Journal
HEALTH & PLACE
Volume 42, Issue -, Pages 87-95Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.healthplace.2016.09.008
Keywords
Urbanization; Socioeconomic status; Health disparity; Income-health relationship; Lifestyle
Categories
Funding
- Research Grants Council of the Hong Kong SAR [646411]
- National Institute for Nutrition and Health, China Center for Disease Control and Prevention, Carolina Population Center [P2C HD050924, T32 HD007168]
- University of North Carolina at Chapel Hill
- NIH [R01-HD30880, DK056350, R24 HD050924, R01-HD38700]
- NIH Fogarty International Center [D43 TW009077, D43 TW007709]
- China-Japan Friendship Hospital, Ministry of Health
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While urbanization is associated with a wide range of human welfare outcomes, its impacts on population health are much less obvious. This article aims to investigate how rapid urbanization in contemporary China affects health, and how it shapes health disparities between groups of different socioeconomic status (SES). Using data from eight waves of the China Health and Nutrition Survey (CHNS) spanning a period of 20 years from 1991 to 2011, we examine the confounding effects of urbanization on health and the income-health relationship and explore the underlying mechanism. Results from multilevel analysis show that living in more urbanized areas increases the risk of acquiring chronic diseases, and the health penalty of urbanization is more severe among those with a higher income. Lifestyle is the pathway through which urbanization affects health, and a high-fat diet and decreased physical activity diminish the health benefit brought by high income and accelerate health decline in more urbanized areas. These results suggest an urgent need to design and implement health promotion programs to encourage healthy lifestyles in China under rapid urbanization.
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