Publications
Publications
Attention Deficit Hyperactivity Disorder (ADHD) among Elementary Students in Rural China: Prevalence, Correlates, and Consequence
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Background: Attention deficit hyperactivity disorder (ADHD) is a widely recognized mental health problem in developed countries but remains under-investigated in developing settings. This study examines the prevalence, correlates, and consequences of ADHD symptoms among elementary school students in rural China. Methods: Cross-sectional data were collected from 6,719 students across 120 rural primary schools in China on ADHD symptoms, demographic characteristics, and academic performance in reading and math. ADHD symptoms were evaluated using the caregiver-reported ADHD Rating Scale-IV. Results: The prevalence of ADHD symptoms was 7.5% in our sample. Male students, students in lower grade levels, and students with lower cognitive ability showed a significantly higher prevalence of ADHD symptoms (ORs = 2.56, 2.06, and 1.84, respectively; p<0.05). Left-behind children showed a significantly lower prevalence of ADHD symptoms than did children who were living with their parents (OR = 0.74, p < 0.05). Adjusted regressions show that students with ADHD symptoms scored 0.12 standardized deviations lower in reading (p < 0.05) and 0.19 standardized deviations lower in math (p < 0.01). Limitations: The ADHD Rating Scale-IV is a screening scale rather than a diagnostic test. Caregiver self-report measures also may underestimate ADHD symptoms for our sample. Conclusions: ADHD is a common disorder among rural students in China and appears to be contributing to poor academic outcomes. The higher prevalence of ADHD among students with low cognitive ability also suggests that many rural children in China face multifactorial learning challenges. Taken together, the findings indicate a need for educators and policymakers in rural China to develop programs to reduce risk and support students with ADHD symptoms.
Complicating China’s Rise: Rural Underemployment
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Special Issue: Agriculture, the Rural Economy and China's Growth in the 21st Century: Celebrating the 10th Anniversary of AAEA China Section
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Infant Cognitive Development and Stimulating Parenting Practices in Rural China
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An Ecosystem Service Perspective on Urban Nature, Physical Activity, and Health
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Nature underpins human well-being in critical ways, especially in health. Nature provides pollination of nutritious crops, purification of drinking water, protection from floods, and climate security, among other well-studied health benefits. A crucial, yet challenging, research frontier is clarifying how nature promotes physical activity for its many mental and physical health benefits, particularly in densely populated cities with scarce and dwindling access to nature. Here we frame this frontier by conceptually developing a spatial decision-support tool that shows where, how, and for whom urban nature promotes physical activity, to inform urban greening efforts and broader health assessments. We synthesize what is known, present a model framework, and detail the model steps and data needs that can yield generalizable spatial models and an effective tool for assessing the urban nature–physical activity relationship. Current knowledge supports an initial model that can distinguish broad trends and enrich urban planning, spatial policy, and public health decisions. New, iterative research and application will reveal the importance of different types of urban nature, the different subpopulations who will benefit from it, and nature’s potential contribution to creating more equitable, green, livable cities with active inhabitants.
Association of Child Mental Health with Child and Family Characteristics in Rural China: A Cross-Sectional Analysis
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Assessing the mental health problems encountered by school children and understanding the contributing factors are crucial to inform strategies aimed at improving mental health in low-resource contexts. However, few studies have investigated the mental health problems among disadvantaged children in poorer countries. This study examines the prevalence of mental health problems in rural China and their association with child and family characteristics. The study uses survey data from 9696 children in 120 rural primary schools and measures child mental health using the Strengths and Difficulties Questionnaire (SDQ). Overall, 17.9% of the sample children were found to be in the abnormal range of the SDQ total difficulties scores. The mean score was 12.93 (SD = 4.94). Abnormal scores were associated with child and family characteristics, including older child age (Odds Ratio, OR = 0.704, 95% CI: 0.611, 0.810; p < 0.001), gender (OR = 1.235, 95% CI: 1.112, 1.371; p < 0.001), and academic performance (OR = 0.421, 95% CI: 0.369, 0.480; p < 0.001). Reading time was found to be protective for mental health. Risk factors include excessive screen time (OR = 1.685, 95% CI: 1.409, 2.016; p < 0.001) and being bullied (OR = 3.695, 95% CI: 3.301, 4.136; p < 0.001). Our study suggests that future mental health illness prevention programs in rural China should consider targeting different aspects of children’s social contexts.
Comparing the Quality of Primary Care between Public and Private Providers in Urban China: A Standardized Patient Study
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Health, Economic, and Social Implications of COVID-19 for China's Rural Population
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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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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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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.
Publishing and Assessing the Research of Economists: Lessons from Public Health
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Variations in the Home Language Environment and Early Language Development in Rural China
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Skill Levels and Gains in University STEM Education in China, India, Russia, and the United States
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It All Starts at Home: 'Home Reading Environment and Reading Outcomes in Rural China'
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Improving Learning by Improving Vision: Evidence from Two Randomized Controlled Trials of Providing Vision Care in China
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The Impact of Internet Use on Adolescent Learning Outcomes: Evidence from Rural China
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Early Childhood Reading in Rural China and Obstacles to Caregiver Investment in Young Children: A Mixed-Methods Analysis
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Just Above the Exam Cutoff Score: Elite College Admission and Wages in China
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Coastal Vulnerability to Climate Change in China’s Bohai Economic Rim
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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.
Tracking the Effects of COVID-19 in Rural China Over Time
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Rural Minimum Living Standard Guarantee (Rural Dibao) Program Boosts Children's Education Outcomes in Rural China
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IQ, Grit, and Academic Achievement: Evidence from Rural China
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The Performance of State-Owned Enterprises: New Evidence from the China Employer-Employee Survey
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Cognitive Ability and Academic Performance Among Left-Behind Children: Evidence from Rural China
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