The Health Penalty of China's Rapid Urbanization

Tinbergen Institute Discussion Paper No. 09-016/3

41 Pages Posted: 19 Feb 2009

See all articles by Ellen van de Poel

Ellen van de Poel

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE)

O. O'Donnell

University of Macedonia

Eddy van Doorslaer

Erasmus School of Economics

Date Written: February 19, 2009

Abstract

Rapid urbanization could have positive and negative health effects, such that the net impact on population health is not obvious. It is, however, highly pertinent to the human welfare consequences of development. This paper uses community and individual level longitudinal data from the China Health and Nutrition Survey to estimate the net health impact of China's unprecedented urbanization. We construct an index of urbanicity from a broad set of community characteristics and define urbanization in terms of movements across the distribution of this index. We use difference-in-differences estimators to identify the treatment effect of urbanization on the self-assessed health of individuals. The results reveal important, and robust, negative causal effects of urbanization on health. Urbanization increases the probability of reporting fair or poor health by 5 to 15 percentage points, with a greater degree of urbanization having larger health effects. While people in more urbanized areas are, on average, in better health than their rural counterparts, the process of urbanization is damaging to health. Our measure of self-assessed health is highly correlated with subsequent mortality and the causal harmful effect of urbanization on health is confirmed using more objective (but also more specific) health indicators, such as physical impairments, disease symptoms and hypertension.

Keywords: urbanization, health, China, treatment effects, difference-in-differences

JEL Classification: I12, I18, O18

Suggested Citation

van de Poel, Ellen and O'Donnell, O. and van Doorslaer, Eddy, The Health Penalty of China's Rapid Urbanization (February 19, 2009). Tinbergen Institute Discussion Paper No. 09-016/3. Available at SSRN: https://ssrn.com/abstract=1346351 or http://dx.doi.org/10.2139/ssrn.1346351

Ellen Van de Poel (Contact Author)

Erasmus University Rotterdam (EUR) - Erasmus School of Economics (ESE) ( email )

P.O. Box 1738
3000 DR Rotterdam, NL 3062 PA
Netherlands

O. O'Donnell

University of Macedonia

156 Egnatia St.
P.O. 1591
Thessaloniki, 54006
Greece

Eddy Van Doorslaer

Erasmus School of Economics ( email )

Netherlands

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