Rural Chinese Research Articles

Family Structure, Social Capital, Neighbourhoods Environment and Health Behaviors for the Rural and Urban Chinese

Objectives: Improving health behavior like mental health is much needed for healthy aging and is commonly required among all age groups and family members. Such prolific results are reasonably possible by investigating the functional and effective role of the family structure, neighboring environment, and social Capital. However, limited research studies in the Chinese regional setting on the stated domain of interest were found while completely missing the role of life satisfaction as a mediating variable between Family structure, social Capital, neighborhood health, and mental health. Methods: Addressing such literature backdrop is the key concern of the present research for which primary data was focused using different methodological approaches. Results: The outcomes demonstrate that family structure, social Capital, and two components of the neighborhood environment, like natural and social environment, positively related to the mental health of the urban and rural Chinese coming from age groups 20 to above 50 years. Conclusion: The partial mediating effect of life satisfaction is between the family structure, mental health, and the social environment and mental health.

Effect of physical activity intervention on weight change in rural older Chinese: a cluster randomized controlled trial.

Current randomized trial evidence for the effects of physical activity intervention on weight change in adults was mainly from western countries, with little reliable evidence from low- and middle-income countries, such as China, where lifestyle factors and obesity patterns differ substantially from those in western countries. We examined the effects of physical activity intervention on weight change using cluster randomized trial data among Chinese older adults. The cluster randomized controlled trial included an 8-week physical activity intervention period and was followed up to 24 months. Eight villages were randomly assigned to the intervention group (4 villages, n = 240) or the control group (4 villages, n = 268). The intervention group received physical activity intervention based on the socio-ecological model, while the control group did not. The intervention involved three levels: individual, interpersonal, and community levels, which aimed to promote leisure-time physical activity of participants. The primary outcome of the present study was the difference in percentage weight change at 24 months from baseline. We used Tanita BC-601 analyzer scales to measure weight and recorded it to the nearest 0.1 kg. Among the 508 participants, the mean age was 70.93 (SD, 5.69) years, and 55.5% were female. There were significant differences in percentage weight change between the intervention group and the control group with a mean change of -1.78% (95% CI, -2.67% to -0.90%; p < 0.001) in the total sample, -1.94% (95% CI, -3.14% to -0.73%; p = 0.002) in participants with overweight/obesity, and -1.45% (95% CI, -2.73% to -0.18%; p = 0.027) among participants with underweight/healthy weight in favor of the intervention group at 24 months. Physical activity intervention resulted in weight loss in rural older sample at 24 months. This suggested that physical activity interventions are feasible for weight loss among older adults, especially for those with overweight/obesity or aged under 80. The study has been registered on the Chinese Clinical Trial Registry on April 20, 2021 (ChiCTR2100045653), https://www.chictr.org.cn/showproj.html?proj=123704 .

Flush toilet use and its impact on health and non‐health expenditures

AbstractThis study analysed the effects of flush toilet use on health and non‐health expenditures incurred by rural Chinese. The instrumental‐variable‐based Tobit and endogenous treatment regression models were used to analyse the 2016 China Labour Force Dynamics Survey data while addressing the selection bias inherent in flush toilet use. The results showed that by improving rural residents' physical and mental health, flush toilet use reduced per capita health expenditure while increasing non‐health expenditure. Furthermore, using flush toilets had positive spillover effects, reducing the health expenditures of even those who did not use them. Factors affecting flush toilet use were also analysed.

Prevalence and factors associated with dynapenia among middle-aged and elderly people in rural southern China

To estimate the prevalence of dynapenia and examine potential risk factors for dynapenia using a sample of rural middle-aged and elderly Chinese. A cross-sectional study of 253 Chinese adults aged 50 years and older was conducted from June to August in 2022 in Nanjing. A questionnaire was used to collect data on all socioeconomic variables. Body weight, height, body fat percentage, grip strength, waist circumference, calf circumference, and gait speed were measured. The prevalence of dynapenia was 69.6 %, 62.3 % in men and 72.7 % in women respectively. Binary logistic regressions indicated significant associations between dynapenia and age (odds ratio [OR] = 2.59; 95 % confidence interval [CI] 1.63, 4.12; p < 0.001), educational level (OR = 0.55; 95 % CI 0.38, 0.80; p = 0.002). Dynapenia was prevalent among rural middle-aged and elderly people in southern China. Age and lower education level were both associated with dynapenia. Nutrition and physical activity should be strongly recommended as important strategies to maintain and improve muscle strength.

