Are cities good for health? A study of the impacts of planned urbanisation in China

Bo Hou, James D. Nazroo, James Banks, Alan Marshall

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Urbanisation in developing countries is usually accompanied by migration to cities, making it a challenge to unpack the independent association between migration and health and urbanisation and health, particularly in the presence of health selective migration. Since 1978, unprecedented (planned) urbanisation has taken place in China and further increases to the urban population are expected. This paper explored the impacts of urbanisation in China through a comparative study of in-situ urbanised population.

Methods
Using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset for people aged 45 years or older, we compared self-assessed general health, depressive symptoms and waist circumference among three groups: i. in-situ urbanised-rural residents, ii. rural residents and iii. urban residents. Using a model informed by the literature on the social determinants of health in later life, we investigated the patterning and drivers of differences in health outcomes between these three groups in order to explore the impact of urbanisation independent of the impact of migration.

Results
There are consistent advantages in health and less depression of urbanised-rural residents compared with the rural group; and this group has even better health outcomes than the urban group after adjusting for early-life differences. However, this relationship is reversed for waist circumference. Socioeconomic circumstances and factors related to a planned-urbanisation partly explain these effects.

Conclusions
Urbanisation in China has, on average, had an independent and positive effect on health and well-being. Planned-urbanisation could benefit people’s health in developing countries. It is likely that improved infrastructure is a key driver.
Original languageEnglish
JournalInternational Journal of Epidemiology
Early online date18 Mar 2019
DOIs
Publication statusE-pub ahead of print - 18 Mar 2019

Keywords

  • urbanization
  • self-reported health
  • depression
  • obesity
  • China
  • rural-to-urban migration

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