Public Health
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Lazear-Liang Postdoctoral Scholar, Stanford Graduate School of Business
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PhD

Hanmo's research fields include labor and health economics, development economics, and population studies, with a particular focus on China's fertility, healthcare, and elderly care systems and policies. She primarily conducts empirical research to explore the principles of how various interventions affect caregiving practices, fertility behaviors, and other health or economic outcomes by utilizing data from surveys and hospital records. In 2022, Hanmo received her Ph.D. in economics from Peking University. Building on her doctoral work on health and economic development, she broadened her research to include aging and health systems as a postdoctoral scholar at the Harvard T.H. Chan School of Public Health from 2022 to 2023.

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Tom Kennedy is a project manager at the Stanford Center on China’s Economy and Institutions (SCCEI). He joined the team in Fall 2022 after spending three years working as a Software Engineer at Apple. Tom graduated from Stanford in 2019 with a B.S. in Mathematical and Computational Science. While at Stanford, he worked as a research assistant for SCCEI and multiple other FSI-affiliated researchers. Tom manages projects related to mental health and vision care, among other areas.

Project Manager, Rural Education Action Program
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In late January 2020, China’s government initiated its first aggressive measures to combat COVID-19 by forbidding individuals from leaving their homes, radically limiting public transportation, cancelling or postponing large public events, and closing schools across the country. The rollout of these measures coincided with China’s Lunar New Year holiday, during which more than 280 million people had returned from their places of work to their home villages in rural areas. The disease control policies remained in place until late February and early March, when they were gradually loosened to allow for more free movement of people. Among those that were allowed to move again were the hundreds of millions of migrant workers who originally (before the COVID-19 outbreak) had expected to return to China’s urban and industrial centers to continue working in the nation’s factories, construction sites and service sector. 

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Publication Type
Working Papers
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Authors
Huan Wang
Huan Wang
Sarah-Eve Dill
Huan Zhou
Yue Ma
Hao Xue
Prashant Loyalka
Prashant Loyalka
Sean Sylvia
Matthew Boswell
Matthew Boswell
Jason Lin
Scott Rozelle
Scott Rozelle
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In response to the COVID-19 outbreak in December 2019, China implemented a nationwide travel blockade and quarantine policy that required all public spaces, businesses, and schools to shut their doors until further notice and placed restrictions on individuals leaving their homes or traveling. The lockdown was also implemented across China’s vast rural areas, home to more than 700 million people. These quarantine measures started during the annual Spring Festival in mid-January, when most rural residents had returned to their family homes to celebrate the Lunar New Year together. Many were migrant workers who had expected to return to China’s urban and industrial centers to continue working in factories, construction sites, and service sectors.

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Books
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International Food Policy Research Institute
Authors
Scott Rozelle
Heather Rahimi
Huan Wang
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Background
The coronavirus disease (COVID-19) has been identified as the cause of an outbreak of respiratory illness in Wuhan, Hubei Province, China beginning in December 2019. As of 31 January 2020, this epidemic had spread to 19 countries with 11 791 confirmed cases, including 213 deaths. The World Health Organization has declared it a Public Health Emergency of International Concern.

Methods
A scoping review was conducted following the methodological framework suggested by Arksey and O’Malley. In this scoping review, 65 research articles published before 31 January 2020 were analyzed and discussed to better understand the epidemiology, causes, clinical diagnosis, prevention and control of this virus. The research domains, dates of publication, journal language, authors’ affiliations, and methodological characteristics were included in the analysis. All the findings and statements in this review regarding the outbreak are based on published information as listed in the references.

Results
Most of the publications were written using the English language (89.2%). The largest proportion of published articles were related to causes (38.5%) and a majority (67.7%) were published by Chinese scholars. Research articles initially focused on causes, but over time there was an increase of the articles related to prevention and control. Studies thus far have shown that the virus’ origination is in connection to a seafood market in Wuhan, but specific animal associations have not been confirmed. Reported symptoms include fever, cough, fatigue, pneumonia, headache, diarrhea, hemoptysis, and dyspnea. Preventive measures such as masks, hand hygiene practices, avoidance of public contact, case detection, contact tracing, and quarantines have been discussed as ways to reduce transmission. To date, no specific antiviral treatment has proven effective; hence, infected people primarily rely on symptomatic treatment and supportive care.

Conclusions
There has been a rapid surge in research in response to the outbreak of COVID-19. During this early period, published research primarily explored the epidemiology, causes, clinical manifestation and diagnosis, as well as prevention and control of the novel coronavirus. Although these studies are relevant to control the current public emergency, more high-quality research is needed to provide valid and reliable ways to manage this kind of public health emergency in both the short- and long-term.

