Rural Counties In China Research Articles

Dietary diversity and development among early childhood children in rural China

BackgroundEarly childhood is a critical period for cognitive development, heavily influenced by nutrition. Despite significant economic advancements, malnutrition and micronutrient deficiencies persist in many low- and middle-income countries, including China, where dietary diversity remains suboptimal. Existing research predominantly relies on correlational data, underscoring the need for more rigorous empirical evidence. This study aims to fill that gap by providing stronger empirical evidence on the relationship between dietary diversity and developmental outcomes in rural Chinese children.MethodsWe conducted a longitudinal cohort study of 1,207 children aged 6–23 months, drawn from 100 villages across 22 counties in rural China, with three follow-up rounds extending until the children reached 51–83 months of age. Cognitive and non-cognitive development, as well as key health indicators, were evaluated. Cognitive development was measured using the Bayley Scales of Infant and Toddler Development and the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition. Non-cognitive development was assessed via the Ages and Stages Questionnaire: Social-Emotional and the Strengths and Difficulties Questionnaire. Health indicators included anemia, frequency of illness in the past 2 weeks, and four key anthropometric measures (height-for-age z-scores, weight-for-age z-scores, weight-for-height z-scores, and body mass index-for-age z-scores). Multiple linear regression models were applied to analyze the relationship between dietary diversity scores (DDS) and developmental outcomes, incorporating child fixed effects and adjustments for time-variant confounders. We accounted for the hierarchical structure of the data by clustering standard errors at the village level, which also reflects the township level.ResultsThe regression analysis identified significant positive associations between DDS and cognitive (p < 0.01), as well as reduced illness incidence (p < 0.001) in children aged 6–54 months. Additionally, DDS demonstrated a strong positive effect on non-cognitive development (p < 0.001) in children 2 years and older. The associations between DDS, non-cognitive development (p < 0.01), and illnesses reduction (p < 0.001) remained robust under two-way fixed effects models.ImplicationsTo promote sustainable improvements in child development and health, policymakers should prioritize nutrition-focused interventions in rural areas. Community-based programs offering caregivers training and nutritional support, integrated within healthcare and social services infrastructures, are vital for ensuring families have the necessary resources enhance child wellbeing and long-term developmental outcomes.

Achieving inclusive urbanization through county-led industrial specialization: from the perspective of rural labor supply

PurposeThe role of intermediate urban centers (IUCs) (like towns/small cities/rural counties) between large cities and villages in leading urbanization has been increasingly highlighted. This article conceptually and empirically examines what types of industrial agglomeration (specialized or diversified agglomeration) of rural county in China would provide a more inclusive and efficient local labor market for rural workers to be inclusively urbanized.Design/methodology/approachWe employ a three-stage labor supply model to theoretically generalize the decisions of rural workers to migrate to large city, to undertake nonfarm jobs in rural counties and the length of nonfarm jobs. Then, combining three national-level datasets of China (National Economic Census (NEC), China Household Income Project (CHIP) and the China county statistical yearbook), we explore how the type of industrial agglomeration in a rural county affects the labor supply decision of rural workers.FindingsWe show that rural workers in rural counties with higher level of industrial specialization are more likely to: (1) work locally than migrating to large cities; (2) find nonfarm jobs by themselves instead of relying on social networks (3) find a more stable and formal nonfarm job. These effects are significant when rural counties specialize in industries that they have local comparative advantages compared to large cities. This work provides insights into achieving inclusive urbanization by developing industry specialization in rural counties in China, which may also be useful for other developing countries.Originality/valueFirst, the conceptual framework of this paper extends the basic model of rural-urban migration longstanding in the literature, to a multi-choice and three-stage labor supply model. Second, we empirically quantify the industrial structure of rural counties using unique dataset, which has been emphasized in the development economics literature but neglected due to data limitations. Third, this paper expands our understanding of the role of rural counties in inclusive urbanization and contributes to the future development of the county-led urbanization policies.

