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Karen Eggleston coedits special issue on China-India population ageing

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A rapidly aging population poses serious challenges for many countries around the world, particularly in Asia, home to the most populous countries. China and India account for nearly 36% of the world’s population, and are expected to face social and economic complications from demographic change in the next decades.

A special issue of the Journal of the Economics of Ageing explores these trends in a comparative perspective, “The Economic Implications of Population Ageing in China and India” (December 2014), co-edited by David Bloom, a professor at Harvard University’s School of Public Health, and Karen Eggleston, a Center Fellow at the Shorenstein Asia-Pacific Research Center.

“Population ageing represents uncharted waters for China and India,” Bloom and Eggleston write in their coauthored introduction.

The special issue is a collection of 10 articles that examine the economic benefits and potential dilemmas arising from decreased fertility and increased life expectancy, two trends that will impact the development and future trajectories of China and India at the micro- and macroeconomic levels.

Dropping or continued low birth rates imply fewer young people to refresh the labor market. But will this cause the workforce to shrink to an unsustainable level? Demand will increase for health care, long term care, and other social services that support the elderly. What must the government do to ensure adequate access to care?

Empirical data and commentary presented in the special issue seek to inform stakeholders about emerging patterns, and to provide insight on how to best address related policy challenges going forward.

“By adopting responsive behaviors and consultative institutions that address the challenges of population ageing in ways that are appropriate to their unique circumstances, China and India could reap the full economic and social benefits of longer, healthier lives,” they write.

The special issue includes an introduction by Bloom and Eggleston, a feature interview with Richard Suzman, and additional analysis by noted global health experts following each article. The titles and authors of the 10 original research articles are listed below:

  • Intergenerational co-residence and schooling (Anjini Kochar)
  • Regional disparities in adult height, educational attainment, and late-life cognition: Findings from the Longitudinal Aging Study in India (LASI) (Jinkook Lee, James P. Smith)
  • Healthy aging in China (James P. Smith, John Strauss, Yaohui Zhao)
  • Gender differences in cognition in China and reasons for change over time: Evidence from CHARLS (Xiaoyan Lei, James P. Smith, Xiaoting Sun, Yaohui Zhao)
  • Reprint of: Health outcomes and socio-economic status among the mid-aged and elderly in China: Evidence from the CHARLS national baseline data (Xiaoyan Lei, Xiaoting Sun, John Strauss, Yaohui Zhao, Gonghuan Yang, Perry Hu, Yisong Hu, Xiangjun Yin)
  • Should China introduce a social pension? (Bei Lu, Wenjiong He, John Piggott)
  • China’s age of abundance: When might it run out? (Yong Cai, Feng Wang, Ding Li, Xiwei Wu, Ke Shen)
  • The macroeconomic impact of non-communicable diseases in China and India: Estimates, projections, and comparisons (David E. Bloom, Elizabeth T. Cafiero-Fonseca, Mark E. McGovern, Klaus Prettner, Anderson Stanciole, Jonathan Weiss, Samuel Bakkila, Larry Rosenberg)
  • Economic development and gender inequality in cognition: A comparison of China and India, and of SAGE and the HRS sister studies (David Weir, Margaret Lay, Kenneth Langa)
  • Comparing the relationship between stature and later life health in six low and middle income countries (Mark E. McGovern)

The special issue of the Journal of the Economics of Ageing, vol. 4, pages 1-154 (December 2014) is available through Elsevier’s online platform ScienceDirect.

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Asia health policy scholar Karen Eggleston (Center Right) learns about a digital health information system in a visit to a primary care center in Hangzhou, China in Oct. 2014.
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The Economic Implications of Population Ageing in China and India: Introduction to the Special Issue

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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.

 

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Stanford anthropologist assesses proposed smoking bans in China

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China’s State Council has put forth draft legislation that would ban smoking in public spaces, part of the government’s larger advocacy efforts to help curb tobacco use nationwide. Matthew Kohrman, a professor of anthropology at Stanford University, said it’s a step forward but the ban’s long-term success would depend on local enforcement.

