Longitudinal associations between emotion regulation strategies and subjective well-being in migrant and non-migrant adolescents in urban China.

This study examined the long-term reciprocal impact of two key emotion regulation strategies, cognitive reappraisal and expressive suppression, on the subjective well-being of migrant and non-migrant adolescents in urban China. A total of 2397 middle school students from urban China (864 migrant, Mage  = 13.05 years, SD = 0.62, 41.7% girls; 1533 non-migrant, Mage  = 13.01 years, SD = 0.47, 50.1% girls) were followed from 2016 to 2017. Data on the two emotion regulation strategies (measured using the Chinese version of the Emotion Regulation Questionnaire) and subjective well-being (measured using the Subjective Well-Being Inventory) were collected. Although no differences were found in the use of cognitive reappraisal, migrant adolescents reported greater use of expressive suppression than non-migrant adolescents. Furthermore, a two-group cross-lagged panel analysis showed that cognitive reappraisal positively predicted subjective well-being among both migrant and non-migrant adolescents, whereas expressive suppression was positively related to subjective well-being in only migrant adolescents. Migrant adolescents with higher levels of subjective well-being jointly used cognitive reappraisal and expressive suppression, while non-migrant adolescents were prone to only using cognitive reappraisal. These findings indicate that group-level context influences both the utilisation and functionality of emotion regulation strategies among migrant and non-migrant adolescents in urban China.

Working from Home in Urban China during the COVID-19 Pandemic: Assemblages of Work-Family Interference.

During the COVID-19 pandemic, millions of workers globally have been forced to work from home. Empirical data from Chinese cities in the Hubei province reveal work productivity decreased among many respondents working from home in 2020, primarily due to family interference with work. Such interference stems not only from the domain of daily life but also from other family members' e-working and e-learning. Conversely, respondents' work interferes with family; thus, interference operates bi-directionally. This article proposes an analytical framework of work-family interference along three dimensions: work-daily life, work-work, work-study, and each dimension can be understood through four distinct aspects: temporality, physicality, vocality, digitality. Remote workers encounter 'assemblages of work-family interference', consisting of a heterogeneous mixture of these dimensions and aspects. Furthermore, some factors (e.g., living patterns, work culture, digital infrastructure) constrain effective work-family boundary management among urban households.

Medical costs and hospital utilization for hemophilia A and B urban inpatients in China: a national cross-sectional study.

BACKGROUND: Hemophilia care in mainland China has been greatly improved since the establishment of the Hemophilia Treatment Center Collaborative Network of China (HTCCNC), and most of drugs for hemophilia have been covered by basic medical insurance schemes. This study assesses whether medical costs and hospital utilization disparities exist between hemophilia A and hemophilia B urban inpatients in China and, second, whether the prescription of coagulation factor concentrates for hemophilia A and hemophilia B inpatients was optimal, from the third payer perspective. METHODS: We conducted a retrospective nationwide analysis based on a 5% random sample from claims data of China Urban Employees' Basic Medical Insurance (UEBMI) and Urban Residents' Basic Medical Insurance (URBMI) schemes from 2010 to 2016. Univariate analysis and multiple regression analysis based on a generalized linear model were conducted. RESULT: A total of 487 urban inpatients who had hemophilia were identified, including 407 inpatients with hemophilia A and 80 inpatients with hemophilia B. Total medical cost for hemophilia B inpatients was significantly higher than for hemophilia A inpatients (USD 2912.81 versus USD 1225.60, P < 0.05), and hemophilia B inpatients had a significantly longer length of hospital stay than hemophilia A inpatients (9.00 versus 7.00, P < 0.05). Total medical costs were mostly allocated to coagulation factor products (76.86-86.68%), with coagulation factor cost of hemophilia B significantly higher than hemophilia A (P < 0.05). Both hemophilia cohorts utilized greatest amount of plasma-derived Factor VIII, followed by recombinant Factor VIII and prothrombin complex concentrates. CONCLUSIONS: Patients with hemophilia B experienced significantly higher inpatient cost, coagulation factor cost and longer length of hospital stay than patients with hemophilia A. Our findings revealed the suboptimal use of coagulation factor concentrate drugs and a higher drug cost burden incurred by hemophilia B than hemophilia A inpatients. Our results call for efforts to strengthen drug regulatory management for hemophilia and to optimize medical insurance schemes according to hemophilia types.

