Volume 43 - Article 49 | Pages 1429–1460
Estimating rural–urban disparities in self-rated health in China: Impact of choice of urban definition
|Date received:||05 Sep 2018|
|Date published:||03 Dec 2020|
|Keywords:||China, self-rated health, urban-rural differences|
|Additional files:||43-49_Supplement B. Table to accompany Figure 3 (Excel file, 10 kB)|
|43-49_Supplementary Material A Anchoring Vignettes (pdf file, 8 kB)|
Objective: We use the 2014 China Family Panel Studies (CFPS), which includes anchoring vignettes, to provide an up-to-date assessment of rural–urban health disparities as measured by self-rated health (SRH) in China. Our analysis is based on multiple definitions (hukou and the two different residence-based definitions) of rural–urban and migration status; previous research was inconclusive due to the use of different definitions and concerns about status-based differential health expectations (reporting heterogeneity).
Results: We find a nonlinear difference between rural and urban Chinese in how they self-assess health status, regardless of the urban definition used. Urban respondents do not always hold a higher standard for self-assessment of health. Instead, their rating styles depend on the level of latent health. After controlling for the reporting heterogeneity, we find on average a slight urban advantage in SRH, but it is most pronounced when using the statistical (density dependent) definition of urban.
Contribution: We study rural–urban health disparities based on three different urban definitions and migration status. Although we examine the urban definitions that are specific to China, we demonstrate a mindful approach when multiple definitions exist and caution against any simplistic approach that ignores context-specific urban definition. We also provide clear illustrations of the different types of reporting heterogeneity, as well as a way to visualize the cut-points, thresholds, and latent health estimates.
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