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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2016

Open Access 01-12-2016 | Research

The gender gap among school children in poor rural areas of western China: evidence from a multi-province dataset

Authors: Hua Zhou, Di Mo, Chengchao Zhou, Alexis Medina, Yaojiang Shi, Linxiu Zhang, Scott Rozelle

Published in: International Journal for Equity in Health | Issue 1/2016

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Abstract

Background

The gender gap remains a major impediment in the path towards equality and it is especially wide in low-income countries. Up to the early 2000s, many studies documented extensive inequalities in China: girls had poorer health, less nutrition and less education than their male counterparts. The goal of this study is to examine whether the gender gap persists, given that China is now making the transition into the ranks of upper-middle income countries. We consider educational outcomes, mental and physical health status, as well as non-cognitive outcomes.

Methods

We draw on a dataset containing 69,565 observations constructed by combining data from 7 different school-level surveys spanning 5 provinces. The surveys were all conducted by the authors between 2008 and 2013 using uniform survey instruments and data collection protocols in randomly selected schools across western provinces in rural China. The sample children range in age from 9 to 14 years (with 79 % of the sample being aged 10 to 12). Our analysis compares rural girls with rural boys in terms of 13 different indicators.

Results

With the exception of anemia rates, the health outcomes of girls are equal to those of boys. Girls and boys are statistically identical in terms of weight-for-age, height-for-age, and prevalence of intestinal worm infections. Girls performed better than boys on five of six cognitive and educational performance indicators. Girls performed worse than boys on all mental health indicators. All estimates are robust to the inclusion of different age ranges, controlling for the level of household assets, ethnic minority status, as well as the addition of provincial dummies.

Conclusions

Our findings suggest that with the exception of non-cognitive outcomes, anemia and standardized math test scores, the gender gap in our study areas in China appears to be diminishing.
Footnotes
1
In order to check whether the gender difference is sensitive to the ethnic minority status, we compare the outcomes between the two gender groups excluding ethnic minorities from our sample (Table B4 in Additional file 1). We find that girls are still not statistically significantly different from boys in terms of WAZ, HAZ and STH infection rates. Also, girls are slightly more likely to be anemic than boys (P-value < 0.01), outperform boys on five out of the six education and cognition outcome measures, and perform worse than boys on all three non-cognitive outcomes, outcomes that are all consistent with results for the whole sample in Table 5. Because of this, we do not believe that ethnicity is a factor affecting the results on gender gaps among our sample.
 
2
By looking at gender differences in our outcomes across years, we show that the patterns in the gender gap over time are largely consistent with the analytical results of our paper. For example, girls score higher than boys on the standardized Chinese language test (P-values < or =0.01) in 2011 and 2012. Boys outperform girls on the standardized math test in all years from 2009 to 2012 (P-values < 0.01). Additionally, girls tend to perform worse than boys in non-cognitive outcomes. For example, girls score higher than boys on the Mental Health Test from 2009 to 2011, indicating girls are more anxious than boys (P-values <0.01). Also, girls, on average, had lower measures of self-esteem than boys from 2010 to 2012 (P-values < or =0.01). Consistent with the results in the paper, anemia levels are higher for girls than for boys in 2011 and 2012 (P-values <0.05), although the difference is not as significant as in the years from 2009 and 2010.
 
