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The Health Penalty of China's Rapid Urbanization

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Author Info

  • E. Van de Poel

    (Erasmus University Rotterdam)

  • O. O'Donnell

    (Erasmus University Rotterdam, University of Macedonia, Thessaloniki, Greece)

  • E. Van Doorslaer

    (Erasmus University Rotterdam)

Abstract

Rapid urbanization could have positive and negative health effects, such that the net impact on population health is not obvious. It is, however, highly pertinent to the human welfare consequences of development. This paper uses community and individual level longitudinal data from the China Health and Nutrition Survey to estimate the net health impact of China’s unprecedented urbanization. We construct an index of urbanicity from a broad set of community characteristics and define urbanization in terms of movements across the distribution of this index. We use difference-in-differences estimators to identify the treatment effect of urbanization on the self-assessed health of individuals. The results reveal important, and robust, negative causal effects of urbanization on health. Urbanization increases the probability of reporting fair or poor health by 5 to 15 percentage points, with a greater degree of urbanization having larger health effects. While people in more urbanized areas are, on average, in better health than their rural counterparts, the process of urbanization is damaging to health. Our measure of self-assessed health is highly correlated with subsequent mortality and the causal harmful effect of urbanization on health is confirmed using more objective (but also more specific) health indicators, such as physical impairments, disease symptoms and hypertension.

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File URL: http://papers.tinbergen.nl/09016.pdf
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Bibliographic Info

Paper provided by Tinbergen Institute in its series Tinbergen Institute Discussion Papers with number 09-016/3.

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Date of creation: 19 Feb 2009
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Handle: RePEc:dgr:uvatin:20090016

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Web page: http://www.tinbergen.nl

Related research

Keywords: urbanization; health; China; treatment effects; difference-in-differences;

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