The greener, the happier? The effects of greenspace on residents' happiness in contemporary urban China.

In recent years, research has begun to touch upon the associations between the natural environment and individuals' subjective wellbeing; however, whether such associations would vary among different groups of people remains under-studied. Using four waves (2010-2013) of data from the Chinese General Social Survey, we investigate the group-specific correlation between environment-specifically, greenspace exposure-and individuals' happiness in contemporary urban China. For this study, the normalized difference vegetation index at the county level is a proxy for greenspace exposure. The results from the ordered logit model indicate that county-level green vegetation is associated with individuals' happiness level, but such effects vary with a household's relative deprivation. While greenspace exposure is positively associated with happiness among individuals from less deprived families, it is negatively associated with happiness among those from deprived households. These findings contribute to the body of knowledge of the heterogeneous effect of greenspace on residents' subjective well-being.

Physician distribution across China's cities: regional variations.

BACKGROUND: Distribution of physicians is a key component of access to health care. Although there is extensive research on urban-rural disparities in physician distribution, limited attention has been directed to the heterogeneity across urban areas. This research depicts variations in physician density across over 600 cities in the context of China's rapid urbanization. METHODS: Data came from National Census Surveys and China statistical yearbooks, 2000-2003, and 2010-2013. Cities were characterized in terms of not only administrative level but also geographic regions and urban agglomerations. We analyzed variations in physician supply by applying generalized estimating equations with an ordinal logistic linking function. RESULTS: Although overall physician density increased between 2003 and 2013, with population and socioeconomic attributes adjusted, physician density declined in urban China. On average, urban districts had a higher physician density than county-level cities, but there were regional variations. Cities in urban agglomerations and those outsides did not differ in physician density. CONCLUSION: Despite the reduced inequality between 2003 and 2013, the growth in physician density did not appear to be commensurate with the changes in population health demand. Assessment in physician distribution needs to take into account heterogeneity in population and socioeconomic characteristics.

Public health insurance and the labor market: Evidence from China's Urban Resident Basic Medical Insurance.

This study provides empirical evidence on the labor market effects of public health insurance using evidence from China. In 2007, China launched a national public health insurance program, Urban Resident Basic Medical Insurance (URBMI), targeting residents in urban areas who were not insured by employment-based health insurance. Using panel data from the China Health and Nutrition Survey, I identify the impacts of the program based on its staggered implementation across cities. I find that URBMI did not have a significant average causal effect on labor force participation. However, it did increase employment mobility, as evidenced by the decrease in long-term employment and expansion of fixed-term contract jobs and self-employment. After the program was implemented, job lock declined and job flexibility increased, especially among women, the less educated, and individuals with good health status. The results also suggest increased employment for unhealthy workers, indicating a direct health improvement effect.

The Nonlinear Linkage Between Earnings Homogamy and Earnings Inequality Among Married Couples.

More married couples today consist of two high-earning or two low-earning partners (i.e., earnings homogamy), which leads to greater earnings inequality in married-couple families. Surprisingly few studies have examined this relationship by earnings level, leaving open the question of whether the increase in earnings homogamy at each level of earnings contributes equally to between-couple earnings inequality. I address this question using data on urban China during 1988-2013. Changes in earnings homogamy account for 6% to 11% of the increase in between-couple inequality, but importantly, decomposition reveals that 57% to 68% of the overall impact is driven by the growing earnings homogamy among the top 20% of husbands and their wives. I reach the same finding by replicating the analyses using data from the United States. Two explanations account for this finding: (1) earnings homogamy has increased more among high earners; and (2) all else being equal, increases among high earners are mechanically more influential in shaping the level of between-couple inequality. These findings have important theoretical and policy implications.