Literature
1.
Bhargava A. Family planning, gender differences and infant mortality: evidence from Uttar Pradesh, India. J Econom. 2003;112:225–40 [Analysis of Data on Health: 2].CrossRef
2.
Murthi M, Guio A-C, Drèze J. Mortality, fertility, and gender bias in India: a district-level analysis. Popul Dev Rev. 1995;21:745–82.CrossRef
3.
Pandey A, Sengupta PG, Mondal SK, Gupta DN, Manna B, Ghosh S, Sur D, Bhattacharya SK. Gender differences in healthcare-seeking during common illnesses in a rural community of West Bengal, India. J Health Popul Nutr. 2002;20:306–11.PubMed
4.
Asfaw A, Lamanna F, Klasen S. Gender gap in parents’ financing strategy for hospitalization of their children: evidence from India. Health Econ. 2010;19:265–79.CrossRefPubMed
5.
Coale AJ. Excess female mortality and the balance of the sexes in the population: an estimate of the number of “Missing Females”. Popul Dev Rev. 1991;17:517–23.CrossRef
6.
Li S, Zhu C, Feldman MW. Gender differences in child survival in contemporary rural China: a county study. J Biosoc Sci. 2004;36:83–109.CrossRefPubMed
7.
Banister J. Shortage of girls in China today. J Popul Res. 2004;21:19–45.CrossRef
8.
9.
Hazarika G. Gender differences in children’s nutrition and access to health care in Pakistan. J Dev Stud. 2000;37:73–92.CrossRef
10.
D’Souza S, Chen LC. Sex differentials in mortality in rural Bangladesh. Popul Dev Rev. 1980;6:257–70.CrossRef
11.
Kounnavong S, Vonglokham M, Houamboun K, Odermatt P, Boupha B. Soil-transmitted helminth infections and risk factors in preschool children in southern rural Lao People’s Democratic Republic. Trans R Soc Trop Med Hyg. 2011;105:160–6.CrossRefPubMed
12.
Siwila J, Phiri IGK, Enemark HL, Nchito M, Olsen A. Intestinal helminths and protozoa in children in pre-schools in Kafue district, Zambia. Trans R Soc Trop Med Hyg. 2010;104:122–8.CrossRefPubMed
13.
Al-Mekhlafi H, Surin J, Atiya AS, Ariffin WA, Mohammed Mahdy AK, Che Abdullah H. Pattern and predictors of soil-transmitted helminth reinfection among aboriginal schoolchildren in rural Peninsular Malaysia. Acta Trop. 2008;107:200–4.CrossRef
14.
Bagni UV, Luiz RR, da Veiga GV. Overweight is associated with low hemoglobin levels in adolescent girls. Obes Res Clin Pract. 2013;7:e218–29.CrossRefPubMed
15.
Abudayya A, Thoresen M, Abed Y, Holmboe-Ottesen G. Overweight, stunting, and anemia are public health problems among low socioeconomic groups in school adolescents (12–15 years) in the North Gaza Strip. Nutr Res. 2007;27:762–71.CrossRef
16.
Muthayya S, Thankachan P, Zimmermann MB, Andersson M, Eilander A, Misquith D, Hurrell RF, Kurpad AV. Low anemia prevalence in school-aged children in Bangalore, South India: possible effect of school health initiatives. Eur J Clin Nutr. 2007;61:865–9.CrossRefPubMed
17.
Pangeni KP. Factors determining educational quality: student mathematics achievement in Nepal. Int J Educ Dev. 2014;34:30–41.CrossRef
18.
van der Niet AG, Hartman E, Smith J, Visscher C. Modeling relationships between physical fitness, executive functioning, and academic achievement in primary school children. Psychol Sport Exerc. 2014;15:319–25.CrossRef
19.
Lopes L, Santos R, Pereira B, Lopes VP. Associations between gross motor coordination and academic achievement in elementary school children. Hum Mov Sci. 2013;32:9–20.CrossRefPubMed
20.
Tester J, Sharma S, Jasik CB, Mietus-Snyder M, Tinajero-Deck L. Gender differences in prediabetes and insulin resistance among 1356 obese children in Northern California. Diabetes Metab Syndr Clin Res Rev. 2013;7:161–5.CrossRef
21.
Hopkins ND, Stratton G, Tinken TM, McWhannell N, Ridgers ND, Graves LEF, George K, Cable NT, Green DJ. Relationships between measures of fitness, physical activity, body composition and vascular function in children. Atherosclerosis. 2009;204:244–9.CrossRefPubMed
22.
Lee K, Valeria B, Kochman C, Lenders CM. Self-assessment of height, weight, and sexual maturation: validity in overweight children and adolescents. J Adolesc Health. 2006;39:346–52.CrossRefPubMed
23.
Elgar FJ, Roberts C, Tudor-Smith C, Moore L. Validity of self-reported height and weight and predictors of bias in adolescents. J Adolesc Health. 2005;37:371–5.CrossRefPubMed
24.
Guo J, Marsh HW, Parker PD, Morin AJ, Yeung AS. Expectancy-value in mathematics, gender and socioeconomic background as predictors of achievement and aspirations: a multi-cohort study. Learn Individ Differ. 2015;37:161–8.CrossRef
25.
