China Family Panel Studies Research Articles

The impact of pharmaceutical distribution chain and market dynamics on patients’ medical expenditure: evidence from the Two-Invoice System reform in China

ABSTRACT As populations age and healthcare demands increase, the pricing of pharmaceuticals plays a crucial role in determining patients’ out-of-pocket medical expenditure, particularly in China. The Two-Invoice System (TIS) reform, introduced in 2017, aims to lower pharmaceutical prices and reduce patients’ medical expenses by streamlining the pharmaceutical distribution chain. This study integrates a theoretical model with empirical analysis to evaluate the reform’s impact. The model reveals that while removing intermediaries reduces costs, market dynamics may drive price increases due to pharmaceutical monopolies on the supply side. On the demand side, patients’ responses to price changes vary with individual characteristics, adding complexity to the reform’s effects on patients’ medical expenses. Using microdata from the China Family Panel Studies and a Difference-in-Differences approach, we find that the TIS reform significantly reduces patients’ out-of-pocket medical expenditure, with robustness checks confirming the results. Moreover, the policy impact is heterogeneous, with greater reductions observed among patients who are female, elderly, chronically ill, less educated, low-income, or urban residents. This study underscores the TIS reform’s contribution to improving healthcare affordability and highlights areas for further enhancements in the healthcare system.

Partnership trajectories toward childlessness in China

AbstractObjectiveDrawing on the life course perspective, this study examined partnership trajectories of childless individuals to understand the drivers and processes of becoming childless in China.BackgroundDespite the rise in childlessness in China, little is known about the within‐group heterogeneity in partnership trajectories leading to childlessness and their sociodemographic correlates.MethodThe study employed sequence analysis and multinomial and ordinary least squares regressions using a sample of 778 childless men and women aged 40 and above from the China Family Panel Studies in 2010, 2012, 2014, 2016, and 2018.ResultsFive clusters of partnership trajectories were identified: never partnered (51.8%), early marriage (24.8%), late marriage (9.4%), on‐time marriage (9.3%), and unpartnered via divorce or widowhood (4.9%). Men with low socioeconomic status were most likely to become childless through never being married, and their privileged counterparts were mostly through on‐time or late marriage. The early‐marriage and unpartnered clusters mostly consisted of women, and among women, those with an urban hukou or low education were more likely to be divorced. The overall heterogeneity in partnership trajectories to childlessness declined, and most complexity observed was limited to the unpartnered cluster.ConclusionPartnership trajectories to childlessness in China are heterogenous and stratified but increasingly homogenous.ImplicationsDue to the persistent connections between marriage and childbearing, Chinese individuals become childless through more standardized life course trajectories than before.

An Empirical Analysis of the Impact of Pesticide and Fertilizer Pollution on Household Income

In agricultural production, agricultural non-point source pollution threatens the safety of water supply and food safety, restricts the sustainable development of the agricultural economy and rural ecological environment, and is the bottleneck of agricultural development in China. To explore the impact of this situation on the real income of rural households, the paper is based on the data from China Family Panel Studies (CFPS) from 2014 to 2018. With the pollution status in agricultural production as the explanatory variable and the total value of household agricultural and sideline products as an explanatory variable, a fixed effect model was established to estimate the influence of fertilizer and pesticide application on labor income level. The results show that the income brought by pesticide and fertilizer input is low efficiency, and some farmers have achieved high yields with low input. In addition, the education level of the agricultural population and the size of the family had no significant effect on this. Considering the output problem, the application of pesticides and fertilizers is necessary, but the cognition that pesticides and fertilizers can increase crop yield and income makes the application of pesticides continue to increase, which is not conducive to the increase of agricultural output value. It is necessary to attach importance to new methods of increasing agricultural production based on the application of small amounts of fertilizers and pesticides and use technological reform and professional agricultural education to promote the rational use of pesticides and fertilizers and achieve rapid development of agriculture.

O impacto da migração de crianças adultas rurais no apoio intergeracional aos pais: o efeito moderador da cultura do clã

ABSTRACT: Rural adult children’s migration has raised growing concerns about the weakness in children’s intergenerational support to their left-behind parents. Based on the data from the China Family Panel Studies, this paper systematically analyzed the impact of rural adult children’s migration on intergenerational support to their middle-aged and elderly left-behind parents and further explores the moderating effect of clan culture on it. It has found that the migration of rural adult children does not weaken intergenerational support for their parents across the board, but affects the forms of intergenerational support; that is, it changes from “serving on the side” to “focusing on material”, and from “face-to-face” emotion comfort to “network” communication. The traditional clan culture has not eased the shift in the forms of children’s intergenerational support but strengthened the financial support. These findings are relevant for an efficient policy design of care for left-behind parents worldwide.