Primary care and all-cause mortality in urban China: a mixed-level analysis.

BACKGROUND: There is still a lack of evidence focusing on primary care supply in developing countries where the educational achievement of primary care practitioners is relatively low. OBJECTIVES: By using a nationally representative longitudinal and prospective cohort study, this study examined whether primary care supply, measured by the availability and the number of community health centres (CHCs), was associated with 4-year mortality risk among community-dwelling participants aged 45 and above in urban China. METHODS: Using the 2011 and 2015 waves of the China Health and Retirement Longitudinal Survey (CHARLS), we conducted a longitudinal mixed-level logistic analysis to study the impact of the availability and the number of CHC on 4-year follow-up mortality risk, after adjusting community- and individual-level covariates. RESULTS: Individuals living in communities with CHC were 31% less likely to die during the 4-year follow-up (P < 0.05) conditional on community-level characteristics, including the basic facilities availability, population size and physical area, and individuals' socio-demographic and health characteristics and health behaviours. Also, an increased number of community-level CHC was shown to decrease residents' 4-year mortality risk significantly (odds ratio = 0.82, P < 0.05). Furthermore, the association was more pronounced among adults aged 65 and above. CONCLUSION: This study provides additional evidence of the health-promoting effect of primary care supply among urban residents in China. Improving primary care coverage in China should be necessary to improve health care access, thus promoting population health.

Family social capital and life satisfaction among older adults living alone in urban China: the moderating role of functional health.

Objectives: The present study examined the moderating effects of functional health on the association between family social capital and life satisfaction among older adults who live alone in urban China.Method: Data for this study were derived from a study "Survey on older adults aged 70 and above who live alone in urban China," which was carried out in five Chinese cities between November 2013 and May 2015. 2801 respondents passed the screening test of cognitive capacities and successfully completed the survey. Family social capital was operationalized as family interaction, number of children, and family relationship. Random-effects logistic regression was conducted to test the proposed hypotheses.Results: The moderating effects of functional health on the association between family interaction and life satisfaction were identified. While family interaction was positively associated with life satisfaction among older adults without disabilities who live alone, family interaction was negatively associated with life satisfaction among those with disabilities. Furthermore, the association between number of children and life satisfaction was nonsignificant among older adults without disabilities, when family relationship was controlled. However, number of children was positively associated with life satisfaction among those with disabilities. Finally, the results showed family relationship were important protective factors of life satisfaction among older adults living alone, regardless of their functional health levels.Conclusion: Theoretical aspects on how family social capital, living alone, and functional health are interwoven and influence mental health in later life were deliberated. Policy and intervention implications were discussed.

Health related quality of life and its impacts by chronic diseases in urban community population, Shanghai, China in 2015.

This survey aimed to describe the health-related quality of life (HRQoL) and to explore the relationship between chronic diseases and HRQoL among urban residents in Shanghai, China. A cross-sectional study of 9 426 adults was conducted in Xuhui District of Shanghai, China in 2015. The EuroQol five-dimension three-level (EQ-5D-3 L) was used to measure HRQoL. The average age of subjects was 55.6 ± 17.4 years and 53% were female. Their mean values of utility and visual analogue scale (VAS) were 0.974 ± 0.099 and 80.00 ± 12.36, respectively, which were above the Chinese norm values. Women had lower scores compared with men. The utility value decreased with age, which accelerated after the age of 55 years. Chronic conditions including diabetes, tumor, cardiovascular disease, and respiratory disease, were significantly related to HRQoL, and the reported proportions of problems in the five dimensions increased with the number of chronic diseases (p < 0.05). Chronic diseases except for respiratory disease had a negative effect on HRQoL utility value and VAS score after the adjustment for covariates (p < 0.05). Chronic diseases had a negative impact on both EQ-5D-3 L utility and VAS scores, although the health-related quality of life for the study was above the national average.

