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. Based on recent mortality data and nationally representative health surveys, we find large and, in some cases, steepening educational gradients. We also find that the gradients vary by cohort, gender and region. Further, we find that the gradients can only partially be accounted for by economic factors. These patterns highlight the double disadvantage of those with low education, and suggest the importance of policy interventions that foster both aspects of human capital for them.

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. We find that providers appeared to compensate for lost drug revenues by increasing office visits, for which no fee reduction occurred. At the same time, physician agency (yielding to patient demand for pharmaceuticals) may have tempered provider incentives to reduce drug expenditures at the visit level. Taken together, the policy may have increased total spending or total out‐of‐pocket expenditures. Mandating payment reductions in a service that comprises a large portion of provider income may have unintended consequences.

This special issue of The Journal of the Economics of Ageing, edited by Anita Mukherjee and APARC's Asia Health Policy Program Director Karen Eggleston, focuses on a key challenge around the world: financing the many needs that come with longer lives, lower fertility, and older population age structures. The triumph of longevity can pose a challenge to the fiscal integrity of public and private pension systems and other social support programs disproportionately used by older adults. This challenge is a formidable but ultimately happy one, as people around the world today can expect to live longer and healthier lives.

The countries and regions studied in this special issue include many that are leading the world in this longevity transition with relatively old population age structures, especially in Europe and Japan. Other areas such as Latin American countries and especially China are rapidly catching up, or have large total populations of older adults at relatively low per capita income and little formal social security, such as India. 

With an estimated 84 million people suffering from diabetes in South Asia, the disease imposes substantial economic burdens on individuals, families, and society. Furthermore, since the disease burden increasingly occurs in the most productive midlife period, it adversely affects workforce productivity and macroeconomic development. Diabetes-related complications lead to markedly higher treatment costs, causing catastrophic medical spending for many households, thus underscoring the importance of preventing diabetes-related complications.

This review describes the unique features of the diabetes epidemic in South Asia, critically assesses and identifies the gaps in the current literature on the economic impact of diabetes in South Asia, and finally, offers recommendations on ways to mitigate the economic burden of diabetes.