Neighborhood contributions in influencing overweight and obesity among Chinese children and adolescents: Temporal, geographical and gender variations.

The precise extent to which neighborhood influences childhood overweight and obesity (O/O) remains unknown. We investigated the magnitudes of neighborhood contributions to childhood O/O and explored potential temporal, geographical and gender variations. This was a pooled analysis using secondary survey data from six China Family Panel Studies from 2010 to 2020. 26262 children and adolescents aged 6-16 years residing in the low, medium and high O/O prevalence areas were included. Multilevel logistic analyses with random slopes were utilized to regress O/O on various individual and neighborhood covariates. Intraclass Correlation Coefficients were applied to quantify neighborhood contributions and 80% Interval Odds Ratio and Proportions of Opposed Odds Ratios were used to evaluate between-neighborhood discrepancies in specific neighborhood factors. Overall, neighborhood accounted for 2%-8% of O/O variations. Temporally, neighborhood contributions declined from 2010 to 2016 but increased thereafter. Geographically, they were higher in medium/low prevalence areas than high prevalence areas (4%-10% vs. 2%-6%). Compared to males, they were greater among females (3%-9% vs. 1%-7%). Neighborhood contributions in high prevalence areas have rapidly increased recently with those among males growing faster. Besides O/O prevalence areas, residence (OR: 1.12, CIs: 1.01-1.23)) and percentage of households with minimum living allowance (1.01, 1.00-1.01) were significant neighborhood factors with the effects of residence exhibited lower between-neighborhood variations (32%-43% vs. 48%-50%). This study empirically suggests the importance of neighborhood and supports the potential of governmental policies aiming at curbing childhood overweight/obesity through tailored neighborhood-based interventions.

Livelihood Capital, Risk Response, and Rural Household Poverty Vulnerability: An Empirical Experience Based in China

ABSTRACTConsolidating the achievements of poverty alleviation and preventing the recurrence of poverty are key priorities for China's future poverty governance. This paper examines the impact of livelihood capital on the vulnerability of rural households to poverty and the underlying mechanisms, using a livelihood capital framework. First, the relationship between livelihood capital and the vulnerability of rural household poverty is discussed theoretically, followed by empirical analysis based on data from the China Family Panel Study (CFPS) spanning 2012 to 2022. To address endogeneity concerns, the average livelihood capital of other households with similar family structures within the same village is used as an instrumental variable for testing. The results show that livelihood capital—particularly human, material, financial, and social capital—has a significant negative effect on the vulnerability of rural households to poverty. Heterogeneity analysis reveals that livelihood capital exerts a stronger suppressive effect on the poverty vulnerability of low‐income households, households with three or less members, and those in western regions. Further analysis indicates that livelihood capital enhances rural households' risk‐bearing capacity, thereby reducing their vulnerability to poverty. Overall, the findings suggest that increasing livelihood capital, especially human and material capital, is crucial for reducing the poverty vulnerability of rural households.

Effect of marriage on overweight and obesity: evidence from China

BackgroundThe number of overweight and obese people in China is showing a rapidly rising trend. Exploring the reasons behind this phenomenon is an urgent academic topic. This study aims to evaluate the effect of marriage on overweight and obesity in China.MethodsA total of 44,095 samples were analyzed Data came from China Family Panel Studies (CFPS), a national, large-scale, multidisciplinary social tracking survey. Four periods of panel data were used and fixed effects regression was performed. Overweight and obesity were defined as BMI ≥ 24 kg/m2 and BMI ≥ 28 kg/m2, respectively.ResultsMarriage significantly increases the probability of being overweight (6.5%, p < 0.01) and obese (2.8%, p < 0.01). An important influencing factor is the reduction of exercise behavior after marriage; that is, marriage reduces exercise time but has no significant effect on drinking. Additionally, we see a greater impact on those aged between 20 and 30, but it has no significant effect on those aged between 40 and 50.ConclusionMarriage is an important socioeconomic factor that led to overweight and obesity. It is urgent to encourage married people to control their weight and government health departments should provide more convenient exercise facilities.