Foreign Language Anxiety of Rural EFL Junior Middle School Chinese Students: A Case Study of A School In East China

The objectives of this study were two folds: 1) to examine the factors and identify the level of the factors affecting the foreign language anxiety of the rural Chinese junior middle school; and 2) to explore anxiety-reducing strategies that should be used by the rural Chinese junior middle school students in this study. The Foreign Language Classroom Anxiety Scale (FLCAS) designed by Horwitz (1986) was adapted to collect quantitative data from 110 students to identify the level of foreign language anxiety factors, and semi-structured interviews were conducted with 9 students and their parents as well as 4 teachers to explore for anxiety-reducing strategies for the students. The results of the FLCAS questionnaire showed that the English learning anxiety level of rural junior middle school Chinese students was moderate (x̄ =3.26), including the level of communication anxiety (x̄ =3.26), the level of test anxiety (x̄ =3.28), and the level of fear of negative evaluation (x̄ =3.24). The results of the semi-structured interviews revealed that the learner-related factors were the most significant, followed by teacher-related factors. The emerging results of qualitative data from the perspectives of students, parents, and teachers in relation to English anxiety-reducing strategies were found; i.e., improving English learning skills, increasing self-regulated learning in English, using effective instructional approach, providing comments and feedbacks to support the students in learning English, and avoiding placing undue focus on English test results.

How marital events explain the suicide rate among Chinese.

The aims for this study was to prove the impacts of marital events (marriage rate, divorce rate and marriage squeeze), economic development, and social development on the suicide rate among urban and rural Chinese and reveal the differences in these impacts between urban and rural areas and between genders. An explanatory time-series analysis methodology was adopted to analyze the nation-wide data ranging from 1987-2017. Marriage rate was a protective factor against the suicide rate among urban and rural men, and rural women; however, divorce rate was a protective factor against the suicide rate only among rural women. For the four groups, the economic development level measured by per capita GDP is a protective factor, while social development measured by urbanization and rural-urban labor migration rates in rural areas plays different roles. Marriage and divorce rates were found to have different meanings for the four groups. This study offers a reference for designing relevant policies and projects to intervene in suicidal behaviors among different groups.

The largest insurance program in history: Saving one million lives per year in China

The New Cooperative Medical Scheme (NCMS), rolled out in China from 2003–2008, provided insurance to 800 million rural Chinese. We combine aggregate mortality data with individual survey data, and identify the impact of the NCMS from program rollout and heterogeneity across areas in their rural share. We find that there was a significant decline in aggregate mortality, with the program saving more than one million lives per year at its peak, and explaining 78% of the entire increase in life expectancy in China over this period. We confirm these mortality effects using micro-data on mortality, other health outcomes, and utilization.

The Expanding Search for Work: The Gender Gap in Livelihood Choices among the Rural Chinese, from 1989 to 2015☆

AbstractSimilar to the rest of developing countries around the world, rural China has experienced rapid growth in the diversification and space expansion of their livelihood choices. However, little is known about the gender gap in the process of expanding. In this study, using the China Health and Nutrition Survey data from 1989 to 2015 and multilevel age, period, and cohort models, we examine the gender gap in livelihood choices of farming, local nonfarm, and distant nonfarming among rural residents over the period. Our study showed that women are constantly behind in taking nonfarming jobs compared with men, and there is no evidence of a convergence trend over time. Further analysis suggests that the family status of being married is the main obstacle for women to close the gap with men, while the gap between unmarried women and men has closed. When comparing the local vs. nonlocal nonfarming work, we found that the gender gap was resistant to close and has even slightly enlarged between married men and women over time. Our study has revealed a concerning trend for rural married women to close the gender gap in pursuing nonfarming occupations and expanding their space in livelihood choice in China.

