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International Journal for Equity in Health

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Open Access 01-12-2014 | Research

Income-related children’s health inequality and health achievement in China

Authors: Lu Chen, Ya Wu, Peter C Coyte

Published in: International Journal for Equity in Health | Issue 1/2014

Abstract

Introduction

This study assessed income-related health inequality and health achievement in children in China, and additionally, examined province-level variations in health achievement.

Methods

Longitudinal data on 19,801 children under 18 years of age were derived from the China Health and Nutrition Survey. Income-related health inequality and health achievement were measured by the Health Concentration and Health Achievement Indices, respectively. Panel data with a fixed effect multiple regression model was employed to examine province-level variations in health achievement.

Results

A growing trend was towards greater health inequality among Chinese children over the last two decades. Although health achievement was getting better over time, the pro-rich inequality component has lessened the associated gain in achievement. Health achievement was positively impacted by middle school enrollments, the urbanization rate, inflation-adjusted per capita gross domestic product, and per capita public health spending.

Conclusion

This study has provided evidence that average health status of Chinese children has improved, but inequality has widened. Widening inequality slowed the growth in health achievement for children over time. There were wide variations in health achievement throughout China.

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Aghion P, Caroli E, García-Peñalosa C: Inequality and economic growth: the perspective of the new growth theories. J Econ Lit. 1999, 37: 1615-1660. 10.1257/jel.37.4.1615.CrossRef

Démurger S, Fournier M, Li S: Urban income inequality in China revisited (1988-2002). Econ Lett. 2006, 93: 354-359. 10.1016/j.econlet.2006.06.010.CrossRef

Brandt L, Rawski T: China Great Economic Transformation 2008. 2014, Cambridge University Press, Cambridge

Chi W: Capital income and income inequality: esvidence from urban China. J Comp Econ. 2012, 40 (2): 228-239. 10.1016/j.jce.2012.03.004.CrossRef

Mukhopadhaya P: Trends in income inequality in China: the effects of various sources of income. J Asia Pacific Econ. 2013, 18: 304-317. 10.1080/13547860.2013.778158.CrossRef

Tang S, Meng Q, Chen L, Bekedam H, Evans T, Whitehead M: Tackling the challenges to health equity in China. Lancet. 2008, 372: 1493-1501. 10.1016/S0140-6736(08)61364-1.PubMedCrossRef

Chen Z, Eastwood DB, Yen ST: A decadeʼs story of childhood malnutrition inequality in China: where you live does matter. China Econ Rev. 2007, 18: 139-154. 10.1016/j.chieco.2006.12.004.CrossRef

Case A, Fertig A, Paxson C: The lasting impact of childhood health and circumstance. J Health Econ. 2005, 24: 365-389. 10.1016/j.jhealeco.2004.09.008.PubMedCrossRef

Currie J: Healthy, wealthy and wise soci-economic status, poor health in childhood, and human capital development. In NBER working Paper. 2007:13987.

10.

Ampaabeng SK, Tan CM: The long-term cognitive consequences of early childhood malnutrition: the case of famine in Ghana. J Health Econ. 2013, 32: 1013-1027. 10.1016/j.jhealeco.2013.08.001.PubMedCrossRef

11.

Case A: Economic status and health in childhood: the origins of gradient. Am Econ Rev. 2002, 92 (5): 1308-1334. 10.1257/000282802762024520.CrossRef

12.

Condliffe S, Link C: The relationship between economic status and child health: evidence from the United States. Am Econ Rev. 2008, 98 (4): 1605-1618. 10.1257/aer.98.4.1605.CrossRef

13.

Apouey B, Geoffard PY: Family income and child health in the UK. J Health Econ. 2013, 32: 715-727. 10.1016/j.jhealeco.2013.03.006.PubMedCrossRef

14.

Allin S, Stabile M: Socioeconomic status and child health: what is the role of health care, health conditions, injuries and maternal health?. Health Econ Pol Law. 2012, 7: 227-242. 10.1017/S174413311100034X.CrossRef

15.

Reinhold S, Jérges H: Parental income and child health in Germany. Health Econ. 2012, 579: 562-579. 10.1002/hec.1732.CrossRef

16.

Khanam R, Nghiem HS, Connelly LB: Child health and the income gradient: evidence from Australia. J Health Econ. 2009, 28: 805-817. 10.1016/j.jhealeco.2009.05.001.PubMedCrossRef

17.

Wagstaff A, Doorslaer E, Van Watanabe N: On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. J Econ. 2003, 112: 207-223. 10.1016/S0304-4076(02)00161-6.CrossRef

18.

Uthman OA: Using extended concentration and achievement indices to study socioeconomic inequality in chronic childhood malnutrition: the case of Nigeria. Int J Equity Health. 2009, 8: 22-30. 10.1186/1475-9276-8-22.PubMedCentralPubMedCrossRef

19.