Case fatality of repeated suicidal acts among suicide attempters in rural China: a retrospective cohort study

Individuals presenting to hospital due to suicide attempt are at high risk for repeated suicidal act, yet there are meager data on the extent to which repeated suicidal acts result in death. This retrospective cohort study was based on a general hospital self-harm register system in a rural county in China. Identified individuals who attempted suicide were contacted and followed up for up to 8 years. Main outcomes over follow-up were: 1) suicide death, 2) nonlethal suicide attempt, and 3) suicidal acts including suicide death and nonlethal attempt. Incidence densities, correlates, and case fatality of repeated suicidal acts were estimated. A total of 1086 individuals (two-thirds females, mean age 40.6 years) with a suicide attempt presenting to hospital (index attempt) were identified and followed up, with most of the index attempts by pesticide ingestion (79%). Over follow-up, there were 116 suicidal acts carried out by 108 individuals (69 females, 39 males), including 34 suicide deaths (21 females, 13 males), yielding a high case-fatality of 29.3%. During follow-up, suicide death rates were also high overall and in the first year of follow-up (846.7 and 1787.2 per 100,000 person years). Over follow-up, pesticide was the most common method (47/116) of repeated suicidal act and yielded a higher case-fatality than other methods (46.8% vs 17.4%, χ2=11.68, P<0.001). The incidence densities of repeated suicidal acts and nonlethal attempts were low compared to rates reported in previous literature. Incidence densities of repeated suicidal acts in a rural China cohort were low compared to previous studies. However, rates of suicide deaths over follow-up were high, a result driven by the high case-fatality of suicidal acts and attributable to the common use of pesticides. Reducing suicidal acts with pesticides is a key target for suicide prevention in rural China. Beijing Municipal High Rank Public Health Researcher Training Program, Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support, and Beijing Hospitals Authority's Ascent Plan.

The association of family doctor contract service and patient trust in doctor: evidence from twenty-five village clinics of three counties in rural China

BackgroundChina is implementing the family doctor (FD) system to reform the primary healthcare (PHC). The family doctor contract service (FDCS) policy plays a crucial role in this system implementation, aiming to transform the doctor-patient relationship and enhance PHC quality. This study aims to investigate the impact of FDCS on the doctor-patient relationship in PHCs using field research methodology.MethodThe field research methodology was employed to address the research questions. Quantitative methods were utilized for data collection and analysis. A structure questionnaire was used to collect data based on the research questions. Our investigation encompassed twenty-five village clinics across three counties in China. A total of 574 subjects helped us to finish this investigation in the study. The collected data was analyzed using statistical analysis including ordinary least squares (OLS) model and propensity scores matching model (PSM) to estimate the relationship.ResultThe findings from ordinary least squares (OLS) regression revealed that FDCS had a positive influence on patient trust in doctors within PHCs, with patients who participated the FDCS exhibiting higher levels of trust compared to those who did not participate. Propensity score matching (PSM) analysis further confirmed these results by accounting for selection bias.ConclusionsThe implementation of family doctor contract service has brought about significant transformation in the doctor-patient relationship within rural Chinese PHCs. In essence, it has revolutionized the service model of doctor in PHC, playing a pivotal role in improving primary health quality and enhance the service capability of doctors in PHC. This transformative process has been crucial for carrying out hierarchical diagnosis and treatment policy, which aims to adjust the medical service structure and optimizing the health service system. Therefore, it is imperative for government authorities and health administration departments to ensure continuous support for this essential service through appropriate formulation.

A multi-case study of the vertically integrated health-care at county-level in rural China: towards holistic and dynamic governance.