Association of triglyceride–glucose index and its 6-year change with risk of hypertension: A prospective cohort study

Background and aimWe aimed to investigate the association of triglyceride–glucose (TyG) index and its dynamic change with risk of hypertension in rural Chinese and, further, to explore whether the TyG index mediates the obesity-related hypertension. Methods and resultsA prospective cohort study, including 10,309 subjects without hypertension at baseline, was conducted in 2007–2008 and followed up in 2013–2014. TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. Logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Mediation analysis was performed to examine the contribution of the TyG index to the association of obesity-hypertension incidence. During a median follow-up of 6 years, 2073 subjects developed hypertension. In multivariate logistic model adjusted for age, sex, alcohol drinking, smoking, physical activity and education, monthly income, family history of hypertension, TC, and HDL-C, the risk of hypertension was 1.14 (1.07–1.22) for per-SD increase in TyG. After additional controlling for obesity, this association was nonsignificant (1.06, 0.99–1.13) and (1.05, 0.99–1.13) for BMI and WC, respectively. Increasing trends were found for hypertension incidence as the TyG change increased, with or without adjustment for obesity (all Ptrend < 0.05). With per-SD increment in TyG change, the risks of hypertension incidence were 1.14 (1.07–1.22) for absolute TyG change, and 1.15 (1.08–1.22) for relative TyG change in multivariate logistic model; the results were significant after further adjustment for BMI or WC, respectively. The TyG index partially mediated the obesity-incident hypertension association: 6.84% for BMI and 6.68% for WC, respectively. ConclusionsElevated TyG index and its dynamic change were positively associated with risk of incident hypertension in rural Chinese population, and the TyG index may play a partially mediating role in obesity-related incident hypertension.

The Impact of FDI on China’s Urban–Rural Income Gap

Since the reform and opening up some forty years ago, China has suffered from a capital shortage problem. To both solve this problem and satisfy its economic and social needs, China has been bringing in foreign investment, much of which has gone toward economic reconstruction. However, with the continuous inflow of foreign direct investment (FDI) into China, not only has the gap between rich and poor become increasingly wide but, due to China’s unique dualistic economic structure, the gap between urban and rural areas also appears to be widening. This aspect of the problem has attracted the attention of scholars around the world, as it may affect the future sustainable development of China’s economy and society. Cognizant of the need for practical solutions, this study conducts a more in-depth study of the relationship between foreign direct investment and the urban–rural income gap in China. Based on a review of previous studies and panel data from 30 Chinese provinces, this paper argues that FDI will affect this income gap through mechanisms such as employment structure, industrial structure and international trade. The findings of this study suggest that FDI inflows will first improve income inequality between urban and rural Chinese at a point in time but then have a worsening effect. In addition, China’s three major economic zones are examined, with results showing that the overall impact of FDI on the urban–rural income gap in China displays an inverted ‘U’ curve. Today, the impact of FDI on the urban–rural income gap is on the right-hand side of the curve, with regional differences in its impact. Urban–rural income inequality in the eastern region responds the most to FDI.

Progression of precancerous lesions of esophageal squamous cell carcinomas in a high-risk, rural Chinese population.

This study investigated the natural history of esophageal squamous cell carcinoma (ESCC) in rural Chinese. We sought to help provide more data to support ESCC screenings. This study was based on an existing Screening Program in Feicheng, China. Esophageal precancerous lesions were identified in 1753 cases, diagnosed from esophageal cancer screenings from 2006 to 2016. We followed up with them through endoscopic screening until October 1, 2017. Pathology results from various grades of precancerous lesions were recorded and the annual transition probabilities and incidence density of ESCC were calculated. As of October 1, 2017, a total of 4055.8 person-years has been observed. The ESCC incidence density of mild, moderate, and severe dysplasia (SD) was 0.17, 0.79, and 1.77 per 100 person-years, respectively. The median follow-up time of mild, moderate, and SD was 3.5, 2.3, and 2.2 years, respectively. The annual transition probability of mild, moderate, and SD to the next pathological level was 0.025, 0.038, and 0.016, respectively. The ESCC incidence density of males was 2.6 times higher than females (0.58 vs. 0.22), and the older age group (56-69 age group) had a ESCC incidence density 1.2 times higher than the younger group (40-55 age group) (0.45 vs. 0.39). The higher the grade of precancerous lesions, the higher the incidence density of ESCC. Screening of esophageal cancer in males and the elderly should be strengthened. It is recommended to reinforce follow-up management for untreated patients with SD/carcinoma in situ. For patients with mild and moderate dysplasia in high-risk rural Chinese populations, endoscopic follow-up intervals can be appropriately adjusted to once every 2 years.

