mechanisms and regional differences to address health inequalities. Purpose Taking per capita life expectancy as the core indicator of public health outcomes, this study explores the action paths and impact intensity of income gap and educational attainment on public health. It emphasizes regional development heterogeneity, revealing divergent effects across regions with different development levels to provide theoretical and empirical support for targeted mitigation of health inequalities. Methods Based on panel data of 31 Chinese provinces (autonomous regions, municipalities directly under the Central Government) from 2010 to 2022, a two-way fixed effects regression model is employed to assess the net effects of income gap and educational attainment on per capita life expectancy. The model controls for medical resource supply, population structure, and environmental quality, with regional hierarchy as a moderating variable to identify overall effects and subgroup differences. Results Income gap exerts a significant negative effect on per capita life expectancy: each 1-unit increase in the Gini coefficient reduces it by 2.1-2.8 years, via imbalanced medical resource accessibility and health consumption capacity, with a more pronounced effect in central and western regions. Educational attainment has a robust positive effect: each 1-year increase in average schooling extends life expectancy by 1.3-1.7 years, through improved health literacy and standardized health behaviors, with a stronger marginal effect in eastern regions. Conclusions Income gap and educational attainment affect public health through differentiated, regionally heterogeneous pathways. Policies should promote balanced cross-regional medical resource allocation and subsidize low-income groups’ health consumption in central and western regions. Health knowledge integration into basic education is needed, focusing on high-end literacy in eastern regions and basic cognition in central and western regions. Improving medical resource supply quality to establish an interactive “narrowing gaps-enhancing literacy-optimizing supply” mechanism will alleviate socioeconomic-driven health inequalities and enhance public health security equity and inclusiveness.