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The same institutions that enabled China’s massive urbanization and spurred its economic growth now require further reform and innovation.

To address the issues facing the next phase of the nation’s transformation, the National New Urbanization Plan (2014–20) set ambitious targets for sustainable, human-centered, and environmentally friendly urbanization. This volume explores the key institutional and governance challenges China will face in reaching those goals. Its policy-focused contributions from leading social scientists in the United States and China explore aspects of urbanization ranging from migration and labor markets to agglomeration economies, land finance, affordable housing, and education policy. Subjects covered in the eleven chapters include:

  • Institutional problems leading to fiscal pressures on local governments and unequal provision of social services to migrant families
  • The history of land financing and threats to its sustainability
  • The difficulty of sorting out property rights in rural China
  • How administrative redistricting has allowed the urbanization of geographical administrative places to outpace the urbanization of populations within those areas
  • How the hukou system may not be the sole, or even primary, mechanism restricting migrants from public goods, such as their childrens’ education 
  • Whether the nation’s food security is threatened by its ongoing urbanization
  • The current state of the provision of low-income housing, and future challenges
 
Karen Eggleston is the director of the Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center (Shorenstein APARC). She is a fellow at Stanford's Center for Health Policy/Primary Care and Outcomes Research and a faculty research fellow of the National Bureau of Economic Research.
Jean C. Oi is the William Haas Professor in Chinese Politics in the department of political science and a senior fellow of the Freeman Spogli Institute for International Studies at Stanford University. Oi is the founding director of the China Program at Shorenstein APARC and the Lee Shau Kee Director of the Stanford Center at Peking University.
Wang Yiming is vice president and senior research fellow at the Development Research Center of the State Council, People’s Republic of China. Previously he was with the National Development and Reform Commission (NDRC), where he served for many years as executive vice president of the Academy of Macroeconomics Research and deputy secretary general of the NDRC.
 

Examination copies: Shorenstein APARC books are distributed by the Brookings Institution Press. You can obtain information on obtaining an examination copy at their website.

 

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Wang Yiming
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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:

  • Policy Challenges and Economic Impact
  • Fertility and Sex Imbalance
  • Human Capital and Urbanization
  • Population Aging
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Keynote Speakers

WANG YIMING, Deputy Secretary General, National Development and Reform Commission (NDRC)

The Institutional Problems in China’s Urbanization Process

CAI FANG, Director, Institute of Population Studies, China Academy of Social Sciences

Urbanization and Labor Markets in China

LI SHUZHUO, Director, Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University

Fertility, Sex Ratio, and Family Planning Policies in China

Stanford Center at Peking University

Conferences
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Little empirical evidence exists on the health costs of air pollution in China, one of the most polluted countries in the world. Unsurprisingly, the lack of reliable data on pollution levels and health outcomes impede research. Because the pollution-health relationship is likely non-linear, it is difficult to extrapolate from existing high quality studies in developed countries to ascertain health costs. We address this deficiency by obtaining new data on Beijing’s daily mortality April 2008-April 2013 from the Chinese Center for Disease Control and Prevention. We combine these data with daily pollution measures from the US Embassy in Beijing, which records particulate matter of 2.5 microns or less in width (PM 2.5). We find that after controlling for weather conditions, year, month, and day of week fixed effects, daily PM2.5 indeed predicts daily mortality, particularly deaths from cardiovaslular disease. A 100 μg/m3 increase in daily PM2.5 is associated with 7 deaths daily, among them 4 cardiovascular deaths, and 0.8 respiratory deaths. Furthermore, deaths among less-educated and outdoor workers show a stronger relationship to PM2.5 levels. Notably, the relationship is robust to controlling for the official measure of Beijing’s air pollution, the average daily air pollution index (API), despite the fact that PM2.5 is measured by 1 monitor at the US embassy whereas API (and mortality) combine data from across the Beijing metropolitan area. Indeed, Beijing’s API does not have a significant relationship to mortality once AQI at the Embassy is accounted for. Our finding supports previous research arguing for measuring PM 2.5 and reporting it promptly to the public. 
 
Shuang Zhang is an assistant professor in the Department of Economics at University of Colorado Boulder. She works on various topics in development, including health, education, environment, political economy, etc,. with a focus on China. She holds a PhD in Economics from Cornell University and was a postdoctoral fellow in SIEPR of Stanford University in 2012-13.

