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The Health Penalty of China's Rapid Urbanization

Author

Listed:
  • 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

This discussion paper resulted in an article in Health Economics (2012). Volume 21, issue 4, pages 367-385. 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.

Suggested Citation

  • E. Van de Poel & O. O'Donnell & E. Van Doorslaer, 2009. "The Health Penalty of China's Rapid Urbanization," Tinbergen Institute Discussion Papers 09-016/3, Tinbergen Institute.
  • Handle: RePEc:tin:wpaper:20090016
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    References listed on IDEAS

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    Cited by:

    1. David Mayer-Foulkes, 2011. "Urbanization as a Fundamental Cause of Development," Working papers DTE 501, CIDE, División de Economía.

    More about this item

    Keywords

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

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O18 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Urban, Rural, Regional, and Transportation Analysis; Housing; Infrastructure

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