Abstract
This study investigates the effects of socioeconomic status on health among older adults in China. It uses three waves of the nationally representative Chinese Longitudinal Healthy Longevity Survey conducted in 2005, 2008–2009, and 2011–2012. It explores two dependent dummy variables of self-rated health and functional health and employs subjective and objective measures of socioeconomic status. Based on two-stage fixed-effects linear probability modeling, where potential endogeneity bias is accounted for, this study finds that socioeconomic status positively affects both self-rated health and functional health of Chinese older people. The positive impact holds true across different gender and age groups, but it is sensitive to the choice of health and socioeconomic status measures.
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Notes
Respondents were asked to indicate whether they had difficulty performing the following activities: bathing, dressing, going to the toilet, indoor transfer, continence, eating, visiting neighbors, going shopping, cooking a meal, washing clothes, walking 1 km, lifting a weight of 5 kg, crouching and standing three times, and taking public transportation.
Since the purpose of this study is not forecasting but exploring the influence of x on a binary dependent variable, the problem of forecasts of the LPM not being restricted to the (0, 1) interval is not the primary concern in this study. Instead, a more important problem in this study is the endogeneity problem. Endogenous explanatory variables are binary and Heckman and MaCurdy (1985) indicated that the LPM can provide a simple alternative estimation method when endogenous dummy explanatory variables are present.
It is worth noting that if there are any excluded components that simultaneously affect these IVs and SES, then the chosen instrumental variables are likely to be inappropriate. However, as we selected the three instrumental variables, two related to characteristics of the respondent’s father and one related to characteristics of the community, we could not find evidence of excluded components. The authors deeply appreciate the reviewer’s comment in this regard.
Results from the first-stage regressions are as follows: SEBS = 1.963*** + 0.162*** FEDU − 0.215*** FOCP + 0.129*** RFRG using the logit model, and INCM = 2.298*** + 7.484*** FEDU − 2.017*** FOCP + 6.840*** RFRG using ordinary least squares (OLS) with the F-statistic = 522.65***, where *** denotes the 0.1% level of significance.
The null hypothesis of the weak-instrument tests is that all instruments are weak and that of tests of overidentifying restrictions is that the covariance between the instrument and the error term is zero.
That is, there are 4 regressions without IV (2 HLTHs × 2 SESs) + 4 regressions with IV (2 HLTHs × 2 SESs) + 8 regressions for genders (2 HLTHs × 2 SESs × 2 genders) + 12 regressions for levels of aging (2 HLTHs × 2 SESs × 3 age groups).
Although the coverage of public health insurance in China is currently almost universal, the receipt of health insurance in the sample (covering the period 2005–2011) was not universal. The two main public health insurance schemes known as the New Rural Cooperative Medical Scheme and the Urban Residents Basic Medical Insurance were initiated in 2003 and 2007, respectively, with the former covering rural residents and the latter covering non-employed urban residents. The descriptive statistics of the health insurance variable (shown in Table 1) reflect the fact that not all older people were eligible for public health insurance at the time of the survey and that the take-up of NCMS and URBMI had been slow.
The test results for all subgroups are quite consistent with those for the entire sample. Test results for all the subsamples by gender and age are available upon request.
This study has also conducted tests for the fixed-effects LPM with IVs and obtained maximum likelihood estimates for the fixed-effects logit model with IVs. The conclusions from these two models are quite consistent. Estimation results are available upon request.
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QX and NW contributed equally to the study. QX conceptualized the study, conducted the literature review and data analyses, and wrote the manuscript. NW co-conceptualized the study, provided codes and guidelines for data analyses, and edited the manuscript.
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Xue, Q., Witvorapong, N. Effects of Socioeconomic Status on Aging People’s Health in China. J Fam Econ Iss 43, 476–488 (2022). https://doi.org/10.1007/s10834-022-09840-5
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DOI: https://doi.org/10.1007/s10834-022-09840-5