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Shuang Zhang assistant professor in the Department of Economics Speaker University of Colorado Boulder
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June 2020 Update:
Dr. Do wins the 2020 Rothman Epidemiology Prize for this article that has been selected as the best paper published in the journal Epidemiology in 2019.
View the announcement of the editors and editorial board of Epidemiology and our news post.

November 2019 Update: 
Paper published: Do, Young Kyung. "Causal Effect of Sleep Duration on Body Weight in Adolescents: A Population-based Study Using a Natural Experiment." Epidemiology 30, no. 6 (2019): 876-884.

 

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. In March 2011, amid growing concerns over the negative consequences of late-night tuition at private tutoring institutes (hagwon), authorities in 3 of the 16 administrative regions in South Korea decreed adjusting the closing hours of hagwon to 10 p.m. This policy change caused a substantial and plausibly exogenous variation in the sleep duration of the “marginal student,” whose sleep duration is most likely to be affected by the policy. The IV estimation results on a sample of general high school 10th- and 11th-graders in the 2009−2012 Korea Youth Risk Behavior Web-based Survey show that a 1-hour increase in sleep duration led to a 0.56 kg/m2 reduction in body mass index, or a 4.3 percentage-point decrease in overweight/obesity. Short sleep duration among adolescents may be an important contributor to increased body weight at the population level.

 
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Asia Health Policy Program working paper # 38
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Young Kyung Do
Young Kyung Do
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We use retrospectively reported data on smoking behavior of residents of Mainland China and Taiwan to compare and contrast patterns in smoking behavior over the life-course of individuals in these two regions. Because we construct the life-history of smoking for all survey respondents, our data cover an exceptionally long period of time – up to fifty years in both samples. During this period, both societies experienced substantial social and economic changes. The two regions developed at much different rates and the political systems of the two areas evolved in very different ways. More importantly, governments in the two areas set policies that caused the flow of information about the health risks of smoking to differ across the regions and over time. We exploit these differences, using counts of articles in newspapers from 1951 to present, to explore whether and how the arrival of information affected life-course smoking decisions of residents in the two areas. We also present evidence that suggests how prices/taxes and key historical events might have affected decisions to smoke.

Dean Lillard received his PhD in economics from the University of Chicago in 1991. From 1991 to 2012, he was a faculty member and senior research associate in the Department of Policy Analysis and Management at Cornell University. In August 2012 he joined the Department Human Sciences at Ohio State University as an Associate Professor. He is Director and Project Manager of the Cross-National Equivalent File study that produces cross-national data. He is a member of the American Economics Association, the Population Association of America, the International Association for Research on Income and Wealth, the International Health Economics Association, the American Society for Health Economics, a Research Associate at the German Institute for Economic Research in Berlin, Germany, and a Research Associate of the National Bureau of Economic Research. He serves on the advisory board of the Danish National Institute for Social Research in Copenhagen, Denmark and the Cross-National Studies: Interdisciplinary Research and Training Program – a collaborative program run by the Polish Academy of Sciences (PAN), and together with the Mershon Centre at OSU.

Dean Lillard's current research focuses on health economics, the economics of schooling, and international comparisons of economic behavior. His research in health economics is primarily focused on the economics of the marketing and consumption of cigarettes and alcohol. His research on the economics of schooling includes studies of direct effects of policy on educational outcomes and on the role that education plays in other economic behaviors such as smoking, production of health, and earnings. His cross-national research ranges widely from comparisons of the role that obesity plays in determining labor market outcomes to comparisons of smoking behavior cross-nationally.

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Dean R. Lillard Associate Professor, Department Human Sciences Speaker Ohio State University
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Co-sponsored by the Center of East Asian Studies, Stanford University

Prominent health policy expert—Rachel Lu from Taiwan—will share her view on recent health policy developments in the region, drawing on her extensive research and policy background.

Jui-fen Rachel Lu, Sc.D., is a Professor in the Department of Health Care Management, at Chang Gung University (CGU) in Taiwan, where she teaches comparative health systems, health economics, and health care financing and has served as department chair (2000-2004), Associate Dean (2009-2010) and Dean of College of Management (2010-2013).  She earned her B.S. from National Taiwan University, and her M.S. and Sc.D. from Harvard University, and she was also a Takemi Fellow at Harvard (2004-2005) and is an Honorary Professor at Hong Kong University (2007-2014), a guest professor at Huazhong University of Science and Technology (2010-2013), and an adjunct professor at Xi’an Jiaotong University (2011-2014) in China.  Her devotion to teaching driven by her firm belief in the value of education and investment in human minds was recognized by the Award of Excellence in Teaching conferred by CGU in both 2002 and 2013.

