Assessing the impact of public transfer payments on the vulnerability of rural households to healthcare poverty in China

Can government subsidies and public mechanisms alleviate the physical and mental health vulnerability of China's urban and rural residents?

BACKGROUND

Poverty vulnerability has been defined as the likelihood of a family falling into poverty in the upcoming months. Inequality is a major cause of poverty vulnerability in developing countries. There is evidence that establishing effective government subsidies and public service mechanisms significantly reduces health poverty vulnerability. One of the ways to study poverty vulnerability is by using empirical data such as income elasticity of demand to perform the analysis. Income elasticity refers to the extent to which changes in consumers' income affect changes in demand for commodities or public goods. In this work, we assess health poverty vulnerability in rural and urban China. We provide two levels of evidence on the marginal effects of the design and implementation of government subsidies and public mechanisms in reducing health poverty vulnerability, before and after incorporating the income elasticity of demand for health.

METHODS

Multidimensional physical and mental health poverty indexes, according to the Oxford Poverty & Human Development Initiative and the Andersen model, were implemented to measure health poverty vulnerability by using the 2018 China Family Panel Survey database (CFPS) as the data source for empirical analysis. The income elasticity of demand for health care was used as the key mediating variable of impact. Our assessment was conducted by a two-level multidimensional logistic regression using STATA16 software.

RESULTS

The first level regression indicates that the marginal utility of public mechanism (PM) in reducing urban and rural vulnerability as expected poverty on physical and mental health (VEP-PH&MH) was insignificant. On the other hand, government subsidies (GS) policies had a positive suppression effect on VEP-PH&MH to a relatively low degree. The second level regression found that given the diversity of health needs across individual households, i.e., the income elasticity of demand (HE) for health care products, PM and GS policies have a significant effect in reducing VEP-PH&MH in rural and urban areas. Our analysis has verified the significant positive impact of enacting accurate GS and PM policies on effectively reducing VEP-PH&MH in rural as well as urban areas.

CONCLUSIONS

This study shows that implementing government subsidies and public mechanisms has a positive marginal effect on reducing VEP-PH&MH. Meanwhile, there are individual variations in health demands, urban-rural disparities, and regional disparities in the effects of GS and PM on inhibiting VEP-PH&MH. Therefore, special consideration needs to be given to the differences in the degree of health needs of individual residents among urban and rural areas and regions with varying economic development. Furthermore, considerations of this approach in the current worldwide scenario are analyzed.

Study on Rural Development Evaluation and Drivers of Sustainable Development: Evidence from the Beijing-Tianjin-Hebei Region of China

Rural areas are the basic units of social development and contain residents’ production and living activities, so understanding the nature of rural development has essential theoretical and practical significance. This paper first constructs a rural development evaluation index system, then analyzes the changes in the development level and development pattern of rural areas in Beijing, Tianjin and Hebei from 2009 to 2020 in five aspects: prosperous industry, eco-friendly, civilized countryside, effective governance, and affluent living, and then further explore the changes in their comprehensive rural development level and development pattern. Finally, the main drivers of sustainable development in rural areas and their dynamic impacts are studied and analyzed using the boosted regression trees method. The research results show that: (1) from 2009 to 2020, all five aspects of rural development in the Beijing–Tianjin–Hebei rural areas have progressed to different degrees, among which the development level of affluent living has progressed very significantly and is the primary driver of sustainable rural development in the region; (2) the development level of rural areas in the Beijing–Tianjin–Hebei region has improved in general, but the development speed of major agricultural areas such as Baoding, Xingtai and Handan slower; (3) improving rural medical and health conditions, narrowing the urban–rural gap, and activating farmers’ vitality are the main ways to promote sustainable rural development. The results of the study help to gain an in-depth understanding of the rural development in the Beijing–Tianjin–Hebei region and also have important reference significance for sustainable rural development in other countries or regions.