Mullola S, Jokela M, Ravaja N, Lipsanen J, Hintsanen M, Alatupa S, Keltikangas-Järvinen L. Associations of student temperament and educational competence with academic achievement: the role of teacher age and teacher and student gender. Teach Teach Educ. 2011;27:942–51.CrossRef
26.
Golsteyn BH, Schils T. Gender gaps in primary school achievement: a decomposition into endowments and returns to IQ and non-cognitive factors. Econ Educ Rev. 2014;41:176–87.CrossRef
27.
28.
Afifi M. Depression in adolescents: gender differences in Oman and Egypt. 2006.
29.
30.
Gu B, Roy K. Sex ratio at birth in China, with reference to other areas in East Asia: what we know. | POPLINE.org. Asia-Pac Popul J. 1995;10:17–42.PubMed
31.
Arnold F, Zhaoxiang L. Sex preference, fertility, and family planning in China. Popul Dev Rev. 1986;12:221–46.CrossRef
32.
Ren XS. Sex differences in infant and child mortality in three provinces in China. Soc Sci Med. 1995;40:1259–69.CrossRefPubMed
33.
Shi Z, Lien N, Kumar BN, Dalen I, Holmboe-Ottesen G. The sociodemographic correlates of nutritional status of school adolescents in Jiangsu Province, China. J Adolesc Health. 2005;37:313–22.CrossRefPubMed
34.
Song L, Appleton S, Knight J. Why do girls in rural China have lower school enrollment? World Dev. 2006;34:1639–53.CrossRef
35.
Das Gupta M, Zhenghua J, Bohua L, Zhenming X, Chung W, Hwa-Ok B. Why is son preference so persistent in East and South Asia? A cross-country study of China, India and the Republic of Korea. J Dev Stud. 2003;40:153–87.CrossRef
36.
Behrman JR, Deolalikar AB. The intrahousehold demand for nutrients in rural south India: Individual estimates, fixed effects, and permanent income. J Hum Resour. 1990;25(4):665–96.CrossRef
37.
Chen Q, Goh C, Sun B, Xu LC. Market Integration in China. World Bank Policy Research Working Paper. Washington, DC: World Bank; 2011.
38.
39.
Yang W. China’s new cooperative medical scheme and equity in access to health care: evidence from a longitudinal household survey. Int J Equity Health. 2013;12:20.CrossRefPubMedPubMedCentral
40.
Sawadogo PS, Martin-Prével Y, Savy M, Kameli Y, Traissac P, Traoré AS, Delpeuch F. An infant and child feeding index is associated with the nutritional status of 6-to 23-month-old children in rural Burkina Faso. J Nutr. 2006;136:656–63.PubMed
41.
Svedberg P, et al. Child malnutrition in India and China. 2007.
42.
Ren W, Rammohan A, Wu Y. Is there a gender gap in child nutritional outcomes in rural China? China Econ Rev. 2014;31:145–55.CrossRef
43.
Chyi H, Zhou B. The effects of tuition reforms on school enrollment in rural China. Econ Educ Rev. 2014;38:104–23.CrossRef
44.
Zhang L, Kleiman-Weiner M, Luo R, Shi Y, Martorell R, Medina A, Rozelle S. Multiple micronutrient supplementation reduces anemia and anxiety in rural China’s elementary school children. J Nutr. 2013;143:640–7.CrossRefPubMed
45.
Wang X, Liu C, Zhang L, Yue A, Shi Y, Chu J, Rozelle S. Does financial aid help poor students succeed in college? China Econ Rev. 2013;25:27–43.CrossRef
46.
47.
Luo R, Shi Y, Zhang L, Zhang H, Miller G, Medina A, Rozelle S. The limits of health and nutrition education: evidence from three randomized-controlled trials in rural China. CESifo Econ Stud. 2012;58(2):ifs023.
48.
Mo D, Luo R, Liu C, Zhang H, Zhang L, Medina A, Rozelle S. Text messaging and its impacts on the health and education of the poor: evidence from a field experiment in rural China. World Dev. 2014;64:766–80.CrossRef
49.
Miller G, Luo R, Zhang L, Sylvia S, Shi Y, Foo P, Zhao Q, Martorell R, Medina A, Rozelle S. Effectiveness of provider incentives for anaemia reduction in rural China: a cluster randomised trial. 2012.
50.
Kleiman-Weiner M, Luo R, Zhang L, Shi Y, Medina A, Rozelle S. Eggs versus chewable vitamins: Which intervention can increase nutrition and test scores in rural China? China Econ Rev. 2013;24:165–76.CrossRef
51.
Luo R, Shi Y, Zhang L, Liu C, Li H, Rozelle S, Sharbono B. Community service, educational performance and social responsibility in Northwest China. J Moral Educ. 2011;40:181–202.CrossRef
52.
Liu C, Zhang L, Luo R, Rozelle S, Loyalka P. The effect of primary school mergers on academic performance of students in rural China. Int J Educ Dev. 2010;30:570–85.CrossRef
53.
Mo D, Yi H, Zhang L, Shi Y, Rozelle S, Medina A. Transfer paths and academic performance: the primary school merger program in China. Int J Educ Dev. 2012;32:423–31.CrossRef
54.
Sylvia S, Luo R, Zhang L, Shi Y, Medina A, Rozelle S. Do you get what you pay for with school-based health programs? Evidence from a child nutrition experiment in rural China. Econ Educ Rev. 2013;37:1–12.CrossRef
