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Much research has linked an increase in adult mortality with the socioeconomic transition of former European socialist societies after 1989. Few studies examine corresponding experiences in China, however. Using the death certificates of Shanghai residents, we examined any such sudden mortality change and crisis when China went through economic transformation. We explored trends in life expectancy at birth and age-specific mortality in Shanghai. We applied Arriaga’s decomposition method to analyze the contributions of specific ages and the causes to the changes in life expectancy. We used harmonic regression models to assess the statistical significance of rising and falling mortality over time. The analysis shows that, coinciding with the economic transition of 1992–1996, the previously steady improvement of life expectancy in Shanghai slowed down. Mortality among working-age males (20–44 years old) increased (P<.001) in Shanghai, largely due to rising cardiovascular disease (CVD) (P<.05) and injury (P<.001). Suicide and liver disease remained stable or fell, while transportation deaths increased in Shanghai. The economic reform in Shanghai seems to include the privatization of state-owned enterprises, economic growth, and initial increases in working-age male mortality in the 1990s.

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Asia Health Policy Program working paper # 33
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This paper investigates whether agricultural households in the rural Philippines insure their consumption against income shocks and whether they use migration, remittances, informal loans, or assets as ex post risk-coping mechanisms. Since these households have limited access to formal insurance and credit markets, any shocks to their volatile income can have substantial impacts. Using panel data, and rainfall shocks as the instrumental variable for income shocks, this paper finds little evidence of effective risk-sharing within the networks of family and friends. 2SLS, OLS, and SUR estimates show that only about 16 percent of consumption is insured. While domestic remittances from other families replace about 51 percent of income decline, informal loans decrease by about 34 percent. Additional tests, however, reveal that agricultural households
engage in entrepreneurial activity when rainfall increases and children are somehow protected from the adverse effects of rainfall shocks. Hours spent on own family-operated businesses likewise increase.

Published:  Pajaron, Marjorie C. Remittances, informal loans, and assets as risk-coping mechanisms: evidence from agricultural households in rural Philippines. No. 2014-16. Discussion Paper, School of Economics, University of the Philippines, 2014.

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Asia Health Policy Program working paper # 32
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Nutrition, physical activity, smoking, and alcohol consumption are major causes of morbidity and mortality related to noncommunicable diseases (NCDs). Hypertension, diabetes type II, cancer, and chronic pulmonary diseases cause 60 percent of deaths worldwide and will likely increase by 17 percent during the next 10 years. Eighty percent of deaths caused by NCDs are registered in low- and middle-income countries in the working-age population and contribute to the growth of poverty [1,2,3].

During the last 15 years in Mongolia the leading causes of mortality have been cardiovascular disease and cancer.

This qualitative survey is one part of the Facility-Based Impact Study (FBIS) and was funded by the MCA Health Project. The overall goal of the MCA Health Project is to reduce mortality and morbidity caused by NCD and traffic accidents. Over a period of five years, the project aims to provide the population with essential knowledge about health promotion, the prevention and early detection of NCDs, and the adoption of healthy lifestyles through capacity building for the health system and, more specifically, for the preventive facilities. One main activity of the project is to improve primary health services related to NCDs through interventions for capacity building on the level of health facilities. This FBIS focuses on assessing the current situation in the facilities to enable a later comparison of the results of this baseline study and a later follow-up study to evaluate the impact of the Health Project on the performance of health staff, their knowledge, attitudes, and practice in the facilities, and the preparedness of facilities in terms of equipment and staff. The survey was carried out by a joint team of local and international consultants from the MCA Health Project, EPOS Health Management and THL Finland, and researchers from the School of Public Health.  

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Asia Health Policy Program working paper # 31
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China and some other Asian countries have experienced a large surplus of men of marriageable age. The existing literature studies the impact of sex imbalance using aggregate sex ratios, such as at the county, city, or province level. However, these studies may miss important impacts on health and behavior because the relevance of surplus sons to family decisions mainly stems from pressure conveyed through social interactions with the local reference group.

This paper draws from unique social network data, collected from households' long-term spontaneous gift exchange records (li dan), combined with household panel data from 18 Chinese villages to explore the prevalence of men's localized pressure to get married. The surveyed villages are home to Chinese ethnic minorities, which largely circumvents endogenous fertility decisions on the first-born child due to the implementation of One Child Policy and its associated relaxations afterwards. To identify the effect of pressure to find wives for their sons on parental risky behavior, we focus on comparing families with a first-born boy versus a first-born girl and distinguish the network spillover effect from the direct effect.

The spatial econometric decompositions suggest that the pressure mainly originates from a few friends with unmarried sons and unbalanced sex ratios in the friendship networks, though own village sex ratio and having an unmarried son also affects parental risk-taking behavior. The results are consistent across specifications allowing for long-run and short-run effects. We also find similar patterns for parental working hours, their likelihood to engage in entrepreneurial activities and decision to migrate. In contrast, parents with a daughter do not demonstrate this pattern. Since the sex ratio imbalance in China will probably worsen in the next decade, disentangling the real sources of marriage market pressure may help design policies to improve parental well-being.

