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Journal Articles
Health, Economic, and Social Implications of COVID-19 for China's Rural Population
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Agricultural Economics,
May 11, 2021
This study examines the effects of local and nationwide COVID‐19 disease control measures on the health and economy of China's rural population. We conducted phone surveys with 726 randomly selected village informants across seven rural Chinese provinces in February 2020. Four villages (0.55%) reported infections, and none reported deaths. Disease control measures had been universally implemented in all sample villages. About 74% of informants reported that villagers with wage‐earning jobs outside the village had stopped working due to workplace closures. A higher percentage of rural individuals could not work due to transportation, housing, and other constraints. Local governments had taken measures to reduce the impact of COVID‐19. Although schools in all surveyed villages were closed, 71% of village informants reported that students were attending classes online. Overall, measures to control COVID‐19 appear to have been successful in limiting disease transmission in rural communities outside the main epidemic area. Rural Chinese citizens, however, have experienced significant economic consequences from the disease control measures.
Journal Articles
Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study
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International Journal of Environmental Research and Public Health,
May 11, 2021
Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions between physicians and standardized patients across 63 CHCs in Xi’an, China. We measured the quality of primary care on seven criteria: (1) adherence to checklists, (2) correct diagnosis, (3) correct treatment, (4) number of unnecessary exams and drugs, (5) diagnosis time, (6) expense of visit, (7) patient-centered communication. Significant quality differences were observed between public CHCs and private CHCs. Private CHC physicians performed 4.73 percentage points lower of recommended questions and exams in the checklist. Compared with private CHCs, public CHC providers were more likely to give a higher proportion of correct diagnosis and correct treatment. Private CHCs provided 1.42 fewer items of unnecessary exams and provided 0.32 more items of unnecessary drugs. Private CHC physicians received a 9.31 lower score in patient-centered communication. There is significant quality inequality in different primary care models. Public CHC physicians might provide a higher quality of service. Creating a comprehensive, flexible, and integrated health care system should be considered an effective approach towards optimizing the management of CHC models.
Journal Articles
Trajectories of Child Cognitive Development During Ages 0-3 in Rural Western China: Prevalence, Risk Factors and Links to Preschool-Age Cognition
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BMC Pediatrics,
April 26, 2021
Background:
Cognitive development after age three tends to be stable and can therefore predict cognitive skills in later childhood. However, there is evidence that cognitive development is less stable before age three. In rural China, research has found large shares of children under age three are developmentally delayed, yet little is known about the trajectories of cognitive development between 0 and 3 years of age or how developmental trajectories predict later cognitive skills. This study seeks to describe the trajectories of child cognitive development between the ages of 0–3 years and examine how different trajectories predict cognitive development at preschool age.
Methods:
We collected three waves of longitudinal panel data from 1245 children in rural Western China. Child cognitive development was measured by the Bayley Scales of Infant Development when the child was 6–12 months and 22–30 months, and by the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition when the child was 49–65 months. We used the two measures of cognitive development before age three to determine the trajectories of child cognitive development.
Results:
Of the children, 39% were never cognitively delayed; 13% were persistently delayed; 7% experienced improving cognitive development; and 41% experienced deteriorating development before age 3. Compared to children who had never experienced cognitive delay, children with persistent cognitive delay and those with deteriorating development before age 3 had significantly lower cognitive scores at preschool age. Children with improving development before age 3 showed similar levels of cognition at preschool age as children who had never experienced cognitive delay.
Conclusions:
Large shares of children under age 3 in rural Western China show deteriorating cognitive development from infancy to toddlerhood, which predict lower levels of cognition at preschool age. Policymakers should invest in improving cognitive development before age 3 to prevent long-term poor cognition among China’s rural children.
Journal Articles
Effects of Vision Health Education and Free Eyeglasses on Knowledge of Vision and Usage of Spectacles Among Primary School Students: Evidence from Gansu and Shaanxi Provinces in China
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Risk Management and Healthcare Policy,
April 9, 2021
Background
In rural China, children’s vision problems are very common, with many who would benefit from refractive correction not getting the care they need. This study examines whether a health information campaign that involves vision health education and a free trial of health product with free eyeglasses is effective at raising students’ awareness of myopia and promoting students’ eyeglasses usage.
Methods
We conducted an in-the-field randomized controlled experiment of a program providing vision health education and subsidized free eyeglasses to myopic children from 168 primary schools in rural Northwestern China in 2012.
