Children's health
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Postdoctoral Scholar, Stanford Center on China's Economy and Institutions
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Ph.D.

Yun Shen is a postdoctoral scholar at the Stanford Center on China's Economy and Institutions. Her research areas include maternal labor supply, childcare service, and early childhood development. She's currently focusing on research related to group-based interventions in early childhood development and caregivers' mental health in rural China. She received her Ph.D in Agricultural Economics from Zhejiang University. Yun is an expert on Friends and The Office.

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Encina Hall, East, 5th Floor
616 Jane Stanford Way
Stanford, CA 94305

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Postdoctoral Scholar, Rural Education Action Program
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PhD

Boya Wang is a postdoctoral scholar at Stanford University, specializing in the field of early childhood development. Her research is dedicated to identifying and implementing effective programs and policies aimed at enhancing the well-being of children in rural China. With a wealth of field experience, she has a keen interest in promoting early human capital formation. Through large-scale randomized controlled trials, she evaluates the profound impact of parenting interventions on enhancing parenting practices, improving caregiver mental health, and fostering early childhood development.

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Clinical Associate Professor, Pediatrics
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
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Xin She is a Global Health pediatrician with 15 years of experience working in low-resource settings. She speaks 5 languages and is committed to creating interdisciplinary, equitable solutions for all vulnerable children to thrive. She is a national representative at the Women Physicians Wellness, Equity and Leadership Alliance (WEL).

She has published on mental health epidemiology and health inequity in Chinese children, early childhood development and quality improvement in pediatric care for Haitian Children. She has presented nationally and internationally on Social Medicine and Global Health, youth mental health, early childhood development, Wellness and professional development. She has collaborated with academic, governmental and non-profit partners in inner city US, Canada, Mexico, Guatemala, Haiti, DR Congo and China.

She has mentored more than 100 youth globally, ranging from rural Chinese children, inner city American youth, to medical trainees in Haiti, at Harvard and at Stanford. She is a mentor at national programs for underrepresented minority students and for international junior researchers. She has been twice awarded the AAP national Advocacy conference scholarship and regularly advocates for underserved communities locally and nationally.

She chairs the Pediatric Wellness Committee at CPMC regional site and serves as a Wellness Champion for the department of Pediatrics. She is certified in Mindfulness-based Stress Reduction and Reiki (Master). She is also a Cordon Bleu graduate in Spanish cuisine and loves hosting friends from all over the world.

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Background:
Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that this low uptake may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that a conditional cash transfer (CCT) has on the uptake of MCH services and, ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China.

Methods:
We designated two different sets of villages and households that were used as comparisons against which outcomes of the treated households could be assessed. In 2014, we conducted a large-scale survey of 1522 households in 75 villages (including 25 treatment and 50 comparison) from nine nationally designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT).

Results:
Overall, the uptake of MCH services in the sample households were low, especially in terms of postpartum care visits, early breastfeeding, exclusive breastfeeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. The results from both the ITT and ATT analyses showed that the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers of MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes.

Conclusions:
The CCT program generated modest improvements in the uptake of MCH services and mothers’ knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two potential reasons: poor CCT implementation and the low quality of rural health facilities.

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Journal Articles
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BMC Public Health
Authors
Yuju Wu
Chang Sun
Alexis Medina
Scott Rozelle
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MA

Yian Guo is a program manager at the Rural Education Action Program (REAP), working primarily on the Healthy Future project. She holds a B.S. in Applied Psychology from New York University and an M.A. in International Education Policy Analysis from Stanford University. Yian's research interests are informed by her volunteering experience in rural Inner Mongolian schools and her involvement in research on Chinese adolescents. From the impact of teacher's perception on students' academic performance to early childhood development and education, Yian is exploring and refining her topic of interest while doing her part to bridge research to practice.

