The socio-economic dynamics of urbanization in China: Inequalities, child health and development

Lead Research Organisation: University of Manchester
Department Name: Social Sciences

Abstract

The proposed fellowship study will expand on my PhD project about parental migration and its influence on children's health and wellbeing in China by considering an important macro contextual factor - rapid urbanization. It aims to examine how rural-urban disparity in child health changes during the process of China's urbanization. I aim to achieve five main objectives during this one-year fellowship: 1) To disseminate findings from my PhD to both academic and non-academic audiences; 2) To build networks and partnerships with academic institutions and non-academic users across sectors in China to develop proposals for future grant calls; 3) To produce publications in order to help establish a track record in the area of migration and urbanization and their influence on population health and wellbeing; 4) To receive specialised training, e.g., communication, translation and dissemination, policy analysis and further advanced methods to make me a well-rounded researcher; 5) To provide an excellent step towards establishing my academic career in the area of migration and urbanization and their impacts on population health and wellbeing.
China has seen rapid urbanization in the last three decades, with the proportion of urban population rising from 18 percent (172.45 million) in 1978 to 51 percent (690.76 million) in 2011. Unlike Western and former socialist countries, China's rapid urbanization is not merely driven by spontaneous rural-urban migration, but also partly planned by the government that has maintained an urban bias in favour of urban residents to preserve regime stability. China's household registration (hukou) system officially segregates its population into 'urban residents' born in urban areas and 'rural residents or peasants' born in rural areas. These are the status markers in contemporary China, and entail different state welfare entitlements. The hukou system is the most crucial institutional arrangement that has affected individuals' life chances and socio-economic well-being in China. The process of China's rapid urbanization may cause the unequal distributions of socio-economic resources and life chances among its population, thus contributing to rural-urban health inequalities.
It has been suggested that targeting at childhood or early years of life has the potential to reduce health inequalities within one generation. The consequences of urbanization on child health in terms of physical health and psychosocial well-being are likely to be mixed. Children may benefit from improved economic status, better access to healthcare, sanitation, and better nutrition. However, rapid environmental, economic and social changes that follow urbanization may put children in risky situations such as environmental hazards, stressors, and unhealthy diets and lifestyles. The effect of urbanization on child health may differ according to the degree of urbanization because, for example, rural, newly urbanized communities and settled urban can be associated with different risk factors of child health and development.
Despite well documented rural-urban inequalities in child health in China, there are few attempts to examine how this relationship changes during the process of China's urbanization and possible mechanisms. Previous research has tended to study socioeconomic status, urbanization and child health separately in a cross-sectional fashion and failed to examine the dynamic socioeconomic inequalities in child health in a rapidly urbanizing society. This proposed fellowship aims to explore the dynamics of socioeconomic inequalities in child health and development by considering important macro contextual factors-rural-urban migration and rapid urbanization in China. Findings will provide a sound evidence base to inform decision-making in public health and social welfare to tackle health and welfare inequalities among children in China and other developing countries with rapid urbanization and internal migration.

Publications

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NAN ZHANG (2020) Air quality and obesity at older ages in China: The role of duration, severity and pollutants. in Apollo - University of Cambridge Repository

 
Description This study aims to examine urban/rural inequalities in cardiovascular risk biomarkers among Chinese adolescents in two decades from 1991 to 2011 during the process of China's rapid urbanisation. Data were drawn from a nationwide longitudinal dataset of the China Health and Nutrition Survey (CHNS) (Sweeps 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011). Children aged between 12 and 17 years (Boys: n=6,055; Girl: n=5,528) were included. A dynamic urbanisation index was created for each community (village or neighbourhood) based on community-level data that can reveal the heterogeneity within and across places and capture dimensions of social, economic and physical characteristics of urban living over time and space. Multilevel modeling analyses (Level 1: Occasions; Level-2: Individuals; Level-3: Households; Level-4: Communities) were performed on outcomes of cardiovascular risk biomarkers including anthropometric measures and blood pressure. Cardiovascular risk biomarkers increase during 1991 to 2011. Urbanisation tends to have an independent and positive impact on BMI and waist circumference for boys but not for girls. We found significant and positive interaction effect between urbanisation index and survey years for waist circumference for girls: time trends become greater when areas become more urbanized. For blood pressure, when areas become more urbanized the trends for boys become less pronounced. Chinese adolescents are experiencing an upward trend of cardiovascular risk in last two decades. Its rapid urbanisation appears to further increase the risk, especially for boys, which may contribute to the development of cardiovascular disease in adulthood. Given China's urbanisation is strongly influenced by the state, there is a possibility for policy intervention to reduce inequality during the process of China's planned urbanisation.
Exploitation Route Submitted to journal, currently under review.
Sectors Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice

 
Description Nan has worked on urbanisation, migration and how it affects health and wellbeing of vulnerable groups in China. Nan has been invited to share her findings with key Laboratory of Health Economic and Policy Research, National Health and Family Planning Commission, Shandong. Nan has been working with collaborators from Public Health Federation of India to work on cross-country comparison studies between China and India. They have secured a GCRF Pump-Priming/Partnership Development grant to strengthen ongoing collaboration. Nan visited Public Health Federation of India during 1-5 December 2019 to discuss challenges faced by vulnerable groups in urban India. Dr Manu Marthur has also visited Nan at University of Manchester early February 2020 to move forward their ongoing work. They have covered issues around environmental challenges and health risks of disadvantaged groups in the Global South, particularly in China and India. The work is still ongoing.
Sector Communities and Social Services/Policy
Impact Types Societal,Policy & public services

