Socioeconomic Inequalities in Health under Marketization and Community Context: Evidence from China
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This dissertation examines China’s market reforms over the last few decades, and their implications for (re)shaping socioeconomic inequalities in health. Specifically, I study the effect of marketization and related structural changes at community level on individual health outcomes. The first part of this dissertation revisits the market transition theory of Nee (1989), using individual health status as the outcome variable to assess Nee’s theory. Using multiple waves of a longitudinal survey from 1991 to 2006, I compare temporal changes in the role of human capital, political capital, and state policy in determining health under marketization. In partial support of the market transition theory, the empirical results show that the significance of human capital for health increases with marketization, while the return to political capital and one’s household registration status diminishes with a growing market. Additionally, I distinguish between marketization effects on community level, and different aspects of community context in shaping the SES-health link. I find that the level of urbanization and available resources within each community exert influences on self-rated health and change the relative importance of individual socioeconomic conditions in shaping health. Overall, this study provides new longitudinal evidence from China to support the notion that health is influenced by dynamic processes moderated by the structural changes as well as the social stratification system. I discuss the findings in the context of China’s market reform, fundamental causes theory, and socio-ecological perspectives, highlighting that health is determined by a nexus of life experiences and social environment that impact individuals at different levels.