The “Difference Between Heaven and Earth”: Urban-rural Disparities in Health and Well-being in China Donald J. Treiman California Center for Population Research, UCLA NUS Sociology Seminar 27 January 2011

22 The problem Massive economic growth in China over the past 60 years, especially the last 30 years (10% annual increase in GDP almost every year since 1978). But still a large urban-rural gap in socioeconomic inequality, well-being, and health. Has the gap been narrowing, increasing, or remaining unchanged?

33 Two competing hypotheses Dramatic improvements in rural well- being, due to increase in job opportunities for migrants, mainly in export-oriented manufacturing, resulting in a narrowing of the gap. The urban sector has led economic growth, resulting in a widening of the gap.

44 Urban-rural status “Hukou” (registration) system, instituted in 1955, created a 2-class society, with access to welfare benefits differentially available to those with “non-agricultural” and “agric- ultural” (or “urban” and “rural”) registration: –Health, unemployment, and retirement insurance; education; housing; jobs; and, in the days of rationing, food. –Also, differential taxation, favoring the urban population: in-kind agricultural tax from 1958 until 2006, but no income tax until In sum, China built an urban welfare state on the backs of the peasants.

5 Hukou conversion It was, and is, very difficult to change from rural to urban hukou, education being the key mechanism. It also was, and is, very difficult to acquire local hukou (required for most benefits), except when moving from a larger to a smaller place. Still, since the Economic Reform that began in 1978, many rural people have moved to cities and towns (see below).

66 Data Two national probability sample surveys of mainland China carried out by me and colleagues: 1996 survey of people age focused on inequality over the life course. N = 6, survey of people age focused on internal migration. Includes an oversample of migrants—people born other than where they are currently living. N = 3,000. The two data sets were merged, to produce a sample of 9,090 people born between 1927 and 1990.

77 Urban-rural status typology To focus on rural-urban differences, I created a 3-category typology based on residence and registration at age 14: 1.those with urban registration (before 1941, urban residence); 2.those with urban residence, but rural registration (born in 1941 or later, since hukou system not introduced until 1955); 3.those with rural residence and registration (before 1941, rural residence).

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9 More on the typology Focusing on origins (measured at age 14) avoids “sample selection bias,” since current status is an outcome, correlated with other aspects of inequality. No distinction by residence is made for those with urban hukou since only a small fraction live in rural areas. The 3-category typology permits two contrasts: –institutionalized discrimination. –urban vs. rural life experience. –Expectation: rural hukou, urban residence group (hereafter “mixed”) will be intermediate. Here is the trend in residence type.

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12 Analytic Strategy Pool the two data sets. Estimate trends for each of the 3 urban- rural status types by single-year birth cohorts: (but for the “mixed” category; for age 30 analysis). Show gross trends (without controls) and, where appropriate, net trends, controlling for the usual suspects. Smooth data using Stata’s –lowess-.

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27 A rising tide lifts all boats Overall conclusion: –The wellbeing of the Chinese population has improved dramatically, especially over the past 30 years, with increased levels of education, a reduction of the agricultural workforce and increase in the non-manual workforce, and increases in income, material wellbeing, diet, and health. –But, overall, there has been neither much increase or decrease in the rural-urban wellbeing gap.