Extended gender inequality? Intergenerational coresidence and division of household labor.

This study investigates the effect of coresidence with the husband's or the wife's parents on division of household labor between the couple in China. We further examine how life course, education, hukou, and the gender composition of coresiding parents moderate the relationship between intergenerational coresidence and division of household labor. Previous research on housework division has looked at nuclear families. Little is known about the effect of intergenerational coresidence on housework division. Despite rapid modernization, intergenerational coresidence remains prevalent in China as families try to adapt to the changing social and economic conditions. While patrilocal coresidence dominates in both rural and urban China, matrilocal coresidence is increasingly common in urban China. Based on panel data from the 2010, 2014, 2016, and 2018 waves of the China Family Panel Studies, fixed effects models are used to account for both observed and unobserved individual-specific confounders. Both patrilocal and matrilocal coresidence seem to widen the within-couple gender gap in housework time among urban hukou holders. Among rural hukou holders, though patrilocal coresidence is associated with reduced housework time for the wife and the couple as a whole, neither patrilocal nor matrilocal coresidence significantly influences how much time the husband spent on housework. Coresidence with the husband's or the wife's parents may exacerbate gender inequality in housework division.

Community-Based Cognitive Social Capital and Depressive Symptoms Among Older Adults in Urban China: The Moderating Role of Family Social Capital.

The present study examined the moderating role of family social capital in the relationship between community-based cognitive social capital and depressive symptoms among community-dwelling older adults in urban China. Cross-sectional data were derived from a community survey conducted in Suzhou, China, in late 2015. Data from 441 respondents were included in the final analysis. Multiple group analysis was used to test the hypotheses. The latent construct of community-based cognitive social capital was based on trust and reciprocity indicators. Measurement invariance was established across groups with high or low family social capital. The results show that family social capital had a moderation effect on the relationship between community-based cognitive social capital and depressive symptoms. The effects of community-based cognitive social capital on depressive symptoms were higher among those with low family social capital. The findings demonstrate the interplay between family and community-based cognitive social capital. Policy and intervention implications are discussed.

Does industrial agglomeration facilitate environmental performance: New evidence from urban China?

This paper presents new evidence on the impact of industrial agglomeration on environmental performance with a sample of prefectural-cities in China. When environmental performance is represented by pollution intensity, the impacts of industrial agglomeration on pollution intensity in terms of sulfur dioxide and soot show the heterogeneous pattern. The results support the existence of a non-linear pattern between agglomeration and emission intensity of sulfur dioxide, whereas the non-linear model could not hold for the emission intensity of soot. However, when we measure environmental performance with environmental efficiency estimated by a data envelopment analysis approach, it documents a U-shape relationship between industrial agglomeration and environmental efficiency. Specifically, environmental efficiency deteriorates in the early stage of industrial agglomeration and then improves as local industrial agglomeration proceeds. Different estimation strategies provide consistent evidence to verify such U-shape pattern.

Determinants of the Proactiveness of Female Migrant Workers with Psychological Distress Seeking Allied Health Services.

Seeking utilization of allied health services (AHS) has significant implications for psychological distress self-management. However, utilization of AHS by Chinese female migrant workers (FMWs) has not received enough attention. This study, therefore, aims to explore what contributes to FMWs' proactiveness in utilizing AHS. A cross-sectional study was conducted to collect data in terms of socio-demographic characteristics, work-related characteristics and AHS accessibility. A logistic regression model was adopted to examine association of these predictors with proactiveness in seeking AHS. 992 FMWs with psychological distress were interviewed with stratified multiple-stage sampling. The results indicated that Basic Public Health Services (BPHS) is a salient predictor affecting proactiveness in seeking AHS. BPHS includes psychological counseling (Odds Ratio (OR) =2.401, 95% Confidence Interval (CI) =1.284-4.490, p = 0.006), psychotherapy (OR = 2.063, 95% CI = 1.438-2.960, p = 0.000) and health knowledge lectures (OR = 1.613, 95% CI = 1.115-2.333, p = 0.011). Moreover, sampled participants under 25 and those who received education for more than 9 years are more likely to seek AHS compared with other groups. In addition, proactiveness in seeking AHS is clearly associated with working hours per day. The probability is only 31.1% for those working more than 12 h per day to seek AHS actively compared with those working below 8 h (95% CI = 0.119-0.812, p = 0.017). There are no differences between those with 8-12 working hours and those working less than 8 h (OR = 1.100, 95% CI = 0.798-1.518, p = 0.560). The present findings suggest that policies be made to improve the coverage of BPHS and to provide specified AHS to meet the increasing demand of different social groups.