Despite popular belief, global cigarette production has tripled worldwide since the 1960s. Leading the surge has been China.

“China has become the world’s cigarette superpower,” said Kohrman, in an interview on National Public Radio’s program, Marketplace.

Moreover, local governments in China have become dependent on tax revenues generated from tobacco sales, thus reinforcing the cigarette’s ubiquity and ease of access.

China has implemented smoking bans in the past, but with varied success. Now rising healthcare costs caused by tobacco-related diseases are creating urgency for new regulations.

“Whether or not these new regulations will be enforced will, in the end, come down to local politics,” he said.

Matthew Kohrman is part of the Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, and leads the project, Cigarette Citadels, a peer-sourced mapping project that compiles more than 480 cigarette factories globally.

The full audioclip is available on the Marketplace website.

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A cigarette stand in Shantou, China.
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Air Pollution and Short-Term Mortality in Beijing

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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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Margaret Triyana

Shorenstein APARC
Encina Hall C331
616 Serra Street
Stanford, CA 94305-6055

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2013-2014 Asia Health Policy Postdoctoral Fellow
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Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.

Triyana received a PhD in Public Policy from the University of Chicago in 2013.

 

Working Papers

“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“

“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”

“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”

“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)

Region-based v. Distance-based Information in Emergency Health Risk Communication: Evidence from the Fukushima Daiichi Nuclear Disaster

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A tremendous amount of radioactive products were discharged as a result of the accident at the Fukushima nuclear power plant in March 2011, which resulted in radioactive contamination of the plant and surrounding areas. While geographical distribution of radioactive iodine, tellurium, and cesium in the surface soils was smoothly (but not always systematically) widespread all over the region, health risk information by the government, media, and other organizations is most likely to be given in terms of administrative boundaries (cf. prefectures, municipalities, etc.) and/or distance from the radiation source.

This paper estimates the effect of such health risk information rather than the actual health risks of radiation on land and other prices in different locations. We find that the prefecture and municipality border effects – but not the distance effect from the nuclear power plant – are significantly related to a reduction in land and other prices after the accident. This shows that people responded to health risk information based on administrative boundaries rather than the actual health risk of radiation after the disaster. Although health risk information based on prefecture and municipality boundaries has an obvious advantage of distilling large and complex risk information into a simple one, the government, media, and other organizations need to recognize and carefully examine the potential of misclassifying non-contaminated areas into contaminated prefectures. Doing so will avoid unintentional consequences to the region’s economy.

Hiroaki Matsuura is currently Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies, University of Oxford and a Junior Research Fellow of St. Antony’s College. His main interests are health economics and demography, with a special interest in the relation between laws and population health. Hiroaki received his B.A. in Economics from Keio University, M.A. in Social Science from the University of Chicago, M.S. in Project Management from Northwestern University’s McCormick School of Engineering and Applied Science, and Sc.D. in Global Health and Population (Economics track) from Harvard University’s School of Public Health. In the past, he was affiliated with Institute of Quantitative Social Sciences, Human Rights in Development, and Takemi Program in International Health at Harvard University. He also worked as a research assistant at the National Bureau of Economic Research. His doctoral dissertation research explores a right to health or to health care in national constitutions of 157 countries and state constitutions of the 50 U.S. states and estimates the impact of introducing (or removing) a right to health or to health care into national and state constitutions on health system and population health outcomes. His most recent article, “The Right to Health in Japan: Challenges of a Super Aging Society and Implication from Its 2011 Public Health Emergency” (with Eriko Sase) will be appeared on “Advancing the Human Right to Health”, edited by José M. Zuniga, Stephen P. Marks, and Lawrence O. Gostin, Oxford University Press, 2013. 

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Hiroaki Matsuura Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies Speaker University of Oxford
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