In contrast to the Grading Diagnosis and Treatment System (GDTS), Vertically Integrated Health-care at County-level (VIHC) is a strategic policy in rural China. This research intends to analyze the shift in governance paradigm with regard to the adjustment of the power structure and interest relationships among various participants, using the building of VIHC as a cut-in point. We carry out a multi-case study to investigate the paradigms of health governance when building VIHC in three different rural counties in China. There were exchanges between government and other participants, vertical and horizontal collaborations among government divisions, and prompt responses to public requirements. County C's local administration, in particular, placed a strong emphasis on bureaucratic power and collaboration between various departments both within and outside of administrative boundaries. In contrast, County B's local administration emphasized the independence of healthcare practitioners and worked to win their support. In contrast to the previous two governments, County A encouraged social actors to participate and saw a little improvement in performance. In examining the health reform in rural China, this study paints a picture of the development of the health governance paradigm. In rural China, a comprehensive and dynamic governance paradigm was created through the integration of the health decision-making process, which was driven by the public's health needs, the operation mechanism, which featured both competition and cooperation, and the action logic of sharing responsibility.

Quality of primary health care for chronic diseases in low-resource settings: Evidence from a comprehensive study in rural China.

There is a paucity of evidence regarding the definition of the quality of primary health care (PHC) in China. This study aims to evaluate the PHC quality for chronic diseases in rural areas based on a modified conceptual framework tailored to the context of rural China. This comprehensive study, involving a patient survey, a provider survey and chart abstraction, and second-hand registered data, was set in three low-resource counties in rural China from 2021 to 2022. Rural patients with hypertension or type 2 diabetes, and health care workers providing care on hypertension or diabetes were involved. The modified PHC quality framework encompasses three core domains: a competent PHC system (comprehensiveness, accessibility, continuity, and coordination), effective clinical care (assessment, diagnosis, treatment, disease management, and provider competence), and positive user experience (information sharing, shared decision-making, respect for patient's preferences, and family-centeredness). Standardized PHC quality score was generated by arithmetic means or Rasch models of Item Response Theory. This study included 1355 patients, 333 health care providers and 2203 medical records. Ranging from 0 (the worst) to 1 (the best), the average quality score for the PHC system was 0.718, with 0.887 for comprehensiveness, 0.781 for accessibility, 0.489 for continuity, and 0.714 for coordination. For clinical care, average quality was 0.773 for disease assessment, 0.768 for diagnosis, 0.677 for treatment, 0.777 for disease management, and 0.314 for provider competence. The average quality for user experience was 0.727, with 0.933 for information sharing, 0.657 for shared decision-making, 0.936 for respect for patients' preferences, and 0.382 for family-centeredness. The differences in quality among population subgroups, although statistically significant, were small. The PHC quality in rural China has shown strengths and limitations. We identified large gaps in continuity of care, treatment, provider competence, family-centeredness, and shared decision-making. Policymakers should invest more effort in addressing these gaps to improve PHC quality.

Perceived social support mitigates the associations among household chaos and health and well-being in rural early adolescents.

Previous studies have demonstrated that early adolescents residing in chaotic households experience adverse health and well-being outcomes. However, the potential protective factors that mitigate the relationship between household chaos and early adolescents' health and well-being remain unknown. Accordingly, this study aims to investigate whether perceived social support moderates the link between household chaos and the health and well-being among Chinese rural early adolescents. Physical health difficulties were assessed using two measures: general health and allostatic load (AL). Mental health difficulties were measured by depression. Well-being was reflected by life satisfaction. Specifically, this study included early adolescents (N = 337; Mage = 10.88 ± 1.36 years) from rural counties in China who reported their household chaos, perceived social support, general health, depression, and life satisfaction. AL scores were determined based on six physiological indices. Household chaos exhibited a negative relationship with the general health and life satisfaction while a positive correlation with depression. Moreover, perceived social support was found to moderate the association between household chaos and these health and well-being indicators of early adolescents. Specifically, early adolescents who reported higher levels of perceived social support exhibited weaker negative connections among household chaos and their general health, depression, and life satisfaction. Furthermore, no significant relationships were observed between the adolescents' AL and household chaos, perceived social support, or their interactions. Household chaos poses a significant risk to health and well-being. Furthermore, the findings indicate that perceived social support can mitigate these negative effects.