Examining the impact of job matching on workers’ non-cognitive skills: insights from China’s labor market

A well-matched job can effectively cultivate employees’ non-cognitive abilities, which in turn enhances their income and career prospects. This study analyzes the mechanism of job matching affecting non-cognitive abilities using data from the 2018 China Family Panel Studies (CFPS). The findings suggest that job matching positively enhances non-cognitive abilities, with a more significant positive impact from negative job matching compared to positive job matching. Job mismatch negatively affects non-cognitive abilities, and the impact intensifies with the duration of mismatch. Intervening in workers’ early career choices by providing sufficient job information can help them identify and terminate mismatched jobs promptly, thereby protecting and promoting their non-cognitive abilities.

Social interactions and household fuel choice: evidence from rural China

Abstract We study household fuel choice in rural China through the lens of social interactions, deploying a structural discrete choice interaction model to explain peer-dependence in household fuel choice. The data comes from the China Family Panel Studies 2010–2020, and we use multiple strategies to examine the robustness of the social interaction effects. We find a significant endogenous social effect, meaning that whether a household chooses non-solid clean fuel for cooking is directly affected by the choice in cooking fuel made by its neighbors in the village. Households with lower non-farm income are more sensitive to the choices of others, and the fuel choices of households with a higher education and/or a higher income attracts more attention from others. Modern communication technologies facilitate information exchange among rural residents, thereby strengthening the endogenous social effect. We suggest that public policies can accelerate rural energy transition by stimulating positive social spillovers.

Urban-rural disparities in the association between social trust patterns and changes in depressive symptoms: longitudinal evidence from an elderly Chinese population

ObjectiveTo examine the relationship between social trust and depressive symptoms among China’s elderly, placing special emphasis on the disparities between urban and rural settings.DesignWe employed latent profile analysis to categorise...

Hedonic adaptation in cultural consumption: evidence from China Family Panel Studies

Understanding the impact of cultural consumption on well-being has both economic and policy implications, offering valuable insights for theory and practice. Most researchers have identified linear relationships between these concepts, but few have explored the nonlinear relationship. This study utilizes household economic data and draws on the China Family Panel Studies (CFPS) database from 2010, 2014, and 2018 to collect a valid sample of 47,949 individuals from 31 provinces. Our findings support the idea that cultural consumption has a significantly positive effect on subjective well-being and that internet use helps strengthen this relationship. Moreover, there is a “satiation point” where excessive cultural consumption may lead to a decrease in subjective well-being. In the case of excessive cultural consumption, cultural consumption leads to a more noticeable decrease in well-being. Our results hold after various robustness checks and after endogeneity concerns are addressed through instrumental variable methodology. Furthermore, heterogeneity analysis revealed that this effect is more pronounced in the elderly and female populations.

Digital Rural Construction and the Welfare of Disadvantaged Children: Exploring the Roles of Government and NGOs

As global sustainable development goals progress, improving the welfare of vulnerable rural populations has become a critical issue for many countries. Using data from the China Family Panel Studies (CFPS) from 2014 to 2022, this paper examines the impact of Digital Rural Construction (DRC) on the welfare of disadvantaged rural children. Specifically, it explores the mechanisms through which DRC enhances child welfare, focusing on information access, educational resource availability, and medical service accessibility. Additionally, the roles of government and non-governmental organizations in moderating this process are analyzed. The findings show that DRC significantly improves children’s health, education, and psychological well-being. Furthermore, interventions by governments and non-governmental organizations amplify these positive effects, with non-governmental interventions proving particularly effective. This study not only addresses a gap in the literature on the mechanisms linking DRC and child welfare but also offers valuable insights for policymakers from a sustainability perspective.

