Health
Paragraphs

Economic growth and socioeconomic changes have transformed nearly every aspect of childhood in China, and many are worried by the increasing prevalence of mental health issues among children, particularly depression. To provide insight into the distribution of depressive symptoms among children in China and identify vulnerable groups, we use data from the 2012 China Family Panel Survey (CFPS), a survey that collected data from a large, nationally representative sample of the Chinese population. Using the CFPS data, we construct a sample of 2679 children aged 10–15 years old from 25 provinces in China. According to our results, the incidence of depression varies by geographic area. Specifically, we find that rates of depressive symptoms are significantly lower in urban areas (14% of sample children) than in rural areas (23% of sample children). Our results also show that children from ethnic minorities, from poorer families, and whose parents are depressed are more likely to be depressed than other children. In contrast, we find that depressive symptoms do not vary by gender.

Keywords: childhood depression; China; depressive symptoms; left-behind children; migrant children

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
International Journal of Environment Research and Public Health
Authors
Scott Rozelle
Paragraphs

This study aims to investigate the developmental status of rural Chinese children, the extent of interactive parenting they receive, and the relation between the two. A sample of 448 six to eighteen-month-old children and their caregivers were randomly selected from two rural counties in Hebei and Yunnan provinces. According the third edition of the Bayley Scales of Infant and Toddler Development, 48.7% of sample children exhibited cognitive delays, 40.6% language delays, and 35% social-emotional delays. According to responses from caregivers, parenting in rural China is largely passive, lacking in interactive practices like storytelling, singing, and playing. Children-with-siblings, left-behind children, and children with less-educated mothers were even less likely to receive interactive practices. Children of caregivers who did engage in best parenting practices showed better cognitive, language, and socialemotional development; however, the public health system provides no platform for learning about optimal parenting.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Early Child Development and Care
Authors
Alexis Medina
Scott Rozelle
Paragraphs

Nearly a quarter of all children under the age of two in China are left behind in the countryside as parents migrate to urban areas for work. We use a longitudinal survey following young children and their caregivers from 6 to 30 months of age to estimate the effects of maternal migration on development, health, and nutritional outcomes in the critical first stages of life.We find significant negative effects on cognitive development and indicators of dietary quality. Taken together with research showing long-term consequences of early life insults, our results imply that, although the reallocation of labor from rural to urban areas has been a key driver of China’s prosperity in recent decades, it may entail a significant human capital cost for the next generation.

All Publications button
1
Publication Type
Working Papers
Publication Date
Journal Publisher
Working Paper
Authors
Scott Rozelle
Paragraphs

Purpose

The purpose of this paper is to evaluate the effect of adult children migration on the health status of elderlyparents. Increased labor migration in developing countries that lack adequate social security systems and institutionalized care for the elderly is a phenomenon that is important to understand. When their adultchildren go away to work, it is not clear what effect there will be on “left-behind” elderly parents.

Design/methodology/approach

This study employs nearly nationally representative data from five provinces, 25 counties, 101 villages and 2,000 households, collected from two waves of data in 2007 and 2011. This sample comprises a subset of households which include both elderly individuals (above 60 years old) and their grown (working-aged)children in order to estimate the impact of adult child migration on the health of elderly parents in ruralChina.

Findings

This study finds that adult child migration has a significant positive impact on the health of elderly family members.

Practical implications

These findings are consistent with the explanation that migration raises family resources, which in turn may contribute to better health outcomes for elderly household members.

Originality/value

This is the first paper to attempt to identify the relationship between household migration and the health of elderly parents within the Chinese context.

 

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
China Economic Agricultural Review
Authors
Number
4
Paragraphs

Purpose

  • Many public health systems have struggled with the dual questions of: why the uptake rate of maternal health (MH) services is low among some subpopulations; and how to raise it. The purpose of this paper is to assess the uptake rate of a new set of MH services in poor rural areas of China.
 

Design/methodology/approach

  • The analysis is based on the survey responses of women’s representatives and village cadres from almost 1,000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China.
 

Findings

  • The authors find that the uptake rate of MH services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of Western China are far below average in China, and that the rates vary across provinces and ethnic groups. The analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all MH services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. The authors also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of MH services.
 

Originality/value

  • The authors believe that the results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with: why the uptake rate of MH services is low among some subpopulations; and how to raise it.