Strengthening the social information processing skills of third graders in rural China: Findings of ‘Let's Be Friends (Shaanxi), Trial 2’

AbstractThis study presents the findings of Let's Be Friends (Shaanxi), Trial 2 (LBF2), which is a second test of the school‐based intervention. Let's Be Friends (LBF) is designed to promote social competence and prevent maladaptive behaviour by strengthening the social information processing (SIP) skills of third‐grade children in rural China. A cluster‐matched design with random sampling was used in LBF2. Two rural counties in China were selected by purposive sampling (one is the treatment site, and another is the control site). Nine treatment schools (n = 343) were selected by random sampling. Fifteen control schools (n = 369) were selected by using vector‐norm matching. All children of the third grade, ages 8–10, in the treatment schools received 12 sessions of LBF2 intervention. Skill‐level Activity Scale and the Carolina Child Checklist–Teacher Form were employed to measure children's SIP skills and aggressive behaviour. LBF2 promoted the improvement of study children's SIP skills and effectively improved children's authority acceptance. LBF has the potential to be applied in China.

Continuity of health care: measurement and application in two rural counties of Guangxi Province, China

BackgroundContinuity of care (COC) is highly regarded in health promotion and health system strengthening. However, there is a lack of multidimensional quantitative assessment of continuity, making it challenging to evaluate and compare. Our objective was to create a novel measurement for COC and apply it in two rural counties in China to assess its validity and feasibility in evaluating health system reform.MethodThis study conducted a scoping literature review on COC, examining existing frameworks and indicators. Following an online expert poll, a composite indicator was developed using the analytical hierarchy process (AHP). The measurement tool was then applied to assess the current state of COC in two rural counties in China. In addition to descriptive analysis, demographic and economic characteristics were analyzed for their association with COC scores using t-tests and multiple linear regression models.ResultsThe final COC measurement encompasses three dimensions, six sub-dimensions, and ten individual indicators, which integrated and improved the current frameworks and indicators. Relational continuity, informational continuity, and management continuity were identified as the primary dimensions of COC measurement. The COC score is 0.49 in County A and 0.41 in County B, with information continuity being the highest-scoring dimension. Notably, the disparity in continuity scores is most pronounced among individuals with varying attitudes towards health, demonstrating a positive correlation.ConclusionThe construction of the composite indicator in this study offers a scientific and effective metric for comprehensively measuring continuity of care. The empirical data analysis conducted in Western China serves as an illustrative application of the indicator, demonstrating its efficiency. The results obtained from this analysis provide a solid foundation and valuable reference for strengthening the health system.

Real‐estate Boom, Commodification and Crises of Social Reproductive Institutions in Rural China

ABSTRACTBased on 12 months of ethnographic, interview and archival research in a poor rural county in China, this article argues that three state policies, namely the concentration of rural educational resources in the county seat, the decision to make access to county‐seat public schools conditional upon homeownership in school districts, and the (former) one‐child policy, have compelled rural households to participate in the real‐estate market to meet the reproductive needs of basic education and marriage. The increasing commodification of education and marriage has fuelled a local real‐estate boom during the past decade. At the same time, it has put peasant‐migrant households under severe economic pressure, forcing them to relocate unpaid female care labour away from the village and to become heavily indebted. These outcomes have had serious repercussions for two other reproductive institutions, leading to a breakdown in intergenerational care and financial support for the elderly, and a sharp decline in the rural birth rate. The Chinese countryside as a social space in which peasant‐migrant households were able to reproduce themselves in a relatively non‐commodified manner has disappeared.

Exploring the effects of rural human settlement on rural development: Evidence from Xianju County in Zhejiang Province, China

While boosting rural development, improvements in rural human settlements have become universal choices in many countries throughout the world. However, few studies have been devoted to in-depth exploration of the effects of rural human settlements on rural development. To fill in the research gap, this study firstly established a mechanism framework of the effects of human settlements on rural development, and proposed a hypothetical structural equation model of variables’ interaction. The framework and model were further applied to a case study in a typical rural county in China with by using 370 household survey data. The results indicated that the effects of rural human settlements on rural development were a layer-by-layer processes with dynamic changes. The implementations of rural human settlement improvement projects can firstly stimulate qualitative changes of the three core factors in rural regional systems (namely population, land, and industry). The changes further bring a series of effects, such as scale effects, health promotion effects, factor mobility effects, and the like, thereby facilitating sustainable rural development. The results also confirmed that the overall impact of rural human settlements on rural development was dimensionally heterogeneous. The effects of the five aspects of human settlements exhibit an order of infrastructure conditions > natural environment conditions > public service levels > housing conditions > human social amenities. In general, this paper deepen the understanding of the drivers of high-quality rural development, and the results obtained in this investigation not only offer some new insights for rural planners and policymakers for better understanding the relationships between human settlements and rural development, but also provide scientific and useful guidance for beautiful countryside construction and rural revitalization.

