AHPP runs its own working paper series and regularly contributes edited volumes that are distributed through the Walter H. Shorenstein Asia-Pacific Research Center’s publishing program. Our faculty and researchers also publish extensively in peer-reviewed academic journals and in scholarly and trade presses. Browse our publications below.
AHPP Working Paper Series
It has been well established that better educated individuals enjoy better health and longevity. In theory, the educational gradients in health could be flattening if diminishing returns to improved average education levels and the influence of earlier population health interventions outweigh the gradient-steepening effects of new medical and health technologies. This paper documents how the gradients are evolving in China, a rapidly developing country, about which little is known on this topic.
Expanding access through insurance expansion can increase health‐care utilization through moral hazard. Reforming provider incentives to introduce more supply‐side cost sharing is increasingly viewed as crucial for affordable, sustainable access. Using both difference‐in‐differences and segmented regression analyses on a panel of 1,466 hypertensive and diabetic patients, we empirically examine Shandong province's initial implementation of China's 2009 Essential Medications List policy. The policy reduced drug sale markups to providers but also increased drug coverage benefits for patients.
"Health Insurance and Chronic Disease Control: Quasi-experimental Evidence from Hypertension in Rural China" is a chapter within the volume China's Healthcare System and Reform. The volume provides a comprehensive review of China’s healthcare system and policy reforms in the context of the global economy. Following a valuechain framework, the 16 chapters cover the payers, the providers, and the producers (manufacturers) in China’s system.
Scholars at Stanford's Shorenstein Asia-Pacific Research Center in the Freeman Spogli Institute for International Studies assess the strategic situation in East Asia to be unsettled, unstable, and drifting in ways unfavorable for American interests. These developments are worrisome to countries in the region, most of which want the United States to reduce uncertainty about American intentions by taking early and effective steps to clarify and solidify U.S. engagement. In the absence of such steps, they will seek to reduce uncertainty and protect their own interests in ways that reduce U.S.
Abstract. Sex differences in mortality (SDIM) vary over time and place as a function of social, health, and medical circumstances. The magnitude of these variations, and their response to large socioeconomic changes, suggest that biological differences cannot fully account for sex differences in survival. We develop a set of empiric observations about SDIM with which any theory will have to contend.
Between 1950 and 1980, China experienced the most rapid sustained increase in life expectancy in documented global history. However, no study of which we are aware has quantitatively assessed the relative importance of the various explanations proposed for these gains in survival.
Sex differences in mortality (SDIM) vary over time and place as a function of social, health, and medical circumstances. The magnitude of these variations, and their response to large socioeconomic changes, suggest that biological differences cannot fully account for sex differences in survival. We develop a set of empiric observations about SDIM with which any theory will have to contend.
Sex differences in mortality vary over time and place as a function of social, health, and medical circumstances. The magnitude of these variations, and their response to large socioeconomic changes, suggest that biological differences cannot fully account for sex differences in survival. Drawing on a wide swath of mortality data across countries and over time, we develop a set of empiric observations with which any theory about excess male mortality and its correlates will have to contend.
The world’s two most populous countries face numerous policy challenges from rapid demographic change. Drawing on social science expertise from China, India, and the United States, the contributors examine the social and economic challenges for policies across a range of domains, from China’s changed family planning policies and India’s efforts to address gender imbalance, to both countries’ policies regarding old-age support, human capital investment, poverty alleviation, and broader issues of governance.
Sections focus on:
In this article, I consider what a casual observer can see of a notorious product’s primary place of fabrication. Few products have been criticized in recent years more than cigarettes. Meanwhile, around the world, the factories manufacturing cigarettes rarely come under scrutiny. What have been the optics helping these key links in the cigarette supply chain to be overlooked? What has prompted such optics to be adopted and to what effect? I address these questions using a comparative approach and drawing upon new mapping techniques, fieldwork, and social theory.
China and India account for nearly 36% of the world’s population. The two countries are expected to see an unprecedented, accelerated rate in elderly populations, a shift that has already begun and will continue in the years ahead as life expectancy continues to increase and fertility to decrease or remain below replacement levels. Examining demographic changes can offer a unique opportunity to enrich the theoretical and empirical understanding of the economic aspects of population ageing. This special issue of the Journal of the Economics of Ageing, coedited by David E. Bloom, the Clarence James Gamble Professor of Economics and Demography at Harvard University, and Karen Eggleston, a Center Fellow at the Shorenstein Asia-Pacific Research Center at Stanford University, is a diverse collection of micro- and macro-economic research on ageing in China and India. This introduction, co-written by Bloom and Eggleston, provides background context to demographic trends in China and India, connections between demographic and economic changes and possible behavioral and policy responses. The introduction also gives a preview of the main contributions of the 10 articles featured in the special issue, which cover topics such as the impact of non-communicable diseases in China and India, how parents’ expectations of co-residence with their children affects educational outcomes, and the prevention of cognitive decline in China.
