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Healthcare spillovers of spousal health shocks in China: evidence from administrative data

Author

Listed:
  • Yufei Xie

    (University of California)

  • Yiheng Liu

    (The Chinese University of Hong kong)

  • Jin Feng

    (Fudan University
    Fudan University)

Abstract

This paper studies the impact of a person’s severe health shocks on their spouse’s healthcare behaviors. Using healthcare administrative data in China, we document that a person’s initial cancer diagnosis has an immediate and lasting positive impact on their spouse’s healthcare utilization. The results point to information spillovers as a primary mechanism and reveal a significant negative impact on mental health, while the negative effect of the financial burden is weak. Notably, there are significant gender differences in responses, with the impact more pronounced among wives. The results highlight the role of family coordination in responding to adverse health events in the developing country context.

Suggested Citation

  • Yufei Xie & Yiheng Liu & Jin Feng, 2025. "Healthcare spillovers of spousal health shocks in China: evidence from administrative data," Journal of Population Economics, Springer;European Society for Population Economics, vol. 38(1), pages 1-28, March.
  • Handle: RePEc:spr:jopoec:v:38:y:2025:i:1:d:10.1007_s00148-025-01081-8
    DOI: 10.1007/s00148-025-01081-8
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    as
    1. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    2. Itzik Fadlon & Torben Heien Nielsen, 2019. "Family Health Behaviors," American Economic Review, American Economic Association, vol. 109(9), pages 3162-3191, September.
    3. Chen, Xi & Ge, Suqin, 2018. "Social norms and female labor force participation in urban China," Journal of Comparative Economics, Elsevier, vol. 46(4), pages 966-987.
    4. Corey White, 2021. "Measuring Social and Externality Benefits of Influenza Vaccination," Journal of Human Resources, University of Wisconsin Press, vol. 56(3), pages 749-785.
    5. Wang, Yajie & Jin, Zhenjie & Yuan, Ye, 2023. "The consequences of health shocks on households: Evidence from China," China Economic Review, Elsevier, vol. 79(C).
    6. Elisabeth Artmann & Hessel Oosterbeek & Bas van der Klaauw, 2022. "Do Doctors Improve the Health Care of Their Parents? Evidence from Admission Lotteries," American Economic Journal: Applied Economics, American Economic Association, vol. 14(3), pages 164-184, July.
    7. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
    8. Angelini, Viola & Costa-Font, Joan, 2023. "Health and wellbeing spillovers of a partner's cancer diagnosis," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 422-437.
    9. Ghazala Azmat & Caterina Calsamiglia & Nagore Iriberri, 2016. "Gender Differences in Response to Big Stakes," Journal of the European Economic Association, European Economic Association, vol. 14(6), pages 1372-1400.
    10. Liu, Kai, 2016. "Insuring against health shocks: Health insurance and household choices," Journal of Health Economics, Elsevier, vol. 46(C), pages 16-32.
    11. Stepan Jurajda & Daniel Munich, 2011. "Gender Gap in Performance under Competitive Pressure: Admissions to Czech Universities," American Economic Review, American Economic Association, vol. 101(3), pages 514-518, May.
    12. Carlos Dobkin & Amy Finkelstein & Raymond Kluender & Matthew J. Notowidigdo, 2018. "The Economic Consequences of Hospital Admissions," American Economic Review, American Economic Association, vol. 108(2), pages 308-352, February.
    13. Manoj Mohanan, 2013. "Causal Effects of Health Shocks on Consumption and Debt: Quasi-Experimental Evidence from Bus Accident Injuries," The Review of Economics and Statistics, MIT Press, vol. 95(2), pages 673-681, May.
    14. Nicholas A. Jolly & Nikolaos Theodoropoulos, 2023. "Health shocks and spousal labor supply: an international perspective," Journal of Population Economics, Springer;European Society for Population Economics, vol. 36(2), pages 973-1004, April.
    15. Song, Yang, 2014. "What should economists know about the current Chinese hukou system?," China Economic Review, Elsevier, vol. 29(C), pages 200-212.