Photovoltaics literature survey (No. 181)

Photovoltaics literature survey (No. 181)

Do the photovoltaic poverty alleviation programs alleviate local energy poverty? —Empirical evidence of 9 counties in rural China

As an innovation of the Chinese government energy policy, solar photovoltaic poverty alleviation projects (PPAPs) play a positive role in solving energy shortages and poverty reduction. However, there is limited research on energy poverty in China's PPAP areas. This study has proposed a three-dimensional theoretical model for energy poverty, evaluated the energy poverty in the PPAP areas and analyzed its influencing path. The results show that: (1) The implementation of PPAPs has improved energy poverty to various degrees in all three types of solar resource areas; (2) The availability of energy services is the most prominent problem in energy poverty, and the PPAPs improve the availability of energy services the most; (3) Farmers' economic status and education have the greatest impact on alleviating energy poverty, and (4) The PPAPs directly improve the availability of energy services by increasing power generation and stability of the grid, and indirectly affect the cleanliness of energy consumption and energy affordability through farmers per se, thus affecting local energy poverty. Thus, public policies for promoting clean energy and energy utilization technologies (such as solar PV, etc) would help alleviate energy poverty in the rural areas.

Can information and communication technologies contribute to poverty reduction? Evidence from poor counties in China

ABSTRACT Information and communication technologies (ICTs) have received increasing attention in recent years as a promising means to address poverty challenges in rural China. This paper uses a unique three-wave panel data set of household surveys, collected from seven officially recognized poor counties in rural China during 2012–2018, to examine the effect of ICT adoption on poverty. The results show that ICTs contributed positively to poverty reduction in the sampled counties, which may have been primarily achieved through increased migration and off-farm income, instead of through improved agricultural production and farm income. This suggests that ICT development facilitated households escaping poverty by helping them diversify their livelihood strategies away from agriculture in remote mountainous areas. The findings highlight the importance of creating incentives to complement the opportunities brought by ICTs for local development. It is important to strike a balance between poverty reduction and food security objectives.

Effect evaluation of the primary screening strategy for liver cancer in rural areas of China

Objective: To estimate the effectiveness of the primary screening strategy for liver cancer in rural areas to provide basic information for the optimization and perfection of the technical program for the early detection and treatment of liver cancer. Methods: Residents including males aged 35-64 and females aged 45-64 from 9 counties in rural China between 2013 and 2015 were selected as the target population. The participant was classified into a high-risk and non-high-risk group based on the standardized questionnaire or HBsAg, and the Chi-squared test was applied to compare differences between the two groups. The Cox proportional hazard regression models were applied to assess hazard ratio (HR) and its 95% confidence interval (CI). Results: 358 348 participants were recruited from 2013 to 2015. 1 196 individuals were identified with liver cancer until December 31, 2021, with an incidence density of 52.0/10(5) person-years. Of the participants, 54 650 were assessed as high risk (15.3%) based on the questionnaire and the status of HBsAg. The high-risk population had a higher incidence density (168.3/10(5) person-years vs 31.5/10(5) person-years) and higher risk of developing liver cancer (HR=2.98, 95% CI=2.64-3.35), compared to the non-high-risk group. Based on the questionnaire-based high-risk assessment system, 47 884 (13.4%) individuals were identified as high risk, who showed statistical differences in terms of incidence density and incidence risk, in comparison to the low-risk population (all P<0.05). HBsAg can screen out a higher proportion of high-risk individuals who are women, non-smokers, non-drinkers, and individuals without a family history of liver cancer (all P<0.05). The sensitivity analysis of the effectiveness of the whole primary screening method is stable, and high-risk individuals still had a higher risk of liver cancer. Conclusions: The primary screening method of the questionnaire-based risk assessment system and HBsAg can achieve satisfactory effectiveness. The questionnaire-based risk assessment system could identify high-risk individuals to some extent, however, it still needs to be improved to meet the actual requirements.