 
Description Cathie Marsh Institute Seedcorn Funding
Amount £2,000 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 03/2019 
End 07/2019
 
Description GCRF Pump-Priming/Research Partner Development Grant
Amount £18,836 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 01/2020 
End 12/2020
 
Description Hallsworth Research Fellowship
Amount £114,000 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 12/2017 
End 12/2020
 
Description Humanities Strategic Investment Fund (HSIF) Internationalisation Mobility award
Amount £2,200 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 08/2018 
End 07/2019
 
Description Tenure track presidential academic fellowship University of Manchester
Amount £180,000 (GBP)
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 09/2018 
End 08/2022
 
Description China-UK healthy ageing grant with three Chinese Universities 
Organisation Fudan University
Country China 
Sector Academic/University 
PI Contribution Nan has worked collaboratively (Co-I) with Chinese colleagues from three top Universities (Shandong University, Fudan University and Harbin Medical University) in China to apply for major China-UK healthy ageing grant. The aim of the project to improve older adults' quality of life by drawing on efforts of individual, household and community in two countries. Nan acted as one of key members and Co-Is through the process and made substantial intellectual contribution to the application. The application is currently under review.
Collaborator Contribution Our partners in China worked closely with the team at the University of Manchester to develop the project from the design to the final submission. This is a comparison study between China and UK on social and healthy challenges of population ageing. They contributed substantially and equally to the project.
Impact This collaboration is at early stage and still ongoing. This collaboration is multi-disciplinary involving sociology, social statistics, public health, gerontology and psychology.
Start Year 2019
 
Description China-UK healthy ageing grant with three Chinese Universities 
Organisation Harbin Medical University
Country China 
Sector Academic/University 
PI Contribution Nan has worked collaboratively (Co-I) with Chinese colleagues from three top Universities (Shandong University, Fudan University and Harbin Medical University) in China to apply for major China-UK healthy ageing grant. The aim of the project to improve older adults' quality of life by drawing on efforts of individual, household and community in two countries. Nan acted as one of key members and Co-Is through the process and made substantial intellectual contribution to the application. The application is currently under review.
Collaborator Contribution Our partners in China worked closely with the team at the University of Manchester to develop the project from the design to the final submission. This is a comparison study between China and UK on social and healthy challenges of population ageing. They contributed substantially and equally to the project.
Impact This collaboration is at early stage and still ongoing. This collaboration is multi-disciplinary involving sociology, social statistics, public health, gerontology and psychology.
Start Year 2019
 
Description China-UK healthy ageing grant with three Chinese Universities 
Organisation Shandong University
Country China 
Sector Academic/University 
PI Contribution Nan has worked collaboratively (Co-I) with Chinese colleagues from three top Universities (Shandong University, Fudan University and Harbin Medical University) in China to apply for major China-UK healthy ageing grant. The aim of the project to improve older adults' quality of life by drawing on efforts of individual, household and community in two countries. Nan acted as one of key members and Co-Is through the process and made substantial intellectual contribution to the application. The application is currently under review.
Collaborator Contribution Our partners in China worked closely with the team at the University of Manchester to develop the project from the design to the final submission. This is a comparison study between China and UK on social and healthy challenges of population ageing. They contributed substantially and equally to the project.
Impact This collaboration is at early stage and still ongoing. This collaboration is multi-disciplinary involving sociology, social statistics, public health, gerontology and psychology.
Start Year 2019
 
Description Collaboration with Professor Xiaojie Sun to compete China National Social Science Foundation grant 
Organisation Shandong University
Country China 
Sector Academic/University 
PI Contribution I have been working with Professor Sun at School of Health Management Shandong University China to write a grant proposal on social capital and healthy ageing among older people with hypertension in order to compete China National Social Science Foundation grant.
Collaborator Contribution Professor Sun and his team will contribute to the grant writing, study design, data collection and dissemination and future impact activities.,
Impact In process
Start Year 2017
 
Description International Conference on Healthy Cities: Urbanisation, Infrastructures and Everyday Life 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Nan presented her research on Ambient air pollution and obesity at older ages in China at an International Conference on Healthy Cities: Urbanisation, Infrastructures and Everyday Life. 1-3 May 2019, Manchester UK. Oral presentation. There was around 300 attendees from academic, public sector and policy makers.
Year(s) Of Engagement Activity 2019
URL https://www.msa.ac.uk/events/2019/healthy-cities/
 
Description International institutional visit-Public Health Federation of India 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Nan visited Public Health Federation of India to discuss further collaboration on challenges around health impact of urbanisation on vulnerable groups.
Year(s) Of Engagement Activity 2019
 
Description Invited talk Thinktank Warwick China Development Annual Summit 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Undergraduate students
Results and Impact 2018 Zhang, N. (Invited talk) Unresolved issues of China's miracle: left-behind children. Thinktank Warwick China Development Annual Summit, 11 Feb 2018, Warwick Oculus Building. Oral presentation.
Year(s) Of Engagement Activity 2018
URL http://www.chinaisgood.com/wn/153/zcfjxabxand.html
 
Description Overseas Institutional visit 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I conducted two one-day visit to Peking University Centre for China Health Development and Sun-Yat Sen University School of Public Health to discuss my findings from PhD and further collaboration on health inequality in China.
Year(s) Of Engagement Activity 2017
 
Description School visit in rural China 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Schools
Results and Impact I went back to the villages where I collected data for my PhD about caregiving practices for children (left-behind children and non-left-behind children) in rural China. I conducted a public lecture and engagement activities with around 300 school children aged 6-12 years. It was a informal interactive sessions followed by questions and fun plays.
Year(s) Of Engagement Activity 2017