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Journal Articles
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Infectious Diseases of Poverty
Authors
Sasmita Poudel Adhikari
Sha Meng
Yuju Wu
Yuping Mao
Ruixue Ye
Qingzhi Wang
Chang Sun
Sean Sylvia
Scott Rozelle
Scott Rozelle
Hein Raat
Huan Zhou
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This study examines the impact of social engagement on elderly health in China. A two-stage residual inclusion (2SRI) regression approach was used to examine the causal relationship. Our dataset comprises 9253 people aged 60 or above from the China Health and Retirement Longitudinal Survey (CHARLS) conducted in 2011 and 2013. Social engagement significantly improved the self-rated health of the elderly and reduced mental distress, but had no effect on chronic disease status. Compared with the rural areas, social engagement played a more important role in promoting the elderly health status in urban areas. Social engagement could affect the health status of the elderly through health behavior change and access to health resources. To improve the health of the elderly in China and promote healthy aging, the government should not only improve access to effective medical care but also encourage greater social engagement of the elderly.

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Journal Articles
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International Journal of Environmental Research and Public Health
Authors
Jin Liu
Scott Rozelle
Scott Rozelle
Qing Xu
Ning Yu
Tianshu Zhou
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In this paper we have two objectives - one empirical; one methodological. Although China's leaders are beginning to pay attention to health care in rural China, there are still concerns about access to health services. To examine this issue, we use measure of travel distances to health services to examine the nature of coverage in Shaanxi Province, our case study. The mean distance by road to the nearest health center is more than 6 km. When we use thresholds for access of 5 and 10 km we find that more than 40 (15) percent of the population lives outside of these 5 (10) kilometer service areas for health centers. The nature of the access differs by geographical region and demographic composition of the household.. The methodological contribution of our paper originates from a key feature of our analysis in which we use Geographic Information System (GIS) network analysis methods to measure traveling distance along the road network. We compare these measures to straight-line distance measures. Road distances (produced by network analysis) produce measures (using means) that are nearly twice as great as straight-line distances. Moreover, the errors in the measures (that is, the difference between road distances and straight-line distances) are not random. Therefore, traditional econometric methodsof ameliorating the effects of measurements errors, such as instrument variables regression, will not produce consistent results when used with straight-line distances.

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Journal Articles
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GeoJournal
Authors
John Gibson
Xiangzheng Deng
Geua Boe-Gibson
Scott Rozelle
Scott Rozelle
Jikun Huang
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3
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Purpose

The purpose of this paper is to measure the turnover (or stability in employment) of village clinicians in rural China over the past decade. The authors also want to provide quantitative evidence on the individual characteristics of the clinicians who provide health care to villagers in rural China and whether we should expect these individuals to be interested in continuing to supply quality health care in China’s villages in the coming years.

Design/methodology/approach

This paper uses data from a survey of rural China’s village clinicians conducted in five provinces, 25 counties, and 101 villages in 2005 and 2012. This paper also uses qualitative data from interviews with 31 village clinicians. Using a mixed methods approach, this study describes the turnover of village clinicians and the main factors that impact the career decisions of clinicians.

Findings
Turnover of China’s village doctors, while not trivial (about 25 percent of village doctors exited their field between 2005 and 2012), is still not overly high. Only five out of 101 villages did not have village clinicians in 2012. Of those that lost village doctors between 2005 and 2012, nearly all of them still had a village doctor in 2012 (either taken over by another local clinician or the position was taken by a newcomer). The authors find that three main sets of factors are correlated with the career decisions of village clinicians: village clinicians’ opportunity cost, the profitability of running a village clinic, and commitment to the field of medicine. In general, clinicians who left the village faced a much higher opportunity cost, had been running a clinic that was not profitable, and had fewer ties to the field of medicine. Newcomers over the same period had higher levels of education, went to higher profit clinics between 2005 and 2012, and had a stronger commitment to the field.
Originality/value

This study makes use of a data set with a large and nationally representative sample to provide a new perspective to better understand clinician turnover at village clinics, the career decisions of clinicians, and the implied trends for the quality and access to rural health care services in the future.

 

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Publication Type
Journal Articles
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Journal Publisher
China Agricultural Economic Review
Authors
Hao Xue
Alexis Medina
Number
4
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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.

 

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Publication Type
Journal Articles
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China Agricultural Economic Review
Authors
Alexis Medina
Scott Rozelle
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Empirical evidence suggests that the prevalence of soil-transmitted helminth (STH) infections in remote and poor rural areas is still high among children, the most vulnerable to infection. There is concern that STH infections may detrimentally affect children’s healthy development, including their cognitive ability, nutritional status, and school performance. Medical studies have not yet identified the exact nature of the impact STH infections have on children. The objective of this study is to examine the relationship between STH infections and developmental outcomes in 2,180 school-aged children in seven nationally-designated poverty counties in rural China. We conducted a large-scale survey in Guizhou province in southwest China in May, 2013. Overall, 42 percent of elementary school-aged children were infected with one or more of the three types of STH—Ascarislumbricoides (ascaris), Trichuris trichuria (whipworm) and the hookworms Ancylostoma duodenaleor Necator americanus. After controlling for socioeconomic status, we observed that children infected with one or more STHs have worse cognitive ability, worse nutritional status, and worse school performance than their uninfected peers.

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Publication Type
Working Papers
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Authors
Shaoping Li
Baiyun Li
Alexis Medina
D. Scott Smith
Scott Rozelle
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