Program Manager, Rural Education Action Program
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China’s rapid urbanization in the past several decades have been accompanied by rural labor migration. An important question that has emerged is whether rural labor migration has a positive or negative impact on the depressive symptoms of children left behind in the countryside by their migrating parents. This paper uses a nationally representative panel dataset to investigate whether parental migration impacts the prevalence of depressive symptoms among left-behind children in China. Using DID and PSM-DID methods, our results show that parental migration significantly increases the depression scores of 10 and 11-year-old children by 2 points using the CES-D depression scale. Furthermore, we also find that the negative effect of decreased parental care is stronger than the positive effect of increased income in terms of determining the depressive symptoms status of children in rural China.

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1
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International Journal of Environmental Research and Public Health
Authors
Mi Zhou
Xiaotong Sun
Li Huang
Guangsheng Zhang
Emma Auden
Scott Rozelle
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China’s competitive education system has produced notably high learning outcomes, but they may be costly. One potential cost is high levels of anxiety. China has launched several initiatives aimed at improving student mental health. However, little is known about how effective these programs and policies are. The goal of this paper is to examine anxiety levels among children and adolescents in rural China, and to identify which subpopulations are particularly vulnerable to anxiety. Data are aggregated from ten different school-­‐‑level surveys conducted in rural areas of five provinces between 2008 and 2015. In total, 50,361 students were evaluated using a 100-­‐‑item, 9-­‐‑subcategory Mental Health Test (a variation of the Children’s Manifest Anxiety Scale). Seven 21 percent of students were at risk for overall anxiety. However, over half of students were at risk for at least one subcategory of anxiety. Students at higher risk for anxiety included students from poorer counties and families, female students, secondary students, and students with lower levels of academic performance. Many students in rural China are at risk for anxiety, and certain student subpopulations are particularly vulnerable. We suggest that China’s government review and update student mental health programs and policies.

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Journal Articles
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Environmental Health and Research
Authors
Hongyan Liu, Yaojiang Shi, Emma Auden
Scott Rozelle
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We report on the results of a randomised controlled trial conducted among over 2,000 children in 60 elementary schools in rural Shaanxi Province, North-west China. We find that providing children with daily iron supplements for six months improved children’s haemoglobin levels and standardised maths scores. In comparison, educating parents about nutrition and anaemia in a special parents meeting produced a modest impact on children’s haemoglobin levels. We also find heterogeneous intervention effects by children’s gender, anaemia status and boarding status. Overall, iron supplementation is more effective. However, given its low cost and simple implementation, parental education should still be considered.

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Journal Articles
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Journal of Development Studies
Authors
Hu Lun Wong
Scott Rozelle
Number
4
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Using individual data collected in rural China and adopting Heckman’s two-step function, we examined the impact of childcare and eldercare on laborers’ off-farm activities. Our study finds that having school-aged children has a negative impact on rural laborers’ migration decisions and a positive impact on their decision to work in the local off-farm employment market. As grandparents can help to take care of young children, the impact of preschoolers is insignificant. Having elderly family to care for decreases the income earned by female members of the family. Although both men and women are actively engaged in off-farm employment today in rural China, this study shows that women are still the primary care providers for both children and the elderly. Therefore, reforming public school enrollment and high school/college entrance examination systems so that migrant children can stay with their parents, this will help rural laborers to migrate to cities. The present study also calls for more public services for preschoolers and the elderly in rural China.

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Journal Articles
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China & World Economy
Authors
Fangbin Qiao
Scott Rozelle
Scott Rozelle
Linxiu Zhang
Yi Yao
Jian Zhang
Number
2
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Taenia solium cysticercosis affects millions of impoverished people worldwide and can cause neurocysticercosis, an infection of the central nervous system which is potentially fatal. Children may represent an especially vulnerable population to neurocysticercosis, due to the risk of cognitive impairment during formative school years. While previous epidemiologic studies have suggested high prevalence in rural China, the prevalence in children as well as risk factors and impact of disease in low-resource areas remain poorly characterized.

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Journal Articles
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PLOS Neglected Tropical Diseases
Authors
John J. Openshaw
Alexis Medina
Alexis Medina
Stephen A. Felt
Tiaoying Li
Zhou Huan
Scott Rozelle
Scott Rozelle
Stephen P. Luby
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