title: Urban-rural disparities in child nutrition-related health outcomes in China: The role of hukou policy.
abstract: BACKGROUND
  Hukou is the household registration system in China that determines eligibility for various welfare benefits, such as health care, education, housing, and employment. The hukou system may lead to nutritional and health disparities in China. We aim at examining the role of the hukou system in affecting urban-rural disparities in child nutrition, and disentangling the institutional effect of hukou from the effect of urban/rural residence on child nutrition-related health outcomes.
  
  
  METHODS
  This study uses data from the China Health and Nutrition Survey 1993-2009 with a sample of 9616 children under the age of 18. We compute height-for-age z-score and weight-for-age z-score for children. We use both descriptive statistics and multiple regression techniques to study the levels and significance of the association between child nutrition-related health outcomes and hukou type.
  
  
  RESULTS
  Children with urban hukou have 0.25 (P < 0.01) higher height z-scores and 0.15 (P < 0.01) higher weight z-scores than children with rural hukou, and this difference by urban vs. rural hukou status is larger than the difference in height and weight (0.23 and 0.09, respectively) by urban vs. rural residence. Controlling for place of residence, children with urban hukou had 0.18 higher height z-scores and 0.17 (P < 0.01) higher weight z-scores than children with rural hukou.
  
  
  CONCLUSIONS
  The hukou system exacerbates urban-rural disparities in child nutrition-related health outcomes independent of the well-known disparity stemming from urban-rural residence. Fortunately, however, child health disparities due to hukou have been declining since 2000.
authors.affiliation: China Economics and Management Academy, Central University of Finance and Economics, Beijing, 100081, China. liuhong@cufe.edu.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Economics and Department of Preventive Medicine, Stony Brook University, Stony Brook, 11794, USA. john.rizzo@stonybrook.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Rizzo
authors.affiliation: China Center for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District, PO Box 505, Beijing, 100191, China. hfang@hsc.pku.edu.cn.
authors.forename: Hai
authors.initials: H
authors.lastname: Fang
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D018673:Nutrition Policy / Q000639:trends*; D011157:Population Dynamics; D012424:Rural Population / Q000706:statistics & numerical data*; D063508:Social Discrimination / Q000706:statistics & numerical data; D012947:Social Work / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*