Arokiasamy P, Pradhan J: Measuring wealth-based health inequality among Indian children: the importance of equity vs efficiency. Health Pol Plan. 2011, 26: 429-440. 10.1093/heapol/czq075.CrossRef

20.

Shen T, Habicht JP, Chang Y: Effect of economic reforms on child growth in urban and rural areas of China. N Engl J Med. 1996, 335: 400-406. 10.1056/NEJM199608083350606.PubMedCrossRef

21.

Luo Y, Yang F, Lei SF, Wang XL, Papasian CJ, Deng HW: Differences of height and body mass index of youths in urban vs rural areas in Hunan province of China. Ann Hum Biol. 2009, 36: 750-755. 10.3109/03014460903120925.PubMedCrossRef

22.

Hejun G, Yunping L: The health inequality of the children in rural China and its affecting factors: an empirical study based on CHNS. South China Pop. 2012, 1: 25-33.

23.

Liu H, Fang H, Zhao Z: Urban-rural disparities of child health and nutritional status in China from 1989 to 2006. Econ Hum Biol. 2013, 11 (3): 294-309. 10.1016/j.ehb.2012.04.010.PubMedCentralPubMedCrossRef

24.

Wagstaff A, Doorslaer E, Paci P: Equity in the finance and delivery of health care: some tentative cross-country comparisons. Oxf Rev Econ Policy. 1989, 5 (1): 89-112. 10.1093/oxrep/5.1.89.CrossRef

25.

Wagstaff A, Paci P, Van Doorslaer E: On the measurement of inequalities in health. Soc Sci Med. 1991, 33: 545-557. 10.1016/0277-9536(91)90212-U.PubMedCrossRef

26.

Clarke PM, Gerdtham UG, Johannesson M, Bingefors K, Smith L: On the measurement of relative and absolute income-related health inequality. Soc Sci Med. 2002, 55: 1923-1928. 10.1016/S0277-9536(01)00321-5.PubMedCrossRef

27.

Xu KT: State-level variations in income-related inequality in health and health achievement in the US. Soc Sci Med. 2006, 63: 457-464. 10.1016/j.socscimed.2006.01.011.PubMedCrossRef

28.

Erreygers G, Van Ourti T: Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: a recipe for good practice. J Health Econ. 2011, 30: 685-694. 10.1016/j.jhealeco.2011.04.004.PubMedCentralPubMedCrossRef

29.

Wagstaff A: Inequality aversion, health inequalities and health achievement. J Health Econ. 2002, 21: 627-641. 10.1016/S0167-6296(02)00006-1.PubMedCrossRef

30.

Yitzhaki S: On an extension of the Gini index. Int Econ Rev. 1983, 24: 617-628. 10.2307/2648789.CrossRef

31.

Clarke PM, Hayes AJ: Measuring achievement: changes in risk factors for cardiovascular disease in Australia. Soc Sci Med. 2009, 68: 552-561. 10.1016/j.socscimed.2008.09.065.PubMedCrossRef

32.

Meheus F, Van Doorslaer E: Achieving better measles immunization in developing countries: does higher coverage imply lower inequality?. Soc Sci Med. 2008, 66: 1709-1718. 10.1016/j.socscimed.2007.12.036.PubMedCrossRef

33.

Osberg L, Shao J, Xu K: The growth of poor children in China 1991-2000: why food subsidies may matter. Health Econ. 2009, 108: 89-108. 10.1002/hec.1463.CrossRef

34.

Popkin BM, Du S, Zhai F, Zhang B: Cohort profile: the China health and nutrition survey-monitoring and understanding socio-economic and health change in China, 1989-2011. Int J Epidemiol. 2010, 39: 1435-1440. 10.1093/ije/dyp322.PubMedCentralPubMedCrossRef

35.

China Statistical Yearbook. 2010, China Statistical Press, Beijing

36.

E Xie, Tu L: Health achievement index in China: equity-efficiency tradeoff. China Soft Sci. 2011, 7: 9-16.

37.

Gong P, Liang S, Carlton EJ, Jiang Q, Wu J, Wang L, Remais JV: Urbanization and health in China. Lancet. 2012, 379: 843-852. 10.1016/S0140-6736(11)61878-3.PubMedCentralPubMedCrossRef

38.

Goode A, Mavromaras K, Rong Z: Family income and child health in China. China Econ Rev. 2014, 29: 152-165. 10.1016/j.chieco.2014.04.007.CrossRef

39.

Song Y: Chinese rural childrenʼs health: analysis of family and community influencing elements. Chinese Rural Econ. 2007, 10: 69-76.

Title: Income-related children’s health inequality and health achievement in China
Authors: Lu Chen
Ya Wu
Peter C Coyte
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: International Journal for Equity in Health / Issue 1/2014
Electronic ISSN: 1475-9276
DOI: https://doi.org/10.1186/s12939-014-0102-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Income-related children’s health inequality and health achievement in China

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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