High proportion of tuberculosis transmission among social contacts in rural China: a 12-year prospective population-based genomic epidemiological study

ABSTRACT Tuberculosis (TB) is more prevalent in rural than urban areas in China, and delineating TB transmission patterns in rural populations could improve TB control. We conducted a prospective population-based study of culture-positive pulmonary TB patients diagnosed between July 1, 2009 and December 31, 2020 in two rural counties in China. Genomic clusters were defined with a threshold distance of 12-single-nucleotide-polymorphisms, based on whole-genome sequencing. Risk factors for clustering were identified by logistic regression. Transmission links were sought through epidemiological investigation of genomic-clustered patients. Of 1517 and 751 culture-positive pulmonary TB patients in Wusheng and Wuchang counties, respectively, 1289 and 699 strains were sequenced. Overall, 624 (31.4%, 624/1988) patients were grouped into 225 genomic clusters. Epidemiological links were confirmed in 41.8% (196/469) of clustered isolates, including family (32.7%, 64/196) and social contacts (67.3%, 132/196). Social contacts were generally with relatives, within the community or in shared aggregated settings outside the community, but the proportion of clustered contacts in each category differed between the two sites. The time interval between diagnosis of student cases and contacts was significantly shorter than family and social contacts, probably due to enhanced student contact screening. Transmission of multidrug-resistant (MDR) strains was likely responsible for 81.4% (83/102) of MDR-TB cases, with minimal acquisition of additional resistance mutations. A large proportion of TB transmission in rural China occurred among social contacts, suggesting that active screening and aggressive contact tracing could benefit TB control, but contact screening should be tailored to local patterns of social interactions.

Quality of Life, Hopelessness, Impulsivity, and Suicide in the Rural Elderly in China: A Moderated Mediation Analysis of Psychological Autopsy Data.

BackgroundPeople who had died by suicide always being associated with negative emotions and even mental disorders. Understanding mechanisms underlying the association between quality of life (QOL), hopelessness, and suicide are of great significance. In this study, we aimed to test a model in which the QOL-suicide relationship was mediated by hopelessness and moderated by impulsivity.MethodsParticipants (N = 484, including 242 suicide deaths and 242 matched controls) were rural residents 60 years of age and older, randomly selected from 12 rural counties in China using a two-stage stratified cluster sampling method. Data were collected with standard psychological autopsy technique from informants (n = 968). The outcome variable was a suicide death. QOL, hopelessness, and impulsivity were assessed using validated scales. The proposed relationships were tested using mediation and moderated mediation models.ResultsOf the total sample, 55.8% were men with a median age of 75.5 years. Results from the moderated mediation analysis indicated that QOL was negatively associated with suicide (beta = −0.141, p < 0.01); this association was mediated by hopelessness (indirect effect: beta =0.578, p < 0.01), accounting for 73% of the total effect. Impulsivity significantly moderated the mediation effect from QOL to hopelessness (beta =0.005, p < 0.01).ConclusionsStudy findings have confirmed the negative association between QOL and suicide with psychological autopsy data, and demonstrated the role of hopelessness in mediating the QOL-suicide relation that is further modified by impulsiveness. These findings depend on our understanding of the suicide epidemiology among the elder in rural China and provide information much needed for suicide prevention.

