Explaining urban-rural health disparities in China.
BACKGROUND
Given strict residency controls and geographic imbalances in health care resources, China may experience serious urban-rural health disparities.


OBJECTIVE
To investigate urban-rural disparities in the patterns of health status and health care utilization in China and to examine the evolution of these disparities from 1997 to 2006.


METHODS
This study uses data from the China Health and Nutrition Survey 1997-2006 with a sample of 27,897 rural and 13,898 urban respondents aged 18 or older.


METHODS
We use self-reported health status, activity limitations due to illness, and diagnosis of serious diseases to measure health status, and physician visits for illness to measure health care utilization.


RESULTS
Self-reported health status of urban residents is consistently worse than their rural counterparts (OR = 0.76; P < 0.01) based on multivariate logistic regression analysis. Urban residents are significantly more likely to have activity limitations due to illness (OR = 1.13; P < 0.01) and to have been diagnosed with a serious disease (OR = 1.69; P < 0.01). Urban residents are less likely to visit physicians for illness than are rural residents, a difference that has increased substantially since 1997.


CONCLUSIONS
Urban residents appear to fare worse than rural residents in terms of overall health status and health care utilization in China. Identifying the causes of these urban-rural health disparities and developing appropriate policy responses are critical directions for researchers and policymakers.
Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA. hai.fang@ucdenver.edu
Hai
H
Fang
Jie
J
Chen
John A
JA
Rizzo
D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult