Abstract
IntroductionThis study assessed income–related health inequality and health achievement in children in China, and additionally, examined province-level variations in health achievement.MethodsLongitudinal data on 19,801 children under 18 years of age were derived from the China Health and Nutrition Survey. Income–related health inequality and health achievement were measured by the Health Concentration and Health Achievement Indices, respectively. Panel data with a fixed effect multiple regression model was employed to examine province-level variations in health achievement.ResultsA growing trend was towards greater health inequality among Chinese children over the last two decades. Although health achievement was getting better over time, the pro-rich inequality component has lessened the associated gain in achievement. Health achievement was positively impacted by middle school enrollments, the urbanization rate, inflation-adjusted per capita gross domestic product, and per capita public health spending.ConclusionThis study has provided evidence that average health status of Chinese children has improved, but inequality has widened. Widening inequality slowed the growth in health achievement for children over time. There were wide variations in health achievement throughout China.
Highlights
This study assessed income–related health inequality and health achievement in children in China, and examined province-level variations in health achievement
The height-for-age z-scores (HAZs) among the richest quintile was 0.08 in 2009 in the second to last column. This result suggests that the health status of children from households in the highest income group was better than the reference World Health Organization (WHO) standard
The mean HAZ is −1.34 when family income is in the bottom quintile, and −0.473 when it is in the top
Summary
This study assessed income–related health inequality and health achievement in children in China, and examined province-level variations in health achievement. Since reforms started in 1978, China has experienced unprecedented economic growth. The benefits of growth are not distributed [1,2,3]. These inequalities in income between urban and rural areas, and between eastern and western regions have widened substantially [3,4]. Increasing income inequality may affect society and economic development in many ways [5]. The unequal distribution of health potentially adversely affects labor supply and productivity of lower income households, and may further exacerbate income inequality [7]
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