Her research focuses on 1) the equity issues of the health care system; 2) impact of the NHI program on health care market and household consumption patterns; 3) comparative health systems in Asia-Pacific region.  She is a long-time and active member of Equitap (Equity in Asia-Pacific Health Systems) research network and is currently the coordinator for the catastrophic payment component of Equitap II research project which involves 21 country teams and is jointly funded by IDRC, AusAID, and ADB.  Professor Lu has also been appointed to serve as a member on various government committees dealing with health care issues in Taiwan, such as National Health Insurance Supervisory Committee (DOH), Hospital Management Committee(DOH), and Hospital Global Budget Payment Committee (BNHI), etc.  Dr. Lu received the Minister Wang Jin Naw Memorial Award for Best Paper in Health Care Management presented by Kimma Chang Foundation in 2002 and was the recipient of IBM Faculty Award in 2009.  She has published papers in Health Affairs, Medical Care, Journal of Health Economics, Health Economics, Social Science and Medicine, Health Economics, Policy and Law, Osteoporosis International, Health and Quality of Life Outcomes, and Taiwan Economic Review etc, and is the author of “Health Economics”(a textbook in Chinese) and various book chapters.  

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Jui-fen Rachel Lu Professor in the Department of Health Care Management Speaker Chang Gung University in Taiwan
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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. As remittances increase, female heads with absent spouses spend less on alcohol and tobacco while male heads with absent spouses spend more on these goods; regardless of gender, household heads with less education allocate more to education than those with more education.

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Asia Health Policy Program working paper # 35
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Marjorie Pajaron
Marjorie Pajaron
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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?

Will Demographic Change Slow China’s Rise? In the eponymous article recently published in the Journal of Asia Studies, five Stanford scholars of political science, sociology, and economics based at the Shorenstein Asia-Pacific Research Center — Karen Eggleston, Jean C. Oi, Scott Rozelle, Andrew Walder, and Xueguang Zhou, with a former postdoctoral fellow Ang Sun — discuss how the intertwined demographic changes pose an unprecedented challenge to social and economic governance, contributing to and magnifying the effects of a slower rate of economic growth.

The authors touch upon a wide range of topics of policy import:
· China must overhaul rural education quickly if it is going to avoid producing tens of millions of workers who will be marginalized in the nation's future high-wage, high-skill economy.
· Growth slowdowns are almost always productivity growth slowdowns. Many forces impinge on multi-factor productivity; the stability and predictability of markets and governance are lynchpins. Discontent with widening disparities in China could undermine this fundamental foundation of growth.
· Demographic change will fundamentally challenge the conventional governance structures in China. Efforts to impose a bureaucratic solution to the intertwined social challenges China faces will almost inevitably stoke tensions between the society and the state. In both urban and rural areas, expansion of the bureaucratic state may become the central target of popular contention.
· China's high savings rate is partly explained by low fertility and parents' need to save for their own old-age support. Initiation of rural pensions and significant expansion of health insurance coverage and are examples of the social policy responses that China has undertaken to prepare for “growing old before becoming rich.” But much remains to be done.
· China's increasing burden of chronic disease further exacerbates the growth-slowing potential of a more elderly population and its associated medical expenditure burden.
· Although reducing precautionary savings and increasing domestic consumption as an engine of economic growth are widely acknowledged goals for China's economy, a rapid decline in savings could also imperil China's future economic growth by jeopardizing the current basis of the financial system.
· Demographic change will shape almost every aspect of how China copes with a slowing rate of economic growth, and may play a decisive role in the future social stability of China, with spillover effects for the region and the rest of the world.
The research is one product of a 3-year project analyzing Asian demographic change which will conclude in 2014 with a conference and edited book on demographic change and urbanization in China, in comparative international perspective.

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Karen Eggleston
Karen Eggleston
Jean C. Oi
Scott Rozelle
Andrew G. Walder
Xueguang Zhou
Ang Sun
Ang Sun
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