An exploration of China’s mortality decline under Mao: A provincial analysis, 1950–80

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. We have created and analysed a new, province-level panel dataset 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-five mortality during our study period. These results underscore the importance of non-medical determinants of population health – and suggest that, under some circumstances, general education of the population may amplify the effectiveness of public health interventions.