Abstract
ObjectivesTo document the association between economic development, income inequality, and health-related public infrastructure, and health outcomes among Chinese adults in midlife and older age.MethodsWe use a series of multi-level regression models with individual-level baseline data from the China Health and Retirement Longitudinal Survey (CHARLS). Provincial-level data are obtained both from official statistics and from CHARLS itself. Multi-level models are estimated with different subjective and objective health outcomes.ResultsEconomic growth is associated with better self-rated health, but also with obesity. Better health infrastructure tends to be negatively associated with health outcomes, indicating the likely presence of reverse causality. No supportive evidence is found for the hypothesis that income inequality leads to worse health outcomes.ConclusionsOur study shows that on top of individual characteristics, provincial variations in economic development, income inequality, and health infrastructure are associated with a range of health outcomes for Chinese midlife and older adults. Economic development in China might also bring adverse health outcomes for this age group; as such specific policy responses need to be developed.
Highlights
Three overarching ideas have been proposed to understand health inequality across time and place
This study uses multi-level data to investigate the association between economic development (ED), income inequality, and health-related public infrastructure (HRPI), and various health outcomes for Chinese midlife and older adults
Coastal areas are more economically developed than inland areas, but the level of Health-Related Public Infrastructures” (HRPI) of these wealthy areas is below the national average
Summary
Three overarching ideas have been proposed to understand health inequality across time and place. A higher level of economic development is seen as leading to better health outcomes (Preston 1975). In a thesis that has been widely discussed, greater income inequality is seen to worsen health outcomes, through both psychosocial and material mechanisms (Wilkinson and Pickett 2010). The provision of health services and infrastructure is considered a key determinant of health (Anand and Ravallion 1993), which may even moderate the effect of economic development and income inequality. It is widely acknowledged that economic development allows to improve the quality of goods and services such as food, health care, and medical services, which in turn leads to improved health and nutrition among the population (Anand and Ravallion 1993). Evidence shows that the urbanisation and economic progress in China have led to a radical reduction in overall and occupational physical activity (Ng et al 2009; Sherif and Sumpio 2015), as well as an increase in fat consumption
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