Impact of the input of women’s working hours on household non-economic welfare

BackgroundThe economic functions of families are strengthened by the labor supply of family members. However, an in-depth discussion can still be held on the impact of the labor supply of family members on the non-economic functions of families, such as residential, social and psychological functions. This paper sought to understand the household non-economic welfare of women’s working hours. In addition, the household non-economic welfare effects of women’s working hours in terms of subdividing women’s working hours and fine-tuning household non-economic welfare were explored. The residential, social and psychological effects of women’s working hours were clarified.MethodThis paper addressed the above problems based on Sen’s welfare theory and Maslow’s hierarchy of needs theory, adopted the feasible ability method, and used nationally representative, timely survey data and data from the 2014–2018 China Family Panel Studies (CFPS).ResultsIn this study, it was shown that the psychological effects of women’s working hours are the largest on average, with an average increase of one hour per week boosting psychological effects by 0.53%. The impact of women’s working hours on both residential and social effects has the extreme points of 68.78 and 35.89 h, respectively. By the interval, the residential effects of women’s working hours are 12.7-16.2% compared with those of weekly working hours shorter than 30 h. Additionally, women’s weekly working hours of more than 60 h have the greatest impact on residential effects, which is 16.2%. From the perspective of gender, the residential effects of women’s working hours are above those of men’s working hours. Compared to weekly working hours of less than 30 h, the social and psychological effects of women’s working hours are weaker than those of men’s working hours.ConclusionsThis study not only contributes to the understanding of contributions to households from the perspective of labor value but also provides lessons for enhancing household non-economic welfare.Contributions to the literatureLimited evidence shows the contributions of working hours and healthy family development in social policies.Women’s working hours increase the residential, social and psychological effects of families. Psychological effects are the largest, with an average increase of one hour per week being associated with an increase of 0.53% in psychological effects. The impact of women’s working hours on subjective health is lower than that of men’s working hours.Few studies systematically analyze the impact of women’s working hours on family residence, socialization and subjective health, and thus target family-friendly policies.

The Impact of Digital Inclusive Finance on Residents’ Cultural Consumption in China: An Urban-Rural Difference Perspective

This paper uses panel data from the 2014–2020 China Family Panel Studies (CFPS) to study the impact of digital inclusive finance (DIF) on the cultural consumption of urban and rural residents using two-way fixed effects. The results show that DIF can promote the growth of cultural consumption of urban and rural residents, and the promotion effect is greater for rural residents. Mechanism analysis shows that DIF increases the cultural consumption of urban and rural residents mainly through easing liquidity constraints, reducing precautionary savings, and increasing payment convenience. Moreover, reducing precautionary savings has a greater impact on the cultural consumption of urban residents, while the other two mechanisms have a greater impact on rural residents. In the heterogeneity analysis, credit business and some indicators reflecting the convenience of payment have a greater impact on rural residents. The insurance business has a greater impact on urban residents. This paper provides policy references for the development of DIF and the enhancement of residents’ cultural consumption.

The influence of family cultural capital on higher vocational school admission opportunities: A case study in China

In the face of the great influence of family background on educational opportunities and educational achievements, an in-depth analysis of the characteristics of vocational college students’ family cultural capital can offer a clearer understanding of this group and help society, families, schools, and individuals to establish a scientific concept of growth and talent. Using the China Family Panel Studies (CFPS) database, through a regression analysis of the adult and children’s self-answers to 840 follow-up questionnaires, it was found that the concern for children’s education and the achievement outcomes of educational expectations in the dimension of educational involvement show significant effects in most models. The value cognition in family cultural capital has a reproduction effect. A person’s self-inflicted efforts can significantly reduce individual vocational college admission opportunities. In the context of the globalization of educational equity, China should break the extant human capital evaluation model that links academic performance with identity at the social level. At the family level, the formation of reasonable educational ideas and expectations is recommended. More importantly, individuals must clearly recognize the mechanism of cultural reproduction, reshape their self-perception and worldview, and transcend habitus.

Evaluating Causal Effects of Increasing Block Pricing Policy on Residential Electricity Consumption in China

ABSTRACTUsing two waves of the China Family Panel Studies (CFPS), a nationally representative longitudinal household‐level survey, this paper investigates how residential electricity consumption is affected by the increasing block pricing (IBP) policy nationwide. The results from the difference‐in‐differences approach suggest that the IBP policy is effective in reducing households' electricity consumption, and the reduction size is about 43 and 120 kWh for households affected by the second and third block pricing, respectively. Compared to rural households, urban households are found to be less impacted by the IBP policy. Besides, there are heterogeneous effects across various income groups, though the trend of the treatment effects is inconsistent. The findings are proved to be robust to different study samples and different model specifications.

Sexual dissatisfaction and its association with health status among older adults in China: a nationwide study.