Patterns and Determinants of Antibiotic Use Behaviors among Rural Community Residents in Eastern China.

Inappropriate antibiotic use may lead to antibiotic resistance, which has become a serious global crisis. Addressing suboptimal antibiotic use in the general population can play a significant role in the fight against antimicrobial resistance. This study aims to describe antibiotic use and sources of acquisition, and to identify factors influencing antibiotic access among rural community residents in Eastern China. A cross-sectional survey was conducted from July to August 2020, and 1494 participants from two villages in Eastern China were enrolled. Information was obtained using face-to-face interviews with a structured electronic questionnaire. Chi-squared and multinominal logistic regression analysis were used to explore possible determinants. In total, 1379 participants were eligible for the analysis. In the past 12 months, nearly half the respondents had taken any antibiotic (48.4%), and this proportion varied across marital status and age group. Two thirds of them (59.9%) obtained antibiotics from medical facilities with a prescription when they last took antibiotics, while 17.7% and 22.4% chose retail pharmacies and other sources, respectively. Multinominal analysis found that a higher proportion obtained antibiotics outside medical facilities among those aged 15 to 44 years, unmarried, non-white collar workers, with more years of education, lower annual household income per capita and lower levels of antibiotic knowledge. The antibiotic use behavior of rural community residents in Eastern China remains suboptimal. Antibiotic use and access behaviors need to be further addressed. Effective antibiotic stewardship in non-medical facility sources and training programs targeted for rural Chinese is warranted in future.

Functional Disability Among Middle-Aged and Older Adults in China: The Intersecting Roles of Ethnicity, Social Class, and Urban/Rural Residency.

This study explores how ethnicity, family income, and education level differentiate patterns of functional limitations among urban and rural Chinese (aged 45 ≥ years). Based on the 2018 China Family Panel Studies (CFPS) (n = 16,589), this nationwide study employed binary/multinomial logistic regression analyses, stratified by urban/rural residency, to estimate the likelihood of instrumental activities of daily living (IADLs) disability (0/1-2/≥3 limitations) by social determinants of health (SDoH). The estimated overall prevalence of IADLs disability was 14.3%. The multivariable analyses did not find significant ethnic disparity in IADLs disability in urban China, while in rural China, ethnic minorities were 44% more likely to have IADLs disability than Han Chinese. Among rural residents, Mongolians, Tibetans, and Yi minority more than tripled the odds of having ≥3 limitations than Han Chinese; and the intersections of ethnicity and social class were associated with functional limitations. Long-term care and anti-poverty programs should target minority aging populations in rural China.

Does community matter?: a study on rural chinese teachers’ turnover

ABSTRACT Teachers’ retention plays a critical role in rural students’ access to quality education. Previous studies on rural teacher turnover have emphasised the role of economic disadvantages, with little attention paid to non-economic factors. The present study examined the effects of teacher-community interactions and community social structure on rural teachers’ intention to leave. Hierarchical Linear Model analysis was conducted with a national sample of 3,742 rural teachers in China. The descriptive statistics showed that rural teachers had a mild level of community engagement on average. However, we found that interactions between teachers and local members were significantly related to a higher level of intention to stay. Teachers working in close-knit communities were more likely to leave than their counterparts in scattered and dispersed communities. Leaders of rural schools and communities should be aware of such interactions’ benefits, especially in areas with strong social ties.

Intergenerational gendered livelihoods: Marriage, matchmaking and Rural-Urban migration in China

This paper uses marriage as a lens to highlight norms, customs, identities and shared values that shape livelihoods and give meaning to intergenerational and gendered practices at the individual and household level. Drawing on feminist contributions to understanding power differences between women and men and between generations, this paper shows that while livelihood may be seen as involving mainly the economic and material aspects of living, it is equally a matter of how people pursue important goals in life such as marital formation, and how these goals are situated in social, cultural, historical and locational contexts. Based on interviews in Anhui and Sichuan provinces, I highlight how intergenerational livelihoods are influenced by gendered ideology and practice, in particular transactional marriage, parents’ and children’s responsibilities in enabling marital formation and lineage, and the pursuit of rural-urban migration to enhance men’s competitiveness in the marriage market. I foreground the voices and narratives of rural Chinese and rural-urban migrants, who share how they live their lives, resources that they have access to, strategies that they pursue, and their goals and desired outcomes that are situated in relevant social, cultural and spatial contexts. Quotes from interviewees underscore the deep-rooted patriarchy that has manifested itself through marriage, especially the traditions of patrilocal exogamy and transactional matchmaking. Specifically, I draw attention to the roles of house-building and bride price in marital formation, and their implications for rural-urban migration as a long-term household strategy and a way of life. By doing so, this paper emphasizes the social and cultural contexts, in particular gender and intergenerational relations, for research on rural-urban migration.

