Two geographers specializing in China analyze that country's health care inequality from 1990 to 2008, for the purpose of: (1) examining spatial-temporal variations of health care inequality at multiple scales (the regional, provincial, and county levels); (2) exploring whether economic growth and transition to a market economy have exacerbated the unevenness of health care; and (3) analyzing the impact of health care inequality on health outcomes, especially mortality. The authors apply GIS-based spatial statistical methods to detect spatial-temporal patterns of health care, and use multilevel regression to examine the linkages between health care, mortality, and regional economic inequality, and ultimately to assess the sensitivity of health care inequality to geographic scale and examine whether reforms implemented to date have resulted in more equitable access to health care. The paper also demonstrates how the concurrent transitions of decentralization, marketization, globalization, and urbanization in China have interactively contributed to health care inequality and mortality.
While increasing income inequality in China has been commented on and studied extensively, relatively little analysis is available on inequality in other dimensions of human development. Using data from different sources, this paper presents some basic facts on the evolution of spatial inequalities in education and healthcare in China over the long run. In the era of economic reforms, as the foundations of education and healthcare provision have changed, so has the distribution of illiteracy and infant mortality. Across provinces and within provinces, between rural and urban areas and within rural and urban areas, social inequalities have increased substantially since the reforms began.
The misdistribution of health manpower is one of the major challenges faced by the Chinese health sector hindering people's access to healthcare. However, this subject remains underexplored, as spatial distribution characteristics have not been fully mapped out, nor have its causes been determined at the macro regional level. To fill this research void, this study aims to conduct sophisticated spatial analyses to examine the characteristics of health manpower distribution and test various determinants of health manpower densities. By introducing spatial techniques, this study sheds light on the distribution of health manpower in China, thus offering invaluable evidence for making national and regional policies to facilitate a more effective distribution of health manpower in China.On the one hand, this study used spatial statistics (space-time scan statistics and Moran's I statistics) to reveal, visualize, and compare the temporal trends, spatio-temporal dynamics, and spatial clustering patterns of different subtypes of health manpower (clinicians, doctors of traditional Chinese medicine, dentists, public health doctors, general practitioners, registered nurses, pharmacists, technologists, and interns) and their total. The results reveal that regional disparities and huge urban-rural imbalances exist in China's health manpower distribution, indicating that some provincial units have been left behind. In addition, spatial distribution characteristics varied across different subtypes of health manpower, which still held with respect to either the urban or rural health manpower distribution.On the other hand, this study theoretically modeled and empirically measured various determinants of health manpower distribution from both the supply and demand sides while taking the spillover effect between adjacent geographical units into consideration. Based on the results of the estimation, the health service demand was, as expected, found to forcefully drive the health manpower distribution across the nation. In light of this, the increase in health services demands in a province could significantly help one unit attract licensed doctors and registered nurses from adjacent units. Unexpectedly but intriguingly, the power of medical education capacity was relatively limited in increasing the health manpower density in local units compared to its spillover effect on neighboring units. In addition, government and social health expenditure played different roles in the health labor market, the former being more effective in increasing the stock of licensed doctors and registered nurses, the latter doing better in attracting dentists and general practitioners.This study has the potential to make profound contributions to the theory and practice of health manpower distribution in China. First, this study advances our understanding of characteristics of health manpower distribution by introducing spatial statistics. By doing so, this study visualizes the detailed spatial distribution characteristics with maps and identifies the priority areas for health manpower allocation in China. Second, this study provides a comprehensive research framework to understand the potential drivers of health manpower distribution, and more importantly, takes spillover effects into consideration and measures them for the first time. Third, this study systematically explores and compares the distribution characteristics and determinants of different subtypes of health manpower, which differ greatly. By exploring both the characteristics and determinants, this study gives a full picture of the health manpower distribution and provides new evidence for making health manpower allocation policies in China.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
The study of contemporary China constitutes a fascinating yet challenging area of scholarly inquiry. Recent decades have brought dramatic changes to China′s economy, society and governance. Analyzing such changes in the context of multiple disciplinary perspectives offers opportunites as well as challenges for scholars in the field known as contemporary China Studies. The SAGE Handbook of Contemporary China is a two-volume exploration of the transformations of contemporary China, firmly grounded in the both disciplinary and China-specific contexts. Drawing on a range of scholarly approaches found in the social sciences and history, an international team of contributors engage with the question of what a rapidly changing China means for the broader field of contemporary China studies, and identify areas of promising future research. Part 1: Context: History, Economy, and the Environment Part 2: Economic Transformations Part 3: Politics and Government Part 4: China on the Global Stage Part 5: China′s Foreign Policy Part 6: National and Nested Identities Part 7: Urbanization and Spatial Development Part 8: Poverty and Inequality Part 9: Social Change Part 10: Future Directions for Contemporary China Studies
This book investigates uneven regional development in China – with particular focus on the cases of Guangdong and Zheijiang provinces – which have been at the forefront of debate since Chinese economic reform. Rapid economic growth since the ‘opening-up’ of China has been accompanied by significant disparities in the regional distribution of income: this book represents one of the most recent studies to present a picture of this inequality. Built upon a multi-scale and multi-mechanism framework, it provides systematic examination of both the patterns and mechanisms of regional development and inequality in provincial China, emphasizing the effects of economic transition. Approaching from a geographical perspective, its authors consider the interplay between the local, the state, and the global forces in shaping the landscape of regional inequality in China. Extensive empirical findings will prove useful to those researching other developing countries within the frontier of globalization and economic transition. Regional Inequality in Transitional China will appeal to scholars and students of geography, economics and Chinese studies more broadly.
This book offers a discussion about the dramatic development of healthcare business around the world during the twentieth century. Through a broad range of cases in Asia, Europe and the US, it shows how health was transformed into a fast-growing and diversified industry. Health and medicine have developed as one of the fastest growing sectors of the economy around the world during the twentieth century. However, very little is known about the conditions of their transformation in a big, globalized business. This book discusses the development of health industries, tackling the various activities in manufacturing (drugs, biotechnology, medical devices, etc.), infrastructure (hospital design and construction) and services (nursing care, insurances, hospital management, etc.) in relation to healthcare. The business history of health carried out in this book offers a systemic perspective that includes the producers (companies), practitioners (medical doctors) and users (patients and hospitals) of medical technology, as well as the providers of capital and the bodies responsible for regulating the health system (government). The chapters in this book were originally published as a special issue of the journal Business History.
"Provides an in-depth overview of how China is governed, how its domestic political system functions and the critical issues it faces in the coming decades. Discusses China's transition to a modern state and its rise within the international system"--
This Handbook explores and explains new developments in the _second generation‘ theory of public finance, in which benevolent rulers and governments have been replaced by personally motivated politicians and the associated institutions. Following a com