 

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
China Agricultural Economic Review
Authors
Alexis Medina
Scott Rozelle
Paragraphs

Background and Objectives: Development during the first two years of life is critical and has a lasting impact on a child’s health. Poor child nutrition can lead to a weakened immune system and deficiencies in essential micronutrients, which in turn have lasting and detrimental impacts on a child’s development. Recent studies in rural Shaanxi Province found an anemia prevalence of 54.3% among rural children aged six to twelve months. While new large-scale, quantitative research has begun to catalogue the extent of child malnutrition and anemia, no effort has yet been made to look more closely at the potential reasons for rural children’s nutritional deficiencies through a more richly textured qualitative analysis. This study aims to elucidate some of the fundamental causes of poor feeding practices that may lead to anemia among children in rural Shaanxi Province, China.

Methodology: We interviewed a total of sixty caregivers from villages participating in a study of 1808 families enrolled in a larger survey of child health and nutrition outcomes. We conducted three waves of interviews with children’s primary caregivers in seventeen rural villages within four nationally-designated poverty counties in the southern part of Shaanxi Province.

Results: The qualitative analysis reveals that poor infant feeding practices are persistent across our qualitative sample. Information gathered from our qualitative interviews suggests that proper feeding practices are impeded by two constraints: a lack of knowledge on infant nutrition and inadequate sources of accurate information on the topic. We find that the poverty does not appear to constrain child feeding practices.

Conclusion: Our research uncovers an absence of accurate information on infant nutrition, which hampers caregiver efforts to provide adequate nutrition to their children. This situation ultimately results in the failure of caregivers to supply an age-appropriate micronutrient-rich diet that can stimulate children’s physical and cognitive development, the absence of which may lead to iron-deficiency anemia among children. We suggest that steps be taken to educate caregivers in nutritional care for their infants

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
PLOS One
Authors
Alexis Medina
Scott Rozelle
Paragraphs

Abstract: The general goal of the present study is to analyze whether children with siblings lag behind their only-child counterparts in terms of health and nutrition, cognition and educational performance, and non-cognitive outcomes. We draw on a dataset containing 25 871 observations constructed from three school-level surveys spanning four provinces in China. The analysis compares children with siblings and only children aged 9 to 14 years old in terms of eight different health, cognitive and non-cognitive indicators. We find that with the exception of the anemia rate, health outcomes of children with siblings are statistically indistinguishable from those of only children. In terms of cognition, children with siblings performed better than only children. Moreover, outcomes of children with siblings are statistically indistinguishable from those of only children in terms of the non-cognitive outcomes provided by measures of anxiety. According to our results, the same general findings are true regardless of whether the difference between children with and without siblings is disaggregated by gender.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
China & World Economy
Authors
Scott Rozelle
Paragraphs

China’s rapid development and urbanization have induced large numbers of rural residents to migrate from their homes to urban areas in search of better job opportunities. Parents typically leave their children behind with a caregiver, creating a new, potentially vulnerable subpopulation of left-behind children in rural areas. A growing number of policies and nongovernmental organization efforts target these children. The primary objective of this study was to examine whether left-behind children are really the most vulnerable and in need of special programs. Pulling data from a comprehensive data set covering 141,000 children in ten provinces (from twenty-seven surveys conducted between 2009 and 2013), we analyzed nine indicators of health, nutrition, and education. We found that for all nine indicators, left-behind children performed as well as or better than children living with both parents. However, both groups of children performed poorly on most of these indicators. Based on these findings, we recommend that special programs designed to improve health, nutrition, and education among left-behind children be expanded to cover all children in rural China.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Health Affairs Volume 34, Issue 11
Authors
Prashant Loyalka
James Chu
Alexis Medina
Scott Rozelle
Paragraphs

Soil-transmitted helminths (STHs) are parasitic intestinal worms that infect more than two out of every five schoolchildren in rural China, an alarmingly high prevalence given the low cost and wide availability of safe and effective deworming treatment. Understanding of local knowledge, attitudes, and practices regarding STHs in rural China has until now, been sparse, although such information is critical for prevention and control initiatives. This study elucidates the structural and sociocultural factors that explain why deworming treatment is rarely sought for schoolchildren in poor villages of rural China with persistently high intestinal worm infection rates. In-depth, qualitative interviews were conducted in six rural villages in Guizhou Province; participants included schoolchildren, children’s parents and grandparents, and village doctors. We found evidence of three predominant reasons for high STH prevalence: lack of awareness and skepticism about STHs, local myths about STHs and deworming treatment, and poor quality of village health care. The findings have significant relevance for the development of an effective deworming program in China as well as improvement of the quality of health care at the village level. 

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
PLoS Neglected Tropical Diseases
Authors
Alexis Medina
Scott Rozelle
Subscribe to Health