Results
A total of 2189 students, mean age 10.5 years (49.3% male), participated in the baseline survey. At the baseline, the average correct response rate for visual knowledge among the sample students was 30.1%, and only 15% who needed eyeglasses used them. Seven months after intervention, the average correct response rate for vision knowledge were 48.5% and 48.3% in the education group and the education plus free eyeglasses group respectively, significantly higher than that of the control group. The rate of eyeglasses usage was 36% and 43% in the free eyeglasses group and the education plus free eyeglasses group respectively, significantly higher than that of the control group. The rate of eyeglasses compliance in the free eyeglasses group and the education plus free eyeglasses group was 19% and 26%, which also were significantly higher than the control group.
Conclusion
The information campaign combined with subsidized eyeglasses had a better effect both on vision knowledge and eyeglasses usage. The information campaign improved knowledge by providing the right information, and free eyeglasses changed the perceived utility and experience by the students using the product and getting benefits. Information and the free eyeglasses (subsidized) are complements.
Journal Articles
Publishing and Assessing the Research of Economists: Lessons from Public Health
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China Economic Review,
April 1, 2021
We highlight a growing concern in the economics profession that young scholars face incentives that are misaligned with conducting research that furthers knowledge and addresses pressing policy problems. The premium given to publication in top journals leads to an emphasis on exhaustive treatment of narrow questions. Detailed, robustly identified studies of novel questions are of undeniable value; however, the opportunity cost of producing such studies is large in terms of research quantity and policy relevance. For economists who aim to achieve what we view as the ultimate goals of academic research (enhancing understanding of the world, solving social problems, and building foundational knowledge to enable future breakthroughs), we offer some insights from publication philosophy in the field of public health. We discuss how public health has developed norms around publishing that are more successful in meeting these ultimate goals. We then offer thoughts on potential lessons for young economists in China and the economics discipline.
Stanford scholars are setting and expanding research agendas to analyze China’s economic development and its impact on the world. The newly launched Stanford Center on China’s Economy and Institutions — co-directed by SIEPR senior fellows Hongbin Li and Scott Rozelle — is supporting their work. In this SIEPR Policy Brief, Li and Rozelle outline the research underway by the new center's affiliates.
Journal Articles
Variations in the Home Language Environment and Early Language Development in Rural China
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International Journal of Environmental Research and Public Health,
March 6, 2021
The home language environment is critical to early language development and subsequent skills. However, few studies have quantitatively measured the home language environment in low-income, developing settings. This study explores variations in the home language environment and child language skills among households in poor rural villages in northwestern China. Audio recordings were collected for 38 children aged 20–28 months and analyzed using Language Environment Analysis (LENA) software; language skills were measured using the MacArthur–Bates Mandarin Communicative Developmental Inventories expressive vocabulary scale. The results revealed large variability in both child language skills and home language environment measures (adult words, conversational turns, and child vocalizations) with 5- to 6-fold differences between the highest and lowest scores. Despite variation, however, the average number of adult words and conversational turns were lower than found among urban Chinese children. Correlation analyses did not identify significant correlations between demographic characteristics and the home language environment. However, the results do indicate significant correlations between the home language environment and child language skills, with conversational turns showing the strongest correlation. The results point to a need for further research on language engagement and ways to increase parent–child interactions to improve early language development among young children in rural China.
Journal Articles
Skill Levels and Gains in University STEM Education in China, India, Russia, and the United States
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Nature Human Behavior,
March 1, 2021
Universities contribute to economic growth and national competitiveness by equipping students with higher-order thinking and academic skills. Despite large investments in university science, technology, engineering and mathematics (STEM) education, little is known about how the skills of STEM undergraduates compare across countries and by institutional selectivity. Here, we provide direct evidence on these issues by collecting and analysing longitudinal data on tens of thousands of computer science and electrical engineering students in China, India, Russia and the United States. We find stark differences in skill levels and gains among countries and by institutional selectivity. Compared with the United States, students in China, India and Russia do not gain critical thinking skills over four years. Furthermore, while students in India and Russia gain academic skills during the first two years, students in China do not. These gaps in skill levels and gains provide insights into the global competitiveness of STEM university students across nations and institutional types.
