Social Pension Scheme and Health Inequality: Evidence From China's New Rural Social Pension Scheme

Hui, Yuan; Chen, Shuoqi; Pan, Guochen; Zheng, Lianyuan

doi:10.3389/fpubh.2021.837431

Cited by 16 publications

(22 citation statements)

References 39 publications

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“…Using Bayesian network analysis, we identi ed age as a common cause of whether to receive NRPS and self-rated health, although there was no direct causal relationship between the two variables. This contrasted with those of Yuan et al [27], who has reported more positive results using the China Family Panel Studies (CFPS) data. Possible explanations are that we used different data and that the effect of NRPS on health status will probably be linked or masked by age.…”

Section: Discussioncontrasting

confidence: 88%

“…According to some literature, the bandwidth is affected by sample size and should be selected based on the minimum bandwidth when the sample size is insu cient, otherwise large bias will result [39,40]. Consequently, the small sample size of each subgroup may be contributing to the instability of sensitivity analysis, which had also been occurred in similar studies [27]. In this study, as bandwidth selection was based on optimal criteria, the results of the regression models remained valid.…”

Section: Subgroup Analysis In Chronic Diseasesmentioning

confidence: 73%

“…The dependent variable An individual's self-evaluation of his or her health combined with self-rated health score is generally considered an appropriate and effective index for representing the real health status of an individual in many previous studies [27,28]. Therefore, the selfrated health, which is an is an essential item in the CHARLS questionnaire containing ve response options ("Extremely poor", "Very poor", "Average", "Very good", "Extremely good") [29], was used to measure subjective health in this study.…”

Section: Variablesmentioning

confidence: 99%

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Do the New Rural Pension Scheme promote the health status of chronic patients in old age? —Evidence from CHARLS 2018 in China

Liang

Chen

Zhang

et al. 2023

Preprint

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Background Many researchers have examined the impact of social insurance on health in elderly. However, in most cases, they have only demonstrated correlational results and have not been able to determine causal effects, possibly because confounding biases have not been fully addressed. In this study, we investigated the health effects of the New Rural Pension Scheme (NRPS) on the elderly with chronic diseases in rural areas, and to explore the causal relationship and effects of NRPS and health status. Methods This paper used data from the 2018 China Health and Aged Care Tracking Survey (CHARLS) and applied Bayesian networks and fuzzy regression discontinuity design to conduct causal analysis. Bayesian networks were used to explore the causal directed acyclic graphs of factors related to NRPS and health status. Based on the results of Bayesian network, a fuzzy regression discontinuity design was employed to estimate the causal effect of NRPS on health status. Results Among rural elderly with chronic diseases, Bayesian network mapping of causal relationships among NRPS, health status and covariates showed that age was a common cause of NRPS receipt and satisfaction with health. The results of the fuzzy regression discontinuity analysis showed that the effect of receiving NRPS on the health status was positive, but there was no statistically significant difference concerning the interval estimates. The results of the subgroup analysis with chronic obstructive pulmonary disease (COPD) and asthma indicated that the effect of NRPS receipt on the health status of elderly people with COPD was positive. There was a statistically significant effect of receiving NRPS on self-rated health description (β1=3.177,P=0.040) and health satisfaction (β1=5.307,P=0.031) in COPD population and a statistically significant effect of receiving NRPS on health satisfaction in asthma population (β1=9.850,P=0.040). Conclusion This paper has confirmed the contribution and positive causal effect of NRPS on health status in a subgroup of older adults with COPD and asthma, using the CHARLS database as evidence. Thus, Chinese government should increase the take-up rate of the NRPS to enhance their positive impact on health status of elderly people with chronic diseases in rural areas.

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Section: Discussioncontrasting

confidence: 88%

Section: Subgroup Analysis In Chronic Diseasesmentioning

confidence: 73%

Section: Variablesmentioning

confidence: 99%

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Do the New Rural Pension Scheme promote the health status of chronic patients in old age? —Evidence from CHARLS 2018 in China

Liang

Chen

Zhang

et al. 2023

Preprint

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“…The insurers are required to pay the medical expenses in advance when seeking medical treatment, then a certain proportion of medical expenses are reimbursed after treatment. A large amount of prepayment may become one of the reasons restricting low-income groups from seeking timely medical treatment ( 36 ), which may potential increase risk of ADL limitations due to lack of heath care access. To reduce the healthcare burden for those with serious chronic diseases, in recent years the reimbursement cap for more than 20 chronic diseases including diabetes has been increased to 140,000 Yuan per year, compared to 6,000 Yuan for general diseases in outpatient clinics ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Activities of daily living and its influencing factors for older people with type 2 diabetes mellitus in urban communities of Fuzhou, China

