Explaining urban-rural health disparities in China

Given strict residency controls and geographic imbalances in health care resources, China may experience serious urban-rural health disparities.

To investigate urban-rural disparities in the patterns of health status and health care utilization in China and to examine the evolution of these disparities from 1997 to 2006.

This study uses data from the China Health and Nutrition Survey 1997-2006 with a sample of 27,897 rural and 13,898 urban respondents aged 18 or older.

We use self-reported health status, activity limitations due to illness, and diagnosis of serious diseases to measure health status, and physician visits for illness to measure health care utilization.

Self-reported health status of urban residents is consistently worse than their rural counterparts (OR = 0.76; P < 0.01) based on multivariate logistic regression analysis. Urban residents are significantly more likely to have activity limitations due to illness (OR = 1.13; P < 0.01) and to have been diagnosed with a serious disease (OR = 1.69; P < 0.01). Urban residents are less likely to visit physicians for illness than are rural residents, a difference that has increased substantially since 1997.

Urban residents appear to fare worse than rural residents in terms of overall health status and health care utilization in China. Identifying the causes of these urban-rural health disparities and developing appropriate policy responses are critical directions for researchers and policymakers.