Journal Articles
It All Starts at Home: 'Home Reading Environment and Reading Outcomes in Rural China'
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Journal of Research in Reading,
March 1, 2021
Background: The educational resources that parents provide at home are crucial to their children’s development. In this study, we focused on home reading environment, a key contributor to success rates regarding the mastery of reading skills. We aimed to investigate students’ home reading environments and examine its effect on the reading development of primary school students in rural China. Methods: We draw on a dataset composed of 10,740 randomly selected primary school students and their households in rural areas of Jiangxi province in China. Surveys were administered by trained enumerators in May 2015. Results: The results show that students exhibited quite poor reading environments and reading outcomes. Specifically, we found the majority of the rural students lacked reading and learning resources in the context of their families and their parents did not enjoy reading or support their children’s reading. Moreover, our regression analysis documented students with poorer home reading environments are more likely to have worse reading performance. Conclusion: Our study supports the significance of the home reading environment in the reading development of students in the upper elementary grades in rural China. Furthermore, the results suggest that the home reading environments of rural Chinese students must be improved.
Journal Articles
Improving Learning by Improving Vision: Evidence from Two Randomized Controlled Trials of Providing Vision Care in China
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Journal of Development Effectiveness,
February 26, 2021
This paper examines the external validity of health intervention by comparing the impacts of providing free eyeglasses on the educational performance of nearsighted children in two settings: rural public schools in Western China and urban private migrant schools in Eastern China. The intervention significantly improves educational outcomes by 0.14 standard deviations in math in rural public schools but not in private migrant schools. The difference in measured impacts is due in part to lower quality schooling in migrant schools in Eastern China. Our findings show that only when school is providing a quality education, health interventions might increase student learnings.
Journal Articles
The Impact of Internet Use on Adolescent Learning Outcomes: Evidence from Rural China
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China Agricultural Economic Review,
February 12, 2021
Purpose:
Internet use has become particularly prevalent among adolescents, prompting much thought and concern about both its potential benefits and adverse effects on adolescent learning outcomes. Much of the empirical literature on the impact of Internet use on adolescent learning outcomes is mixed, and few studies examine the causal relationship between the two in rural China. In order to bridge these gaps, we use empirical analysis to investigate the effect of Internet use on the learning outcomes of adolescents in rural China.
Design/methodology/approach:
We use fixed effect models with samples drawn from a large nationally representative dataset (the China Family Panel Studies—CFPS) to identify the causal impacts of Internet use on the learning outcomes of three cohorts (Cohort A (N = 540), Cohort B (N = 287) and Cohort C (N = 827)) of adolescents in rural China.
Findings:
The results of the descriptive analysis show a continued increase in the number of adolescents accessing the Internet and the amount of time they spend online. The results of the fixed effect models show that Internet use has positive (in many of the analyses), but mostly insignificant impacts, on the learning outcomes of adolescents. In the sets of results that find significant associations between Internet use and learning outcomes, the measured effects are moderate.
Originality/value:
This study investigates the causal relationship between Internet use and adolescent learning outcomes in rural China. The findings claim that there is not a great need to worry about adverse effects of Internet use on adolescent learning development. Attention, however, should focus on seeking ways to improve the positive effects of the Internet use on adolescent learning outcomes. The study will provide a reference and experience for the development of education and the Internet in rural areas and promote the integrated development of urban and rural areas in China.
Journal Articles
Early Childhood Reading in Rural China and Obstacles to Caregiver Investment in Young Children: A Mixed-Methods Analysis
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International Journal of Environmental Research and Public Health ,
February 4, 2021
Journal Articles
Coastal Vulnerability to Climate Change in China’s Bohai Economic Rim
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Environment International,
February 1, 2021
Climate change and human activities exert a wide range of stressors on urban coastal areas. Synthetical assessment of coastal vulnerability is crucial for effective interventions and long-term planning. However, there have been few studies based on integrative analyses of ecological and physical characteristics and socioeconomic conditions in urban coastal areas. This study developed a holistic framework for assessing coastal vulnerability from three dimensions - biophysical exposure, sensitivity and adaptive capacity - and applied it to the coast of Bohai Economic Rim, an extensive and important development zone in China. A composite vulnerability index (CVI) was developed for every 1 km2 segment of the total 5627 km coastline and the areas that most prone to coastal hazards were identified by mapping the distribution patterns of the CVIs in the present and under future climate change scenarios. The CVIs show a spatial heterogeneity, with higher values concentrated along the southwestern and northeastern coasts and lower values concentrated along the southern coasts. Currently, 20% of the coastlines with approximately 350,000 people are highly vulnerable to coastal hazards. With sea-level rises under the future scenarios of the year 2100, more coastlines will be highly vulnerable, and the amount of highly-threatened population was estimated to increase by 13–24%. Among the coastal cities, Dongying was categorized as having the highest vulnerability, mainly due to poor transportation and medical services and low GDP per capita, which contribute to low adaptive capacity. Our results can benefit decision-makers by highlighting prioritized areas and identifying the most important determinants of priority, facilitating location-specific interventions for climate-change adaptation and sustainable coastal management.
