Health, wealth, and inequality in the Chinese city

The Effects of Childhood Circumstances on Health in Middle and Later Life: Evidence From China

Background: This study examined the relationship between childhood circumstances and health in middle and later life. We quantified how childhood circumstances contribute to health in later life, both directly and indirectly, through their effects on potential mediators.

Methods: This study used three waves of data from the national longitudinal survey of the China Health and Retirement Longitudinal Study (CHARLS). The final model in this study included 7,476 eligible respondents aged 45 years and above. We constructed a simple health status measure based on the first principal component of CHARLS survey responses with 25 health-related information. It is a multi-dimensional measurement that comprehensively reflects the individual's healthy aging. We formulated childhood circumstances factors into five domains: childhood health and nutrition, childhood socioeconomic status, access to health care, parental genetics, and adverse childhood experiences. Ordered logit regression was conducted to analyze the relationship between health in middle and later life and childhood circumstances, with other explanatory variables controlled.

Results: Controlling for educational attainment, personal income, and health status in the last wave, adults who experience good childhood health (poor as the base, coefficient 0.448, p < 0.01), and better family financial status (worse as the base, coefficient 0.173, p < 0.01) have significantly better health during their middle and later life, in comparison, being inconvenient to visit a doctor (coefficient −0.178, p < 0.01), and having two or three adverse childhood experiences (0 as the base, coefficient −0.148, p < 0.01) are significantly associated with poorer health. Childhood circumstances appear to act both through a lasting effect of initial health and financial status in childhood and through their impact on achievements in adulthood.

Conclusion: Our findings suggest that investments in health during childhood not only contribute to health in later life but also dynamically improve an individual's educational attainment and personal income, as well as other life prospects. All these returns may extend far beyond childhood and continue throughout the lifespan.

Therapeutic itineraries in a global world: Yemenis and their search for biomedical treatment abroad

Focusing upon how Yemenis travel to Jordan and other countries for medical reasons, this article explores a variety of issues and experiences pertaining to care-seeking abroad. Topics include state support for treatment outside the country, links between countries that facilitate movements, therapeutic reputations leading to destination selection, medical travelers' funding and logistical decisions, and notions of "good" patient care. The study is set within a context of increasing globalization, where advances in communication, transportation, and medical devices and procedures all contribute to people's ideas about where to go for medical care. As such, it extends care-seeking research beyond local services and national boundaries.

Ageing and aged care in the People's Republic of China: national and local issues and perspectives

China's population is rapidly ageing at a time when former socialist collective provision and provision by the state in all sectors, especially in social welfare, is being radically reduced because of economic reform and financial stringency. The traditional Chinese approach to family care for elderly members is being encouraged but may be difficult because of smaller family sizes and the disruption of migration. This paper discusses some urban responses to pressures for change in care of elderly people, drawing on the example of Guangzhou (Canton) in southern China, which typifies many of the problems of caring for elderly people in times of social and economic change. It notes the development of homes and facilities for elderly people and the emergence of some prestige homes, often occupied by the better off, which have received both local and international investment. By contrast, the bulk of elderly people will not be adequately provided for by a declining public/collective sector. The dilemmas faced by the Chinese authorities attempting to stimulate local provision for all elderly people are identified.