Dr. Xi Chen's main research interests involve health economics and development economics in the developing contexts. He recently completed his PhD in applied economics at Cornell. His research seeks to better understand how social interactions affect health behavior and outcomes, how socioeconomic status drives social competition. Most of his current work draws on primary data from China and secondary data from India and Indonesia.

Philippines Conference Room

Xi Chen Assistant Professor Speaker Department of Health Policy and Management Yale School of Public Health
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Visiting Scholar at APARC, 2026
Asia Health Policy Postdoctoral Fellow, 2012-2013
DSC_0165.JPG PhD

Marjorie Pajaron joins the Walter H. Shorenstein Asia-Pacific Research Center as Visiting Scholar beginning April 2026 through July 2026 from the University of the Philippines Diliman (UPSE), where she serves as Associate Professor in the School of Economics. She was previously at APARC as Asia Health Policy Postdoctoral Fellow during the 2012–13 academic year.

While at APARC, she will be conducting research on the migration of healthcare workers from the Philippines and the nexus with climate change.

Pajaron received a PhD in economics from the University of Hawai’i at Manoa.

Publications:

Ramel, R. C. D., Legaspi, J. D., & Pajaron, M. C. (2026). Illuminating the land: the effects of nighttime lights on land values in the Philippines. Remote Sensing Letters, 17(5), 465–477. https://doi.org/10.1080/2150704X.2026.2650396

Pajaron M, Vasquez GN. (2023). Weather, Lockdown, and the Pandemic: Evidence from the Philippines. Philipp J Sci 152(S1): 47–62. https://doi.org/10.56899/152.S1.04

Pajaron, M.C., Vasquez, G.N.A. (2020). Weathering the storm: weather shocks and international labor migration from the Philippines. Journal of Population Economics 33, 1419–1461. https://doi.org/10.1007/s00148-020-00779-1

Pajaron, M. (2017). “The Role of Remittances as a Risk-Coping Mechanism: Evidence from Agricultural Households in the Philippines.” Asian and Pacific Migration Journal 26 (1): 3–30. https://doi.org/10.1177/01171968166806

Pajaron, M. (2016). “Heterogeneity in the Intrahousehold Allocation of International Remittances: Evidence from Philippine Households.” Journal of Development Studies 52 (6): 854–875. https://doi.org/10.1080/00220388.2015.1113261

 

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Countries throughout the world increasingly share similar health policy challenges such as healthcare and insurance reform, rapid demographic change, and high rates of chronic diseases like diabetes. The Asia-Health Policy Program (AHPP) is one of several Stanford organizations seeking solutions to major global health issues through a comparative study of the health policies of different countries. Visiting fellows and scholars from Asia play an integral part in AHPP’s research, publishing, and outreach activities.

Since AHPP’s founding in 2007, the program has hosted 10 visitors from Asia, including Cambodia, China, and Korea, and, in the coming academic year, it will welcome three new visitors, from Japan, Mongolia, and the Philippines. In just five years AHPP has established strong postdoctoral and developing Asia fellowship programs, in addition to the visiting scholars it hosts. Lasting ties have been established, resulting in numerous publications as well as research and outreach projects in Asia.

Even now we still keep in touch and collaborate on certain research areas.
-Yan Wang, 2009–10 Visiting Scholar


Three former AHPP visitors recently spoke about their experience with the program and about the work they have been doing since their time at Stanford.

Young Kyung Do, AHPP’s inaugural postdoctoral fellow (2008–09), conducted research on the social and economic implications of population aging in Asia. Focusing on education and diabetes care, Do also examined the impact of socioeconomic disparities on the health and health care of elderly citizens. AHPP helped define his future research agenda, and also provided him with publishing opportunities, including collaborating on a chapter on diabetes in the edited volume Aging Asia (2010). Do is now an assistant professor with the Duke-National University of Singapore Graduate Medical School, where he studies health economics and policy issues related to population aging and noncommunicable diseases in Southeast and East Asia.

Byongho Tchoe served as a visiting scholar during the 2008–09 academic year, researching and writing about health care reform in South Korea. Tchoe enjoyed conducting research in Stanford’s peaceful campus environment, and taking part in seminars offered by the Shorenstein Asia-Pacific Research Center and other Stanford organizations. He contributed the chapter “Old-Age Pension Reform in South Korea” to Aging Asia, and published a working paper and article on the impact of population aging on medical costs in South Korea. Tchoe is now the president of the Korea Institute for Health and Social Affairs in Seoul.

Yan Wang (former), an AHPP visiting scholar from 2009 to 2010, is currently deputy director of the Division of Disease Control in the Health Department of China’s Shandong Province. At AHPP, Wang studied how private health care providers, in conjunction with government-run health services, can help improve the overall primary care available in China’s cities. She also collaborated with Stanford’s Asian Liver Center to develop an online program to provide better hepatitis B education to health professionals in Shandong. Wang appreciated attending AHPP seminars and learning about health reform around the world, and still remains in touch with some of the scholars she connected with during her time at Stanford.

AHPP looks forward to continuing to welcome and collaborate with visiting fellows and scholars in the coming years, and to expanding its postdoctoral and developing Asia fellowship programs.

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