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Urbanization and the spread of diseases of affluence in China

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  • Van de Poel, E
  • O'Donnell, O
  • van Doorslaer, E

Abstract

A new methodology is used to quantify, track and explain the distribution of obesity and hypertension across areas differentiated by their degree of urbanicity. We construct an index of urbanicity from longitudinal data on community characteristics from the China Health and Nutrition Survey and compute a rank-based measure of inequality in disease risk factors by degree of urbanicity. Prevalence rates almost doubled over the period 1991-2004 and the risk factors became less concentrated in more urbanized areas. Decomposition analysis shows that urbanicity-related inequalities are mostly attributable to differences in community level characteristics and to disparities in incomes and in the physical and farming activity of individuals.

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Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 08/25.

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Date of creation: Oct 2008
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Handle: RePEc:yor:hectdg:08/25
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Keywords: China; urbanization; health inequalities; obesity; hypertension; decomposition;

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  1. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
  2. Chou, Shin-Yi & Grossman, Michael & Saffer, Henry, 2004. "An economic analysis of adult obesity: results from the Behavioral Risk Factor Surveillance System," Journal of Health Economics, Elsevier, vol. 23(3), pages 565-587, May.
  3. Owen O’Donnell & Eddy van Doorslaer & Adam Wagstaff, 2012. "Decomposition of Inequalities in Health and Health Care," Chapters, in: The Elgar Companion to Health Economics, Second Edition, chapter 17 Edward Elgar Publishing.
  4. Liu, Gordon G. & Dow, William H. & Fu, Alex Z. & Akin, John & Lance, Peter, 2008. "Income productivity in China: On the role of health," Journal of Health Economics, Elsevier, vol. 27(1), pages 27-44, January.
  5. Sicular, Terry & Yue, Ximing & Gustafsson, Bjorn & Li, Shi, 2006. "The Urban-Rural Income Gap and Inequality in China," Working Paper Series RP2006/135, World Institute for Development Economic Research (UNU-WIDER).
  6. Currie, Janet & DellaVigna, Stefano & Moretti, Enrico & Pathania, Vikram, 2009. "The Effect of Fast Food Restaurants on Obesity," Working Papers 47830, American Association of Wine Economists.
  7. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
  8. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
  9. McDade, Thomas W. & Adair, Linda S., 2001. "Defining the "urban" in urbanization and health: a factor analysis approach," Social Science & Medicine, Elsevier, vol. 53(1), pages 55-70, July.
  10. Shahid Yusuf & Tony Saich, 2008. "China Urbanizes : Consequences, Strategies, and Policies," World Bank Publications, The World Bank, number 6337, April.
  11. Ng, Shu Wen & Norton, Edward C. & Popkin, Barry M., 2009. "Why have physical activity levels declined among Chinese adults? Findings from the 1991-2006 China health and nutrition surveys," Social Science & Medicine, Elsevier, vol. 68(7), pages 1305-1314, April.
  12. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
  13. Dahly, Darren L. & Adair, Linda S., 2007. "Quantifying the urban environment: A scale measure of urbanicity outperforms the urban-rural dichotomy," Social Science & Medicine, Elsevier, vol. 64(7), pages 1407-1419, April.
  14. Liu, Yuanli & Hsiao, William C. & Eggleston, Karen, 1999. "Equity in health and health care: the Chinese experience," Social Science & Medicine, Elsevier, vol. 49(10), pages 1349-1356, November.
  15. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432.
  16. Colin Bell, A. & Adair, Linda S. & Popkin, Barry M., 2004. "Understanding the role of mediating risk factors and proxy effects in the association between socio-economic status and untreated hypertension," Social Science & Medicine, Elsevier, vol. 59(2), pages 275-283, July.
  17. Gordon G. Liu & Xiaodong Wu & Chaoyang Peng & Alex Z. Fu, 2003. "Urbanization And Health Care In Rural China," Contemporary Economic Policy, Western Economic Association International, vol. 21(1), pages 11-24, 01.
  18. World Bank, 2007. "World Development Indicators 2007," World Bank Publications, The World Bank, number 8150, April.
  19. Sahn, David E. & Stifel, David C., 2000. "Poverty Comparisons Over Time and Across Countries in Africa," World Development, Elsevier, vol. 28(12), pages 2123-2155, December.
  20. Barry M. Popkin, 2003. "The Nutrition Transition in the Developing World," Development Policy Review, Overseas Development Institute, vol. 21(5-6), pages 581-597, December.
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Cited by:

  1. Liu, Hong & Fang, Hai & Zhao, Zhong, 2012. "Urban-Rural Disparities of Child Health and Nutritional Status in China from 1989 to 2006," IZA Discussion Papers 6528, Institute for the Study of Labor (IZA).
  2. Tafreschi, Darjusch, 2015. "The income body weight gradients in the developing economy of China," Economics & Human Biology, Elsevier, vol. 16(C), pages 115-134.
  3. Zhao, Meng & Konishi, Yoshifumi & Glewwe, Paul, 2013. "Does information on health status lead to a healthier lifestyle? Evidence from China on the effect of hypertension diagnosis on food consumption," Journal of Health Economics, Elsevier, vol. 32(2), pages 367-385.
  4. Dolton, Peter & Xiao, Mimi, 2015. "The intergenerational transmission of BMI in China," Economics & Human Biology, Elsevier, vol. 19(C), pages 90-113.
  5. Zhou, Song & Awokuse, Titus O., . "Urbanization, Nutrition Transition, and Obesity: Evidence from China," 2014 Annual Meeting, July 27-29, 2014, Minneapolis, Minnesota 170458, Agricultural and Applied Economics Association.
  6. 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.
  7. Heckley, Gawain & Gerdtham, Ulf-G. & Kjellsson, Gustav, 2016. "A general method for decomposing the causes of socioeconomic inequality in health," Journal of Health Economics, Elsevier, vol. 48(C), pages 89-106.

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