Health status and air pollution related socioeconomic concerns in urban China.

BACKGROUND: China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investigated with consideration of the socioeconomic factors. METHODS: Based on nationwide survey data of China in 2014, we applied the multilevel mixed-effects model to evaluate how socioeconomic status (represented by education and income) contributed to the relationship between self-rated air pollution and self-rated health status at community level and individual level. RESULTS: The findings indicated that there was a non-linear relationship between the community socioeconomic status and community air pollution in urban China, with the highest level of air pollution presented in the communities with moderate socioeconomic status. In addition, health effects associated air pollution in different socioeconomic status groups were not equal. Self-rated air pollution had the greatest impact on self-rated health of the lower socioeconomic groups. With the increase of socioeconomic status, the effect of self-rated air pollution on self-rated health decreased. CONCLUSIONS: This study verified the different levels of exposure to air pollution and inequality in health effects among different socioeconomic groups in China. It is imperative for the government to urgently formulate public policies to enhance the ability of the lower socioeconomic groups to circumvent air pollution and reduce the health damage caused by air pollution.

Community environmental satisfaction: its forms and impact on migrants' happiness in urban China.

BACKGROUND: The great number of internal migrants has become an important part of China's urban population. Improving migrants' well-being is emerging as a key to the state policy emphasized in China's New-type Urbanization Plan. Previous studies on subjective well-being (SWB) have primarily focused on the impacts of objective measures of community environment and consider migrants as a homogeneous group. This study extends the literature by exploring the impacts of perceived community environment on migrants' SWB and incorporating cohort differences in the analysis. METHODS: We use the 2015 national scale data-China Household Financial Survey (CHFS) data-to analyse the different forms of community environmental satisfaction and their impacts on migrants' subjective well-being. A total of 12,607 migrants were sampled from 29 of mainland China's 31 provinces. Latent class analysis is applied to explore the potential forms of community environmental satisfaction; multinomial and ordinal logistic regression models are constructed to examine the sociodemographic characteristics of different forms of community environmental satisfaction and the association between community environmental satisfaction and subjective well-being among migrant cohorts in urban China. RESULTS: Latent class analysis defines four distinctive latent classes, which mirror four different domains of migrants' perception of their local environments. They are called 'unsatisfying local environment', 'satisfying social environment', 'satisfying physical environment', and 'satisfying social life'. Results from the multinomial logistic regression model reveals that the four forms of community environmental satisfaction are underpinned by distinct sociodemographic characteristics. Results from a series of ordinal logistic regression models show that different forms of community environmental satisfaction, in particular satisfaction with the physical environment and with social life, are positively associated with migrants' happiness. The model results also suggest that cohort differences do exist among migrants. The positive effect of a satisfying physical environment on happiness tends to be greater in younger cohorts, while the positive effect of a satisfying social life on SWB is more observable in older cohorts. CONCLUSION: Satisfaction with community environment has a salient impact on urban Chinese migrants' happiness. For their SWB, improving migrants' physical living environments and social lives is relatively more important than social environment, which in a way mirrors migrants' current status with its deficiencies in terms of a comfortable living environment and social life. Moreover, there exist cohort differences that should be considered when making policies to enhance migrants' subjective well-being.