GC gene polymorphisms found with type 2 diabetes and low vitamin D status among rural Chinese in Henan province.

Accumulating evidence suggests that vitamin D may be involved in the pathogenesis of type 2 diabetes (T2D). Group-specific component (GC) gene is the most important transporter of vitamin D and plays a regulatory role in vitamin D metabolism. We aimed to evaluate the association of GC gene polymorphisms with T2D susceptibility and vitamin D status in the Chinese rural population. A total of 1372 subjects were eligible in this cross-sectional study. Three SNPs of the GC gene (rs7041, rs4588, and rs2282679) were genotyped by TaqMan probe assays. Logistic regression and Kruskal-Wallis one-way analysis were performed to determine the possible risk genotype for T2D and vitamin D metabolite concentrations, respectively. The serum 25-hydroxyvitamin D3 [25(OH)D3] and vitamin D binding protein (DBP) concentrations were significantly lower in the T2D group than the non-T2D group. GG genotype carriers of rs7041 (T>G) were more likely to have T2D compared with AA carriers (OR=2.00, 95% CI: 1.19-3.37). Variants of rs4588 (C>A) and rs2282679 (A>C) were associated with a lower risk of T2D under the dominant inheritance model (OR=0.65, 95% CI: 0.48-0.88; OR=0.66, 95% CI: 0.49-0.90, respectively). We further found that non-T2D subjects with the AA genotype of rs4588 had significantly higher 25(OH)D3 concentrations than the CC genotype (p=0.022). In contrast, the T2D cases with the CC genotype of rs2282679 had lower DBP concentrations compared to the AA genotype (p=0.020). Our study indicates a potential role for GC gene polymorphisms in T2D susceptibility and vitamin D metabolite concentrations in the Chinese rural population.

Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China

BackgroundThis study aimed to estimate whether metabolic syndrome (MetS) and its components could be used to predict cardiovascular disease (CVD) in a longitudinal analysis in a rural elderly Chinese population.MethodAt baseline during 2012–2013, a total of 2486 elderly from rural Chinese were enrolled and were followed up during 2015–2017. Stroke and coronary heart disease (CHD) were included in CVD and were diagnosed by clinicians. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) criteria were used to define MetS separately.ResultHazard ratios adjusting for CHD, stroke and CVD in those with MetS using the NCEP ATP III criteria in females were 1.27 (95 % CI 0.73, 2.21), 1.54 (95 % CI 0.99, 2.40) and 1.45 (95 % CI 1.00, 2.10), respectively; 1.33 (95 % CI 0.77, 2.32), 1.44 (95 % CI 0.92, 2.25) and 1.36 (95 % CI 0.94, 1.97), respectively, with the AHA/NHLBI criteria; and 1.10 (95 % CI 0.89,1.36), 1.62 (95 % CI 1.03, 2.55) and 1.36 (95 % CI 0.93, 1.97), respectively, with the IDF criteria. Additionally, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95 % CI 1.01, 2.52). However, among rural elderly males, neither MetS nor its components predicted new-onset CVD.ConclusionsMetS is correlated with high incidence of CVD among rural elderly female, and only using the NCEP ATP III criteria to define MetS could make the incidence of CVD obvious difference. In order to reduce rural elderly CVD, effective measures to prevent, diagnose, and treat MetS should be enacted in a timely manner, especially among females.

Development and Validation of an Esophageal Squamous Cell Carcinoma Risk Prediction Model for Rural Chinese: Multicenter Cohort Study.