Working Papers
Just Above the Exam Cutoff Score: Elite College Admission and Wages in China
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National Bureau of Economic Research,
February 1, 2021
A burgeoning literature has documented the importance of elite colleges. Yet, little is known about access to elite education and its labor market implications in China, a country that produces one in every five college graduates in the world. College admission in China is governed by a single exam—the national college entrance exam, and the government sets admission cutoff scores for elite colleges. We examine the impacts of scoring above the elite-tier cutoff on a student's access to elite colleges and wage outcomes after graduation, using the discontinuity around the cutoff score. By employing hand-collected survey data, we find that scoring above the cutoff not only increases the chance of entering an elite college but also raises a young person's first-job wages after graduation. We also find that those just above the cutoff have peers with higher scores and better social networks than those below the cutoff, but it is less clear whether the two groups use their time differently in college.
Journal Articles
Tracking the Effects of COVID-19 in Rural China Over Time
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International Journal for Equity in Health,
January 14, 2021
Journal Articles
Rural Minimum Living Standard Guarantee (Rural Dibao) Program Boosts Children's Education Outcomes in Rural China
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China Agricultural Economic Review,
January 8, 2021
Journal Articles
IQ, Grit, and Academic Achievement: Evidence from Rural China
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International Journal of Educational Development,
January 1, 2021
Journal Articles
The Performance of State-Owned Enterprises: New Evidence from the China Employer-Employee Survey
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Economic Development and Cultural Change,
January 1, 2021
Journal Articles
Cognitive Ability and Academic Performance Among Left-Behind Children: Evidence from Rural China
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Compare: A Journal of Comparative and International Education,
December 17, 2020
Journal Articles
The Impact of Online Computer Assisted Learning at Home for Disadvantaged Children in Taiwan: Evidence from a Randomized Experiment
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Sustainability,
December 3, 2020
Journal Articles
The Status Quo of Teaching Reading Skills in Rural Primary Schools in China: PIRLS Questionnaires in Guizhou and Jiangxi
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Journal of East China Normal University,
December 1, 2020
Journal Articles
Maternal Health Behaviors During Pregnancy in Rural Northwestern China
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BMC Pregnancy and Childbirth,
December 1, 2020
Background: Maternal health during pregnancy is a key input in fetal health and child development. This study
aims to systematically describe the health behaviors of pregnant women in rural China and identify which
subgroups of women are more likely to engage in unhealthy behaviors during pregnancy.
Journal Articles
The Impacts of Highly Resourced Vocational Schools on Student Outcomes in China
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China & World Economy,
December 1, 2020
Journal Articles
Valuing Natural Capital amidst Rapid Urbanization: Assessing the Gross Ecosystem Product (GEP) of China’s ‘Chang-Zhu-Tan' Megacity
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Environmental Research Letters,
November 27, 2020
Gross Ecosystem Product (GEP) is an aggregate measure of the monetary value of final ecosystem services, or the direct benefits that people derive from nature. In this study, we focus on the 'Chang-Zhu-Tan' (CZT) urban agglomeration—an emerging megacity of over 15 million people situated on the Yangtze River—as a case study of the dynamics of ecological production amidst rapid urbanization. In this study, we couple a spatial-temporal analysis of regional ecological change based on remote-sensing data with economic valuation methods (e.g. travel cost method) using official statistics and survey data. We find that while the land cover of natural ecosystems decreased slightly between 2000 and 2015, their quality—and therefore economic value—greatly improved. From 2000 to 2015, the GEP of CZT increased by 56.77%. In particular, the value of regulating services grew by 7.43% (calculated using inflation-adjusted prices). GEP can reflect nature's contribution to human well-being. At the same time, its long-term trends can serve as an indicator of the extent and quality of local and regional ecosystems, thereby providing a corrective or complement to more conventional measures of development. Although urbanization increases spatial constraints on the management of natural capital, progress in ecological protection and restoration can still improve the quality of ecosystems and the services they provide. Our study shows how GEP, and the value of natural capital it reflects, can grow amidst the pressures of rapid urbanization.
Journal Articles
Effects of Baby-Friendly Practices on Breastfeeding Duration in China: A Case-Control Study
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International Breastfeeding Journal,
November 3, 2020