Background Most population-based sexual health research in China excludes older adults. To fill the gap, this study aims to characterise sexual dissatisfaction among people aged 50years or older from a nationwide, population-representative sample and to explore its association with physical, mental, and self-reported overall health indicators. Methods Data were collected as part of the China Family Panel Studies in 2020, led by the Institute of Social Science Survey of Peking University. Multivariable logistic regressions with robust estimators were used to investigate the association between sexual dissatisfaction and health indicators and potential demographic confounders. Results Among the 8222 partnered Chinese adults aged 50years or older (median age: 59, IQR: 54-66, 47% identified as women), 78% (6380/8222) reported being satisfied or very satisfied in their sex life. After adjusting for demographic variables, poor self-rated health status (aOR: 1.59, 95% CI: 1.42-1.77), experiencing depression symptoms (aOR: 2.02, 95% CI: 1.80-2.26), and having chronic diseases (aOR: 1.20, 95% CI: 1.07-1.36) were positively associated with sexual dissatisfaction in multivariable analyses. Among sociodemographic factors, younger age, female gender, and education level at senior high school or above were more likely to experience sexual dissatisfaction (all P Conclusion Based on our sample, more than one in five Chinese adults aged 50years or older might face sexual dissatisfaction. Comorbidities common in older age likely exacerbate sexual dissatisfaction. Greater attention to sexual satisfaction research and sexual health programs among older adults is needed with respect to gender differences and chronic disease comorbidities.

A comorbidity survey of growth retardation and obesity in Chinese children aged 7-12 years and analysis of influencing factors

To investigate the changing trends and influencing factors for growth retardation-related obesity in Chinese children aged 7-12 years in 2010-2020, providing a basis for formulating physical health interventions for children. The data of body height and body mass index were collected from 16 289 children aged 7-12 years in the China Family Panel Studies (CFPS) in 2010-2020, and the trends of growth retardation, obesity, and growth retardation-related obesity in 2010-2020 were analyzed and compared between different sexes and between urban and rural areas. From 2010 to 2020, the overall rates of growth retardation and growth retardation-related obesity among children aged 7-12 years in China showed a declining trend (P<0.05). By gender and urban-rural classification, the overall obesity rate from 2010 to 2020 showed an increasing trend in all groups except for the rural male and female children groups, the rural children group, and the female children group (P<0.05). The prevalence rates of growth retardation, obesity, and growth retardation-related obesity in male children were significantly higher than those in female children, and similarly, these indicators were also significantly higher in rural children compared to urban children (P<0.05). Urban/rural residence, age, sex, and year were influencing factors for growth retardation and growth retardation-related obesity in children aged 7-12 years (P<0.05). The prevalence of growth retardation, obesity, and growth retardation-related obesity among Chinese children aged 7-12 years shows gender and urban-rural disparities, which highlights the needs for targeted interventions for boys and children in rural areas.

Impacts of population aging on tourism development in China: direct, indirect and spatial perspectives

ABSTRACT The increase in global life expectancy and population aging profoundly affect tourism development. This study examines the direct and indirect impacts of population aging on tourism development using China’s provincial panel data (2003–2022) and the China Family Panel Studies (2014, 2016, 2018 and 2020). A two-way fixed econometric model and the spatial Durbin model are applied to account for the distinct structures of the datasets. The results show that population aging positively influences tourism development, both directly and indirectly, through labour supply and consumer demand. The heterogeneity analysis reveals that tourism enterprises, Eastern regions, and higher education have significant and positive moderation effects between population aging and tourism development. Population aging also exhibits significant and negative spatial spillover effects on tourism development. This study provides a unified framework to explore the relationship between aging and tourism development, offering new insights into senior tourism and its implications for China’s population aging.

Digital infrastructure and cognitive ability of children

Digital technologies have become an integral part of most children’s lives, significantly influencing their development. This study takes the Broadband China Pilot Policy as a quasi-experiment, using the data from China Family Panel Studies (CFPS) to analyze the effects of digital infrastructure on children’s cognitive ability. The extended two-way fixed effects estimator was employed to conduct the Staggered Difference-in-Differences estimation. The findings indicate that the average treatment effect of treatment group of “Broadband China” is significantly positive on children’s cognitive ability. Additionally, heterogeneities of gender and urban-rural were found: (1) The Broadband China policy had a significant positive impact on boys only; (2) The policy had a greater and more significant impact on the word test scores results of urban children; (3) The policy had a negative impact on the math test scores of urban children, while showing a positive impact on the math test scores of rural children. Finally, the paper makes the following recommendations: (1) Digital infrastructure development should be emphasized; (2) More emphasis should be placed on rural areas when building digital infrastructure; (3) Gender differences should be considered when formulating policies to help girls benefit from digital technologies.