Background: In China, large-scale population movement and increased childcare costs have brought about a "care crisis" for rural children left-behind when their parents migrate to cities. The unprecedented scale of internal population migration poses multiple challenges to the health of left-behind children in rural areas. Rural left-behind children are currently experiencing insufficient caregiving capacity of intergenerational guardians; the impact of serious parental absences; inadequate nutritional and dietary support and healthy behaviours; limited health service utilization; and abnormally high levels of poor mental health.Purpose: Using 2016 China Family Panel Studies’ micro-data two issues were explored: What is the current status of health inequality in rural left-behind children, including the degree of health inequality and differences in health inequalities of left-behind children in different regions and different age groups; and, second, what are the socioeconomic factors (income deprivation, access to medical services, migrating parents) and inter-generational care arrangements that impacted the health inequality of left-behind children? Method: The health indicators of left-behind children were measured by the concentration index (CI), and the contribution of each socio-economic variable to health inequality was decomposed through the RIF-I-OLS model.Results: The health inequality of left-behind children in rural areas was pro-rich. Left-behind children under 5 years of age had the highest health inequality in all regions; the availability of medical services had a significant negative impact on the health inequality of left-behind children in rural areas, especially in the western provinces; income deprivation had a significant positive effect on the health inequality of left-behind children in rural areas, most notably in the eastern provinces; migrant parents had a negative, and intergenerational caregivers a positive, impact on the health inequality of left-behind children; and left-behind children in the western provinces suffered the largest negative impact on their health. Finally, left-behind children experienced relative health inequality due to their sex, education level and health endowments. Policy recommendations are advanced to address issues of health inequalities in rural left-behind children.

Objective: To provide the first estimates of the cost of productivity losses attributed to diabetes age 20-69 years old in urban and rural areas of China. Methods: Construct through life table modelling, expectancy life of diabetes sufferers, including the years of potential life lost and working years of life lost. Using the human capital approach, we measured the productivity losses attributed to absenteeism, presenteeism, labor force dropout and premature deaths due to diabetes of the population aged 20-69 years in urban and rural areas in China. Results: In 2017, we estimated that there were 100.46 million diabetes lost hours, with the total cost of productivity losses US$613.60 billion, comprising US$326.40 billion from labor force dropout, US$186.34 billion from premature death, US$97.71 billion from absenteeism, and US$27.04 billion from presenteeism. Productivity loss was greater in urban (US$490.79 billion) than rural areas (US$122.81 billion), with urban presenteeism (US$2.54 billion) greater than rural presenteeism (US$608.55 million); urban absenteeism (US$79.10 billion) greater than rural absenteeism (US$18.61 billion); urban labour force dropout (US$261.24 billion) greater than rural labour force dropout (US$65.15 billion) and urban premature death (US$147.90 billion) greater than rural premature death (US$38.44 billion). Conclusions: Diabetes had a large and significant negatively impact on productivity in urban and rural in China, with a significant gap in the level of diabetes management in urban compared to rural regions. Productivity loss was significantly higher in urban than rural regions. Further investment is required in the prevention, diagnosis and control of diabetes in under-resourced health services in rural locations and also in urban areas, where most diabetes cases reside. Specifically, targeted and effective diabetes prevention and management actions are urgently required.