Objective: This study focuses on Hangzhou, a Chinese city with a population of nine million urban and rural residents, to examine the successful development and innovation experience of its primary health care service system during the new health reform in China since 2009 and then disseminate the findings through international third parties.
The decreasing effectiveness of antimicrobial agents is a growing global public health concern. Low-income and middle-income countries are vulnerable to the loss of antimicrobial efficacy because of their high burden of infectious disease and the cost of treating resistant organisms. We aimed to assess if copayments in the public sector promoted the development of antibiotic resistance by inducing patients to purchase treatment from less well regulated private providers.
Between 1950 and 1980, China experienced the most rapid sustained increase in life expectancy of any population in documented global history. We know of no study that has quantitatively assessed the relative importance of the various explanations proposed for this gain in survival. We have created and analysed a new, province-level panel data set spanning the decades between 1950 and 1980 by combining historical information from China's public health archives, official provincial yearbooks, and infant and child mortality records contained in the 1988 National Survey of Fertility and Contraception. Although exploratory, our results suggest that gains in school enrolment and public health campaigns together are associated with 55–70 per cent of China's dramatic reductions in infant and under-5 mortality during our study period. These results underscore the importance of non-medical determinants of population health, and suggest that, in some circumstances, general education of the population may amplify the effectiveness of public health interventions.
We estimate the degree of supplier-induced demand for newborn treatment by exploiting changes in reimbursement arising from the introduction of the partial prospective payment system (PPS) in Japan. Under the partial PPS, neonatal intensive care unit (NICU) utilization became relatively more profitable than other procedures, since it was excluded from prospective payments.
Despite a large number of observational studies consistently reporting the association between shorter sleep duration and higher body weight, causality has yet to be established at a population level. This study aims to estimate the population-level causal effect of sleep duration on adolescent body weight, using an instrumental variable (IV) approach that exploits a unique natural experiment in the context of South Korea’s highly competitive secondary education.
How do demand- and supply-side incentives interact, when there are potentially large provider income effects? We develop a simple model and empirically test it with data from China’s Essential Medications List (EML) policy, which reduced patient copayments and changed provider incentives by removing a large source of revenue from primary care providers: drug dispensing revenues.
Background: For the past two decades, more and more women in certain European countries, Japan, and the United States are giving birth to their first child at a considerably later age than ever before. It remains unclear as to what extent this age-related general fertility decline is affected by changing social and cultural norms.
This paper shows that the individual’s bargaining power within the household, proxied by gender and educational attainment of household head, affects how remittances sent by Overseas Filipino Workers are spent in the Philippines. Gender of the household head, not of the remitter, matters in the allocation of remittances.
China's population of 1.34 billion is now 50 percent urban, over 13 percent above age 60, and with 118 boys born for every 100 girls. For such a large population at a relatively low level of per capita income, how will aging interact with substantial gender imbalance and rapid urbanization?
"Old while not affluent" situation, together with an unsustainable high investment rate and high dependency on foreign trade, spurs hot debates on the challenges of a fast-aging population and the exploitation of the second demographic dividend in today’s China. Literature related to elderly health in countries other than China often starts with medical concepts and then dwells on economic issues, mainly focusing on socioeconomic, behavioral, and environmental factors and their effects on the health of the elderly.
Introduction. This study investigated the intensity of cigarette consumption and its correlates in China among urban male factory workers, a cohort especially vulnerable to tobacco exposure, one that appears to have benefitted little from recent public health efforts to reduce smoking rates.
Methods. Data were collected from men working in factories of Kunming city, Yunnan, China, who are current daily smokers (N = 490). A multinomial logistic regression was conducted to examine the factors in association with smoking intensity in light, moderate, and heavy levels.
Results. Light smoking correlated with social smoking, smoking the first cigarette later in the day, self-reported health condition, and quit intention. Heavy smoking was associated with purchase of lower priced cigarettes, difficulty refraining from smoking, and prehypertensive blood pressure.
Conclusion. Even in regions where smoking is highly prevalent, even among cohorts who smoke heavily, variation exists in how cigarettes are consumed. Analyses of this consumption, with special consideration given to smoking intensity and its correlates, can help guide tobacco-control strategists in developing more effective interventions.