Jie¹,

Li²,

Jia³

et al. 2022

Front. Public Health

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BackgroundType 2 diabetes mellitus (T2DM) is an independent risk factor for functional limitations among the older population. The predicted increase in T2DM cases combined with the ongoing rapidly aging population may further burden the already overloaded healthcare system and aggravate the loss of economic self-sufficiency. This study aimed to investigate the activities of daily living (ADL) and its influencing factors on older people with T2DM, and to provide implications for the development and improvement of community nursing services in the context rapidly aging population in China.MethodsFrom March 2019 to June 2020, we conducted a cross-sectional questionnaire survey among older T2DM patients in Fuzhou, using a multi-stage cluster sampling approach. Functional status was measured by the Lawton ADL scale. Stata “nptrend” test was used to examine the trend of ordinal variables on ADL. Non-conditional logistic regression was used to identify factors affecting ADL limitations.ResultsA total of 2016 questionnaires were received, with a response rate of 96%. 12.4% of participants suffered from varying degrees of functional impairment. ADL limitations increased with age. More comorbidities were associated with a greater risk of developing functional limitations in ADLs. the following sub-groups were more likely to suffer from ADL impairment: those aged 70 and over years (OR = 1.99, 95%CI 1.77–2.56), living in an aged care house or with spouse/children (OR = 2.31, 95%CI 1.25–4.26), low monthly income (OR = 1.49, 95%CI 1.28–1.64), without health insurance (OR = 1.82, 95%CI 1.40–2.40), tight family expenses (OR = 1.95, 95%CI 1.42–2.69), having stroke (OR = 6.70, 95%CI 2.22–20.23) or malignant tumor (OR = 4.45, 95%CI 1.27–15.53), irregular eating habit (OR = 2.55, 95%CI 2.23–2.92), smoking (OR = 1.40, 95%CI 1.22–1.60), sedentary lifestyle (OR = 2.04, 95%CI 1.46–2.85), lack of physical exercise (OR = 1.35, 95%CI 1.19–1.53), sleeping difficulty (OR = 1.25, 95%CI 1.10–1.42), and lack of family support (OR = 1.19, 95%CI 1.10–1.29).ConclusionOlder adults (≥70 years) with T2DM had a high prevalence of functional limitations across a range of daily living tasks, which not only affect individual life of quality but also present a huge burden on the family, health services system, and the whole society. Identified factors associated with ADL limitations may provide useful information for targeted nursing practice and health promotion.

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“…This paper contributes to the strand of literature that examines the effects of the NRPS. Most of extant studies focused more on its effect on labor supply, child transfer payments, medical service utilization, mental health, and health inequality ( 38 , 40 – 43 ). However, we innovatively complement the effect of the NRPS from the perspective of dietary health.…”

Section: Introductionmentioning

confidence: 99%

Has new rural pension system reduced the intake of junk food among rural older adults? Evidence from China

Purun

Sun²,

Cao³

et al. 2023

Front. Public Health

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At present, China has become one of the fastest growing countries in terms of junk food consumption. However, there has been less previous evidence for the effect of endowment insurance on dietary health. Using the data China Family Panel Studies (CFPS) from 2014, this paper exploits a policy, the New Rural Pension System (NRPS), that only the older adults who have reached 60 years old can receive pensions and conduct a fuzzy regression discontinuity (FRD) to address endogeneity and examine the causal effect of the NRPS on the intake of junk food among rural older adults in China. We find that the NRPS can significantly reduce junk food intake among them, which remains robust after a series of robustness tests. In addition, heterogeneity analysis shows that the female, low-educated, unemployed, and low-income groups are more sensitive to the pension shock from the NRPS. The result of our study provides insights to effectively improve people's dietary quality and related policy formulation.

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Social Pension Scheme and Health Inequality: Evidence From China's New Rural Social Pension Scheme

Cited by 16 publications

References 39 publications

Do the New Rural Pension Scheme promote the health status of chronic patients in old age? —Evidence from CHARLS 2018 in China

Do the New Rural Pension Scheme promote the health status of chronic patients in old age? —Evidence from CHARLS 2018 in China

Activities of daily living and its influencing factors for older people with type 2 diabetes mellitus in urban communities of Fuzhou, China

Has new rural pension system reduced the intake of junk food among rural older adults? Evidence from China

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