The purpose of this project is to define and statistically test the determinants of health outcome differences over regions and changes over time in 8 provinces of China through a model that incorporates individual, household, and community variable The model will be designed to take advantage of panel data estimation techniques to estimate both a fixed effect for individual (an estimate of unobserved, innate healthiness) and the impact of random shocks to health that cannot be explained by t variables in the model. No one-health outcome will be defined as the objective; the determinants of several specific ill health outcomes (such as diarrhea for children and high blood pressure for adults) will be modeled and the relationships estimated. The project addresses 2 basic failings of the literature on the determinants of health outcomes. A statistical model based on the micro-economic theory of household behavior is developed. Second, household and community data collected as part (the China Health and Nutrition Survey, over the 1989 to 1997 time period, is used so that the impact of the full set (determinants on changes in health can be analyzed. The hypothesis is that interventions such as education and higher incomes raise the demand for health care and also increase the efficiency of the use of inputs that enhance the ability of the household to deal with health shocks and to slow the depreciation of the stock of health. Government investments in public health goods reduce the probability of health shocks from specific sources (e.g., malaria) and reduce costs of curative interventions (b increasing the availability of inexpensive sources of curative care). The project outputs will include: (1) behavioral and statistical models of determinants of health; (2) a comparative analyst of the periods 1989, 1991, 1993 and 1997; (3) a longitudinal comparative analysis across the 4 panels of the China data; (4) a macro-level policy paper relating changes in macro-model variables to societal outcomes; and (5) a final report an Presentation of the findings.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD038063-04
Application #
6705009
Study Section
Special Emphasis Panel (ZRG1-SNEM-3 (01))
Program Officer
Spittel, Michael
Project Start
2001-03-20
Project End
2006-02-28
Budget Start
2004-03-01
Budget End
2006-02-28
Support Year
4
Fiscal Year
2004
Total Cost
$193,624
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Miscellaneous
Type
Schools of Arts and Sciences
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Xie, Jipan; Dow, William H (2005) Longitudinal study of child immunization determinants in China. Soc Sci Med 61:601-11
Akin, John S; Dow, William H; Lance, Peter M et al. (2005) Changes in access to health care in China, 1989-1997. Health Policy Plan 20:80-9
Akin, John S; Dow, William H; Lance, Peter M (2004) Did the distribution of health insurance in China continue to grow less equitable in the nineties? Results from a longitudinal survey. Soc Sci Med 58:293-304
Lance, Peter M; Akin, John S; Dow, William H et al. (2004) Is cigarette smoking in poorer nations highly sensitive to price? Evidence from Russia and China. J Health Econ 23:173-89