Hukou system, mechanisms, and health stratification across the life course in rural and urban China.

Abstract

The literature on rural-urban health disparities have mostly focused on de facto rural/urban differences, and its intersections with de jure rural-urban divide are less understood. This research provides a comprehensive investigation of how the intersection of rural\urban residence and rural\urban household registration (hukou) status is associated with a range of health outcomes in later life. We investigate major mechanisms in accounting for these health disparities across the life span. Results show that rural hukouers in rural areas were exposed to highest level of hardships and adversities throughout life and are disadvantaged in a variety of health measures. In urban areas, those who have obtained urban hukou are better off than rural hukouers in psychological well-being but have higher risks of diabetes. These differences are mainly explained by disparities in socioeconomic status between the two groups. We discuss these results in a life course perspective and in the context of China's unique social, economic, and political settings.