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Longitudinal study of child immunization determinants in China


  • Xie, Jipan
  • Dow, William H.


This paper exploits longitudinal data and methods to study the determinants of child immunization in 1990s China. Many countries such as China are experiencing rapid economic transitions characterized by declining public health expenditures, privatizing health-care sectors, increased inequality and high income growth. It is still poorly understood how such changes affect utilization of preventive health care. Data from three waves of the China Health and Nutrition Survey were used to examine the immunization effects of child, household, and community health facility characteristics, as well as changes of such effects over time. Results indicate that gender and wealth differentials in immunization increased during China's transition, though these effects were small. The most important determinants were service price and maternal education. Wealth effects were minimal, indicating that the long-run effect of economic transition on immunization rates may depend crucially on the extent to which more rapid economic growth leads to increased educational investments. Methodologically, the paper finds substantial bias from standard cross-sectional models in contrast to panel data approaches, adding to the case for expanded collection of longitudinal health data in developing countries.

Suggested Citation

  • Xie, Jipan & Dow, William H., 2005. "Longitudinal study of child immunization determinants in China," Social Science & Medicine, Elsevier, vol. 61(3), pages 601-611, August.
  • Handle: RePEc:eee:socmed:v:61:y:2005:i:3:p:601-611

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    References listed on IDEAS

    1. Zhang, Xinglu & Wang, Lixia & Zhu, Xu & Wang, Kean, 1999. "Knowledge, attitude and practice survey on immunization service delivery in Guangxi and Gansu, China," Social Science & Medicine, Elsevier, vol. 49(8), pages 1125-1127, October.
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    6. John Mullahy, 1999. "It'll only hurt a second? Microeconomic determinants of who gets flu shots," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 9-24.
    7. Liu, Xingzhu & Mills, Anne, 2002. "Financing reforms of public health services in China: lessons for other nations," Social Science & Medicine, Elsevier, vol. 54(11), pages 1691-1698, June.
    8. Mark Montgomery & Michele Gragnolati & Kathleen Burke & Edmundo Paredes, 2000. "Measuring living standards with proxy variables," Demography, Springer;Population Association of America (PAA), vol. 37(2), pages 155-174, May.
    9. Pande, Rohini P. & Yazbeck, Abdo S., 2003. "What's in a country average? Wealth, gender, and regional inequalities in immunization in India," Social Science & Medicine, Elsevier, vol. 57(11), pages 2075-2088, December.
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    Cited by:

    1. Chowa, Gina & Ansong, David & Masa, Rainier, 2010. "Assets and child well-being in developing countries: A research review," Children and Youth Services Review, Elsevier, vol. 32(11), pages 1508-1519, November.
    2. Yusuf, Shahid & Nabeshima, Kaoru & Wei Ha, 2007. "What makes cities healthy ?," Policy Research Working Paper Series 4107, The World Bank.
    3. Woohyeon Kim & Stephen Wolff & Vivian Ho, 2016. "Measuring the Volume-Outcome Relation for Complex Hospital Surgery," Applied Health Economics and Health Policy, Springer, vol. 14(4), pages 453-464, August.
    4. Elizabeth Crouch & Lori Dickes, 2015. "A Prediction Model of Childhood Immunization Rates," Applied Health Economics and Health Policy, Springer, vol. 13(2), pages 243-251, April.
    5. Barham, Tania & Maluccio, John A., 2009. "Eradicating diseases: The effect of conditional cash transfers on vaccination coverage in rural Nicaragua," Journal of Health Economics, Elsevier, vol. 28(3), pages 611-621, May.
    6. Driessen, Julia & Olson, Zachary D. & Jamison, Dean T. & Verguet, Stéphane, 2015. "Comparing the health and social protection effects of measles vaccination strategies in Ethiopia: An extended cost-effectiveness analysis," Social Science & Medicine, Elsevier, vol. 139(C), pages 115-122.


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