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

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Sun J (2021) Subjective Wellbeing in Rural China: How Social Environments Influence the Diurnal Rhythms of Affect in International Journal of Environmental Research and Public Health

 
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 I have actively and productively engaged with various communities in different socio-cultural contexts, for example, school children and staff, local authorities and NGOs in China, and older Chinese communities, Manchester City Council and NGOs (for example, Wai Yin Society, Runnymede Trust) in the UK. I was invited to serve on the advisory board for a Chinese community engagement project to promote health and well-being of senior BAME communities in Greater Manchester. The evidence being generated from this project will be fed into policy-making aimed at reducing social isolation and enhancing the well-being of older Chinese people. My growing engagement with external stakeholders-public sector, local communities, NGOs in China and the UK - has led to effective collaborations, and potential impact on policy-making in relation to improving well-being and reducing inequality for marginalised groups in both countries, which is at the heart of my research agenda.
First Year Of Impact 2020
Sector Communities and Social Services/Policy
Impact Types Cultural,Societal,Economic,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 Grandparents on the move: urban migration and grandparenting in post-one-child policy China
Amount £9,827 (GBP)
Funding ID SG2122\210325 
Organisation University of Manchester 
Sector Academic/University
Country United Kingdom
Start 04/2022 
End 04/2024
 
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 Establishing the first international network-Global Network for Ageing Research on China (URL: https://www.gnarchina.com/ ) 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact I established and lead the first international research network focused on the ageing of Chinese populations (The Global Network for Ageing Research on China (GNARC)). This brings together scholars, public sector and NGOs, and has attracted over 200 members from all over the world: China, UK, America, Australia, Hongkong, etc. GNARC has an active seminar series, with presentations from the leading scholars in the field, and provided opportunities for networking, the development of new research programmes, and joint policy work. We have organised monthly seminars and reading groups which have attracted over 200 participants from worldwide: China, UK, US, Japan, India, Australia, Europe, etc.
Year(s) Of Engagement Activity 2021
URL https://www.gnarchina.com/
 
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
 
Description Symposium on Ageing and Well-being in China 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact We, on behalf of the Global Network for Ageing Research on China/Chinese (GNARC) and Manchester Institute for Collaborative Research on Ageing (MICRA), are inviting leading scholars and stakeholders to attend a one-day hybrid symposium on 'Ageing and Well-being in China' on 30thMarch 2023. A mix of established scholars and rising stars will present their exciting research on ageing, health and well-being in the Chinese context during the symposium (please see the provisional programme below). It will offer an excellent opportunity for intellectual exchange, networking and incubating future collaboration among participants.
Year(s) Of Engagement Activity 2023