Income-related children’s health inequality and health achievement in China

INTRODUCTION: This study assessed income–related health inequality and health achievement in children in China, and additionally, examined province-level variations in health achievement. METHODS: Longitudinal data on 19,801 children under 18 years of age were derived from the China Health and Nutrition Survey. Income–related health inequality and health achievement were measured by the Health Concentration and Health Achievement Indices, respectively. Panel data with a fixed effect multiple regression model was employed to examine province-level variations in health achievement. RESULTS: A growing trend was towards greater health inequality among Chinese children over the last two decades. Although health achievement was getting better over time, the pro-rich inequality component has lessened the associated gain in achievement. Health achievement was positively impacted by middle school enrollments, the urbanization rate, inflation-adjusted per capita gross domestic product, and per capita public health spending. CONCLUSION: This study has provided evidence that average health status of Chinese children has improved, but inequality has widened. Widening inequality slowed the growth in health achievement for children over time. There were wide variations in health achievement throughout China.