Availability, use, and affordability of medicines in urban China under universal health coverage: an empirical study in Hangzhou and Baoji.

BACKGROUND: This study aimed to examine the availability, use, and affordability of medicines in urban China following the 2009 Health Care System Reform that included implementation of universal health coverage (UHC). METHODS: This longitudinal study was performed in Hangzhou (high income, eastern China) and Baoji (lower income, western China). Five yearly household surveys were conducted (one each year from 2009 to 2013) to evaluate the impact of UHC on medicines use and expenditure, and a health facility survey was conducted in 2013 to evaluate availability of medicines. A cohort of over 800 households in Hangzhou and Baoji was established in 2009, and 20 hospitals were included in the health facility survey. Medicines use was determined using data from health facility and household surveys. An average, two-week out-of-pocket medicines expenditure was calculated to assess the affordability of medicines. RESULTS: The number of medicines stocked in primary health facilities in Hangzhou decreased, while the number in Baoji increased. In Baoji, patients usually chose a pharmacy to buy medicines directly, despite the 48.2% increased availability of essential medicines in primary health care centers. The majority of survey respondents stated that their medicines need was basically met; however, medicines cost still accounted for a major part of their health expenditure. Medicines expenditure showed an increasing trend from 2009 to 2013. The average annual growth rate of household overall medical expenditure was significantly higher than that for household non-food consumption expenditure. CONCLUSIONS: Following China's Health Care System Reform and implementation of UHC, availability and use of medicines has improved in urban areas. However, the affordability of medicines is still a concern.

Does social capital influence preferences for aging in place? Evidence from urban China.

OBJECTIVE: This study investigated the relationships between social capital and preferences for aging in place among older urban adults in eastern China. METHOD: Quota sampling was used to recruit 456 respondents aged 60 and older from Gusu District, Suzhou City, in 2015. Random-effects logistic regression was used to test the proposed model. RESULTS: Respondents who had better quality family social capital, a higher level of social trust, and more organization memberships were more likely to choose to live in local communities, even after we controlled for individual characteristics. DISCUSSION: The findings highlight the important role of both family and community social capital in influencing preferences for aging in place among older adults in urban China. This is particularly important for developing long-term care systems for older adults living in naturally occurring retirement communities.

The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes.

At the end of 1998, China launched a government-run mandatory insurance program, the urban employee basic medical insurance (UEBMI), to replace the previous medical insurance system. Using the UEBMI reform in China as a natural experiment, this study identifies variations in patient cost sharing that were imposed by the UEBMI reform and examines their effects on the demand for healthcare services. Using data from the 1991-2006 waves of the China Health and Nutrition Survey, we find that increased cost sharing is associated with decreased outpatient medical care utilization and expenditures but not with decreased inpatient care utilization and expenditures. Patients from low-income and middle-income households or with less severe medical conditions are more sensitive to prices. We observe little impact on patient's health, as measured by self-reported health status. Copyright © 2015 John Wiley & Sons, Ltd.

Women's employment trajectories during early adulthood in urban China: A cohort comparison.

This study uses retrospective work history data from CGSS 2008 and employs group-based trajectory analysis to model the diverse employment trajectories of cohorts of urban Chinese women (born in the 1940s-1970s) during young adulthood (age 20-35). We identify ideal-types of urban women's employment trajectories and explore traits associated with each group type. In particular, we examine whether and how the timing of marriage and fertility as well as socioeconomic background help to distinguish patterns of women's labor force attachment in young adulthood. We also examine how these patterns change across cohorts given China's rapid social transformations in the past few decades. We find that delaying family formation is generally associated with more consistent work attachment, but this relationship is also largely associated with one's socioeconomic background. Our results reveal significant cohort variations in the shape of women's employment trajectories and we discuss how institutional and cultural contexts of different historical periods could have shaped family formation and employment processes differently. Our findings highlight the heterogeneity of urban women's work and family formation patterns in the context of rising gender inequalities and rapid socioeconomic transformation over time.