    16. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    17. Felix Glaser & Gerald J. Pruckner, 2023. "A hard pill to swallow? Parental health shocks and children's mental health," Health Economics, John Wiley & Sons, Ltd., vol. 32(12), pages 2768-2800, December.
    18. Pilar García-Gómez & Hans van Kippersluis & Owen O’Donnell & Eddy van Doorslaer, 2013. "Long-Term and Spillover Effects of Health Shocks on Employment and Income," Journal of Human Resources, University of Wisconsin Press, vol. 48(4), pages 873-909.
    19. Michael Darden & Donna Gilleskie, 2016. "The Effects of Parental Health Shocks on Adult Offspring Smoking Behavior and Self‐Assessed Health," Health Economics, John Wiley & Sons, Ltd., vol. 25(8), pages 939-954, August.
    20. Lex Borghans & Bart H. H. Golsteyn & James J. Heckman & Huub Meijers, 2009. "Gender Differences in Risk Aversion and Ambiguity Aversion," Journal of the European Economic Association, MIT Press, vol. 7(2-3), pages 649-658, 04-05.
    21. Yiqun Chen & Petra Persson & Maria Polyakova, 2022. "The Roots of Health Inequality and the Value of Intrafamily Expertise," American Economic Journal: Applied Economics, American Economic Association, vol. 14(3), pages 185-223, July.
    22. Cohn, Jonathan B. & Liu, Zack & Wardlaw, Malcolm I., 2022. "Count (and count-like) data in finance," Journal of Financial Economics, Elsevier, vol. 146(2), pages 529-551.
    23. Li, Xin & Zhang, Wei, 2013. "The impacts of health insurance on health care utilization among the older people in China," Social Science & Medicine, Elsevier, vol. 85(C), pages 59-65.
    24. Hodor, Michal, 2021. "Family health spillovers: evidence from the RAND health insurance experiment," Journal of Health Economics, Elsevier, vol. 79(C).
    25. Francetic, Igor & Meacock, Rachel & Sutton, Matt, 2022. "Understanding Concordance in Health Behaviours among Couples: Evidence from the Bowel Cancer Screening Programme in England," Journal of Economic Behavior & Organization, Elsevier, vol. 201(C), pages 310-345.
    26. Denton, Margaret & Prus, Steven & Walters, Vivienne, 2004. "Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health," Social Science & Medicine, Elsevier, vol. 58(12), pages 2585-2600, June.
    27. Xiqian Cai & Yi Lu & Jessica Pan & Songfa Zhong, 2019. "Gender Gap under Pressure: Evidence from China's National College Entrance Examination," The Review of Economics and Statistics, MIT Press, vol. 101(2), pages 249-263, May.
    28. Sophie Mitra & Michael Palmer & Daniel Mont & Nora Groce, 2016. "Can Households Cope with Health Shocks in Vietnam?," Health Economics, John Wiley & Sons, Ltd., vol. 25(7), pages 888-907, July.
    29. Lex Borghans & Bart H.H. Golsteyn & James J. Heckman & Huub Meijers, 2009. "Gender Differences in Risk Aversion and Ambiguity," Working Papers 200903, Geary Institute, University College Dublin.
    30. Ida Lykke Kristiansen, 2021. "Consequences of serious parental health events on child mental health and educational outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1772-1817, August.
    31. Itzik Fadlon & Torben Heien Nielsen, 2021. "Family Labor Supply Responses to Severe Health Shocks: Evidence from Danish Administrative Records," American Economic Journal: Applied Economics, American Economic Association, vol. 13(3), pages 1-30, July.
    32. Courtney J. Ward, 2014. "Influenza Vaccination Campaigns: Is an Ounce of Prevention Worth a Pound of Cure?," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 38-72, January.
    33. Alam, Shamma Adeeb, 2015. "Parental health shocks, child labor and educational outcomes: Evidence from Tanzania," Journal of Health Economics, Elsevier, vol. 44(C), pages 161-175.
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    More about this item

    Keywords

    Health shocks; Family health behaviors; Information spillovers;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J12 - Labor and Demographic Economics - - Demographic Economics - - - Marriage; Marital Dissolution; Family Structure

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