Mental accounting and consumption of self-produced food

This is an exploratory study on mental accounting and food budgeting of agricultural households, in which we assumed that agricultural households may have a mental account for consumption of their self-produced food. Accordingly, they may reserve a certain quantity of self-produced food as a set budget for own consumption, implying that they may keep on consuming their own produce until they have consumed the quantity set for the mental budget. By making the mental accounting assumption, we hypothesized that the consumption of self-produced food is independent of market price. Also, we hypothesized that the consumption of self-produced food is increasing in the quantity of production if production is lower than the set budget, and independent of the quantity of production if production exceeds the set budget. By applying a double-log demand model and using survey data from six poor rural counties in China, we tested these hypotheses for five food items, which are rice, flour, potatoes, pork, and eggs. We found that the hypothesis of no significant effect of price holds for flour, potatoes, and pork if production is lower than the set budget, and for rice, pork, and eggs if production is higher than the set budget. Production has a significant positive effect on consumption of self-produced food but with a much greater influence when production is lower than the set budget for all five food items. These findings partly support our assumption of mental accounting of self-produced food. Limitations, policy implications, and possible future studies are discussed.

Job creation or job relocation? Identifying the impact of China's special economic zones on local employment and industrial agglomeration

Since the early 1980s, special economic zones (SEZs) in China have benefited from targeted place-based policies intended to promote local employment and economic growth. What remain poorly understood is whether SEZs serve to give birth to new firms, or rather attract and support the re-establishment of firms from other places. To address this question, this paper examines the impact of SEZs on employment growth in rural counties in China. Using ASIF panel data representing the activity of manufacturing firms for the period 1999 to 2008, this paper assesses the employment effects of SEZs according to firm births, relocation, expansion, and firm closure. By matching counties with future SEZs as comparison groups, the difference-in-differences estimates show that SEZs significantly increase employment in rural counties due to the creation of new firms and the expansion of existing large firms; in contrast, SEZs fail to promote firms to move in and restrain firms from moving out. Further, data analysis reveals significant regional heterogeneity, with the employment effects of SEZs on firm entry strongest for the eastern coastal region. Finally, we confirm that SEZs tend to reduce local industrial agglomeration in the eastern and central regions.

Impact of parent-child separation on children\u2019s social-emotional development: a cross-sectional study of left-behind children in poor rural areas of China

BackgroundParent-child separation is a considerable adversity for left-behind children (LBC), but there is little evidence on the association between detailed characteristics of parent-child separation and social-emotional development among LBC. This study examined the characteristics of parent-child separation and its impacts on developmental delay among under-3 LBC in poor rural China.MethodsWe used data from 811 LBC surveyed in five poor counties in rural China in 2018. Detailed characteristics of their parental migration were recalled by their primary caregivers in face-to-face interviews. The children’s social-emotional development was measured by using the Ages and Stages Questionnaire: Social-Emotional. Logistic regression was employed to examine the association of detailed characteristics of parent-child separation with early social-emotional problems after adjusting for the children’s and primary caregivers’ sociodemographic characteristics.Results287 (35.4%) children were left behind by fathers and cared for by mothers (FM-MC), while 524 (64.6%) were left behind by both parents and cared for by grandparents (PM-GC). The rate of social-emotional problems among LBC was 36.8% (PM-GC vs FM-MC: 40.6% vs 29.5%; aOR 1.51, 95% CI: 1.06 to 2.16). For paternal migration, the medians of the child’s age at the first migration and average duration per migration were 3 months (IQR: 1 to 9 months) and 4.48 months (IQR: 2.38 to 7.54 months), respectively. For maternal migration, the corresponding values were 9 months (IQR: 6 to 13 months) and 4.65 months (IQR: 2.71 to 7.62 months), respectively. On average, LBC had been separated from fathers for 72% of their life due to paternal migration and from mothers for 52% of their life due to maternal migration. No significant association was found between the detailed characteristics of paternal migration and social-emotional development among LBC, while social-emotional problems among LBC were significantly associated with the proportion of cumulative duration of maternal migration in the child’s lifetime (aOR 2.83; 95% CI: 1.13 to 7.10).ConclusionsLBC under 3 years had a high risk of social-emotional problems in poor rural China. Cumulative exposure to maternal migration may be detrimental to LBC’s early social-emotional development. Programs are necessary to support these children as well as their families.