BackgroundThere are rare prediction models for esophageal squamous cell carcinoma (ESCC) for rural Chinese population. We aimed to develop and validate a prediction model for ESCC based on a cohort study for the population.MethodsData of 115,686 participants were collected from esophageal cancer (EC) early diagnosis and treatment of cancer program as derivation cohort while data of 54,750 participants were collected as validation cohort. Risk factors considered included age, sex, smoking status, alcohol drinking status, body mass index (BMI), tea drinking status, marital status, annual household income, source of drinking water, education level, and diet habit. Cox proportional hazards model was used to develop ESCC prediction model at 5 years. Calibration ability, discrimination ability, and decision curve analysis were analyzed in both derivation and validation cohort. A score model was developed based on prediction model.ResultsOne hundred eighty-six cases were diagnosed during 556,949.40 person-years follow-up in the derivation cohort while 120 cases from 277,302.70 in the validation cohort. Prediction model included the following variables: age, sex, alcohol drinking status, BMI, tea drinking status, and fresh fruit. The model had good discrimination and calibration performance: R 2, D statistic, and Harrell’s C statistic of prediction model were 43.56%, 1.70, and 0.798 in derivation cohort and 45.19%, 1.62, and 0.787 in validation cohort. The calibration analysis showed good coherence between predicted probabilities and observed probabilities while decision curve analysis showed clinical usefulness. The score model was as follows: age (3 for 45–49 years old; 4 for 50–54 years old; 7 for 55–59 years old; 9 for 60–64 years; 10 for 65–69 years), sex (5 for men), BMI (1 for ≤25), alcohol drinking status (2 for alcohol drinkers), tea drinking status (2 for tea drinkers), and fresh fruit (2 for never) and showed good discrimination ability with area under the curve and its 95% confidence interval of 0.792 (0.761,0.822) in the deviation cohort and 0.773 (0.736,0.811) in the validation cohort. The calibration analysis showed great coherence between predicted probabilities and observed probabilities.ConclusionsWe developed and validated an ESCC prediction model using cohort study with good discrimination and calibration capability which can be used for EC screening for rural Chinese population.

Determinants and consequences of rural‐to‐urban migration patterns in China: Evidence from sequence analysis

AbstractThis paper adopts a life course perspective that captures the migration trajectory for rural‐to‐urban migrants in China during the observation window. By taking this trajectory approach, we aim to advance the understanding of divergent rural‐to‐urban migration patterns in China and their determinants and consequences. We use data from the Survey of Internal Migration and Health in China (IMHC) and focus on individuals' migration experience between age 14 and 40. First, we apply sequence analysis to characterise the main rural‐to‐urban migration patterns by different timing, duration, frequency, and direction and identify seven common patterns. We next examine the determinants of these patterns. The results suggest that demographic characteristics, socio‐economic background, and hometown characteristics shape migration trajectories in complex ways, highlighting that social origin can substantially determine migration patterns of rural Chinese. Furthermore, we examine via a counterfactual framework how the seven migration patterns shape migrants' occupational attainment while taking account of self‐selection into different migration trajectories. The findings show that (i) there is self‐selection into migration trajectories that has implications for occupational status and (ii) non‐transient adult urban migration is associated with higher occupational attainment whereas other types of migration are not.

Estimating rural–urban disparities in self-rated health in China: Impact of choice of urban definition

Objective: We use the 2014 China Family Panel Studies (CFPS), which includes anchoring vignettes, to provide an up-to-date assessment of rural–urban health disparities as measured by self-rated health (SRH) in China. Our analysis is based on multiple definitions (hukou and the two different residence-based definitions) of rural–urban and migration status; previous research was inconclusive due to the use of different definitions and concerns about status-based differential health expectations (reporting heterogeneity). Results: We find a nonlinear difference between rural and urban Chinese in how they self-assess health status, regardless of the urban definition used. Urban respondents do not always hold a higher standard for self-assessment of health. Instead, their rating styles depend on the level of latent health. After controlling for the reporting heterogeneity, we find on average a slight urban advantage in SRH, but it is most pronounced when using the statistical (density dependent) definition of urban. Contribution: We study rural–urban health disparities based on three different urban definitions and migration status. Although we examine the urban definitions that are specific to China, we demonstrate a mindful approach when multiple definitions exist and caution against any simplistic approach that ignores context-specific urban definition. We also provide clear illustrations of the different types of reporting heterogeneity, as well as a way to visualize the cut-points, thresholds, and latent health estimates.