55.
Wong HL, Luo R, Zhang L, Rozelle S. The impact of vouchers on preschool attendance and elementary school readiness: a randomized controlled trial in rural China. Econ Educ Rev. 2013;35:53–65.CrossRef
56.
Loyalka P, Liu C, Song Y, Yi H, Huang X, Wei J, Zhang L, Shi Y, Chu J, Rozelle S. Can information and counseling help students from poor rural areas go to high school? Evidence from China. J Comp Econ. 2013;41:1012–25.CrossRef
57.
Liu C, Luo R, Yi H, Zhang L, Li S, Bai Y, Medina A, Rozelle S, Smith S, Wang G, et al. Soil-transmitted Helminths in Southwestern China: a cross-sectional study of links to cognitive ability, nutrition, and school performance among children. PLoS Negl Trop Dis. 2015;9:e0003877.CrossRefPubMedPubMedCentral
58.
Organization WH, et al. WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world’s children and adolescents. Geneva: WHO; 2009.
59.
Control centers for D, Prevention, et al. A SAS Program for the 2000 CDC Growth Charts (ages 0 To < 20 Y). 2014.
60.
WHO, UN University, UN Children’s Funds. Iron Deficiency Anaemia: Assessment, Prevention, and Control - A guide for programme managers. 2001.
61.
Wechsler D. Wechsler intelligence scale for children—Fourth Edition (WISC-IV) administration and scoring manual. San Antonio: Psychol Assoc; 2003.
62.
Mo D, Swinnen J, Zhang L, Yi H, Qu Q, Boswell M, Rozelle S. Can one-to-one computing narrow the digital divide and the educational gap in China? The case of Beijing migrant schools. World Dev. 2013;46:14–29.CrossRef
63.
Wang H, Yang C, He F, Shi Y, Qu Q, Rozelle S, Chu J. Mental health and dropout behavior: a cross-sectional study of junior high students in northwest rural China. Int J Educ Dev. 2015;41:1–12.CrossRef
64.
Blascovich J, Tomaka J. Measures of self-esteem. Meas Personal Soc Psychol Attitudes. 1991;1:115–60.CrossRef
65.
Schwarzer R. General Perceived Self-Efficacy in 14 Cultures. 1999.
66.
Schwarzer R, Bä\s sler J, Kwiatek P, Schröder K, Zhang JX. The assessment of optimistic self-beliefs: comparison of the German, Spanish, and Chinese versions of the general self-efficacy scale. Appl Psychol. 1997;46:69–88.CrossRef
67.
Lincove JA. Determinants of schooling for boys and girls in Nigeria under a policy of free primary education. Econ Educ Rev. 2009;28:474–84.CrossRef
68.
Tansel A. Determinants of school attainment of boys and girls in Turkey: individual, household and community factors. Econ Educ Rev. 2002;21:455–70.CrossRef
69.
Lee YD. Do families spend more on boys than on girls? Empirical evidence from rural China. China Econ Rev. 2008;19:80–100.CrossRef
70.
Yuezhong MGYLY. Research on handling sex ratio unbalance at birth in China: stage, characteristics, mechanism and prospects [J]. Chin J Popul Sci. 2007;3:010.
71.
Lavy V, Sand E. On the Origins of Gender Human Capital Gaps: Short and Long Term Consequences of Teachers’ Stereotypical Biases. Cambridge: National Bureau of Economic Research; 2015.
72.
Niederle M, Vesterlund L. Explaining the gender gap in math test scores: THE role of competition. J Econ Perspect. 2010;24:129–44.CrossRef
73.
Spencer SJ, Steele CM, Quinn DM. Stereotype threat and women’s math performance. J Exp Soc Psychol. 1999;35:4–28.CrossRef
74.
Wang X, Liu C, Zhang L, Luo R, Glauben T, Shi Y, Rozelle S, Sharbono B. What is keeping the poor out of college?: Enrollment rates, educational barriers and college matriculation in China. China Agric Econ Rev. 2011;3:131–49.CrossRef
75.
Sinha N, Raju D, Morrison A. Gender Equality, Poverty and Economic Growth. SSRN Scholarly Paper. Rochester: Social Science Research Network; 2007.
76.
Kabeer N, Natali L. Gender equality and economic growth: is there a win-win? IDS Work Pap. 2013;2013:1–58.CrossRef
77.
Guo C, Tsang MC, Ding X. Gender disparities in science and engineering in Chinese universities. Economics of Education Review. 2010;29(2):225–35.CrossRef
78.
Djimeu EW, Houndolo D. Power calculation for causal inference in social science: sample size and minimum detectable effect determination. 3ie Working Paper. 2016. 26.
79.
Samii C. Will your study have enough power? 2015.
Metadata
Title
The gender gap among school children in poor rural areas of western China: evidence from a multi-province dataset
Authors
Hua Zhou
Di Mo
Chengchao Zhou
Alexis Medina
Yaojiang Shi
Linxiu Zhang
Scott Rozelle
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2016
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-016-0442-5

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