Studies in the United States have long shown that rich people tend to be healthier than poor people, and that this “health gap” between the haves and have-nots gets worse as people get older. But is that because the U.S. is a capitalist society? Apparently not. A new study from North Carolina State University shows that the same is true in China. However, there is one key difference. In China, the overall health gap across generations is getting narrower – and it’s getting wider in the U.S.
The research, “Social Change and Socioeconomic Disparities in Health over the Life Course in China: A Cohort Analysis,” was published in March by American Sociological Review.
This article examines social stratification in individual health trajectories for multiple cohorts in the context of China’s dramatically changing macro-social environment. Using data from the China Health and Nutrition Survey, we find significant socioeconomic status (SES) differences in the mean level of health and that these SES differentials generally diverge over the life course. We also find strong cohort variations in SES disparities on the mean levels of health and health trajectories. The effect of education on health slightly decreases across successive cohorts. By contrast, the income gap in health trajectories diverges for earlier cohorts but converges for most recent cohorts. Both effects are more pronounced in rural areas. Given that these cohort effects are opposite those reported in recent U.S. studies, we discuss China’s unique social, economic, and political settings. We highlight the association between SES and health behaviors, China’s stage of epidemiologic transition, and the changing power of the state government and its implications for health care.