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The impact of a large-scale chronic disease prevention and control program on the health benefits of older adults: Evidence from a natural experiment in China

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  • Ma, Qingshan
  • Han, Yuqing
  • Chen, Mingcong
  • Hu, Feng
  • Zhou, Haiyan

Abstract

Chronic diseases impose significant burdens on families and society because of high disability rates and costly treatments. Based on data from the 2014–2020 China Longitudinal Aging Social Survey (CLASS), this paper considers the establishment of National Demonstration Zones for Comprehensive Chronic Disease Prevention and Control (NDZCCDPCs) as a natural experiment, and explores the impact of this policy on the health of older adults by constructing a staggered difference-in-differences (DID) model. The findings indicate that NDZCCDPCs reduces the number of chronic diseases prevalent in older adults by 10.6 %, decreases the probability of ADL difficulty by 2.9 %, and reduces the probability of self-assessed poor health by 3.9 %. NDZCCDPCs achieves these health benefits through mechanisms such as preventive care and behaviors, and healthcare service provision and cost reduction. However, the positive health impact is smaller in areas facing higher fiscal stress, due to crowding-out effects. Heterogeneity analysis indicates that the positive impact is more pronounced among older adults with lower levels of education and rural Hukou, and is more evident in areas with scarce medical resources. Finally, the benefits of establishing NDZCCDPCs outweigh the costs.

Suggested Citation

  • Ma, Qingshan & Han, Yuqing & Chen, Mingcong & Hu, Feng & Zhou, Haiyan, 2026. "The impact of a large-scale chronic disease prevention and control program on the health benefits of older adults: Evidence from a natural experiment in China," China Economic Review, Elsevier, vol. 95(C).
    • Handle: RePEc:eee:chieco:v:95:y:2026:i:c:s1043951x25002901
    DOI: 10.1016/j.chieco.2025.102632
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