چین، توسعه اقتصادی و کاهش مرگ و میر

This article investigates determinants of China’s mortality levels and trends since 1981. Econometric results show that both economic development and social policies matter to survival outcomes, but in different magnitudes for various mortality measures. Economic growth plays a key role in reducing mortality in childhood and especially adulthood, and raises life expectancy. Declining adult illiteracy is a critical factor in reducing child mortality and increasing life expectancy. Stock of health practitioners, share of government expenditure for health and education, and policy biases favoring cities and coastal areas selectively affect survival. Authors propose policies for further reducing mortality in China today.

Populations all over the world are demanding and struggling for a higher quality of life, the most important component of which is better survival outcomes. Sen (1998) has argued strongly that mortality is one of the most important indicators to measure the quality of life and is a central goal of development. The United Nations has included life expectancy at birth in the calculation of the influential composite human development index (HDI). The Millennium Development Goals have even set a target to reduce the mortality rate among children under five by two-thirds by 2015.

The level of mortality at different ages is an important indicator of human development. Understanding the driving forces behind the trends and changes in mortality is helpful for making sound policies to further increase survival chances and to improve quality of life. In the last quarter century, China has engaged in a profound transformation of government policies, social attitudes and customs, educational attainment, the health system, and tolerance for inequality. China’s economy has rapidly shifted from a planned economy toward a market-oriented economy. This historic social and economic experiment provides us with a unique opportunity to examine the relative roles of different forces on survival outcomes and to test competing hypotheses. Even though most collected Chinese mortality data are not available for analysis, and only imperfect measures of the determinants of mortality are collected and released, this analysis highlights major causes of China’s mortality changes in the economic reform period.