Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (2): 261-266. doi: 10.19723/j.issn.1671-167X.2022.02.010

Previous Articles     Next Articles

Analysis on the relationship between urbanization and health behavior in China: An empirical research based on China Health and Retirement Longitudinal Study (CHARLS)

HE Shan,JIAN Wei-yan()   

  1. Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
  • Received:2020-02-15 Online:2022-04-18 Published:2022-04-13
  • Contact: Wei-yan JIAN E-mail:jianweiyan@bjmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(71774003)

RICH HTML

  

Abstract:

Objective: To explore the relationship between urbanization and residents’ health behaviors in China, and to clarify the impact of urbanization on health behaviors. Methods: Based on China Health and Retirement Longitudinal Study (CHARLS),we established a panel data fixed effect model tracked in 2011, 2013 and 2015 to analyze the effect of urbanization level on smoking cessation, drinking, sleep quality and physical exercise behavior. The ratio of population density, gross domestic product (GDP) per capita and output value of secondary and tertiary industries to GDP were used to represent the levels of urbanization. Results: From 2011 to 2015, China’s urbanization levels showed an increasing trend, which showed that the ratio of population density, GDP per capita and output value of secondary and tertiary industries in GDP increased year by year. Smoking cessation increased with the increase of GDP per capita and the proportion of the output value of secondary and tertiary industries. Compared with the low-level, the drinking rate in the regions with per capita GDP of more than 45 000 yuan increased by 2.49%, and the drinking rate in the regions with secondary and tertiary industries for 80%-85% decreased by 2.48%. However, there was no significant difference with population density. The sleep quality decreased with the increase of per capita GDP. In regions where per capita GDP was more than 93%, the sleep quality decreased by 3.71% compared with the low-level which was not significantly different from the ratio of population density and the output value of secondary and tertiary industries. For low contrast, the exercise rate in regions with the population density of 400-600 people/km2and over 800 people/km2 was reduced by 5.2% and 7.7% respectively. The exercise rate in regions with per capita GDP of 25 000-35 000 yuan and over 45 000 yuan was reduced by 3.26% and 3.73% respectively. The exercise rate in regions with secondary and tertiary industries accounting for more than 93% of GDP was 10.68% lower than that of the low-level regions. Conclusion: Different dimensions of urbanization have different impacts on different health behaviors. The smoking cessation rate increases with the increase of urbanization level, which is related to the proportion of per capita GDP and the output value of secondary and tertiary industries. The exercise rate, related to the three dimensions, decreases with the increase of urbanization. Sleep quality is more closely related to per capita GDP, and the probability of good sleep quality decreases with the increase of urbanization level. However, there is no obvious trend between drinking rate and urbanization level, which needs further study.

Key words: Urbanization, Health behavior, Empirical research

CLC Number: 

  • R193

Table 1

The explanation of variables"

Indicators Explanation
Healthy behavior variable
Smoking cessation If quit smoking now=1, never quit=0
Drinking If current drinking frequency >1 time per month, then drinking=1, else=0
Sleep quality If current bad nights frequency <3 time per week, then sleep quality=1, else=0
Exercise If current exercise time >10 min at a time, then exercise=1, else=0
Urbanization variable
Population density Local population/local area (people/km2)
GDP per capita GDP/local population (thousand yuan)
The output value of secondary and tertiary industries in GDP Value of the secondary industry in GDP + value of the tertiary industry in GDP (%)
Personal characteristics variable
Age Continuous variables, >45 years old
Gender Male=1, female=0
Education level Illiteracy=1, can read=2, primary school=3, junior high school and above=4
Marital status Married=1, other=0

Table 2

Descriptive statistics of personal characteristics indicators"

Indicators Number Percentage/%
Age/years
45-49 2 931 22.27
50-59 4 996 37.96
60-69 3 568 27.11
70-79 1 375 10.45
≥80 292 2.22
Gender
Male 6 306 47.94
Female 6 848 52.06
Education level
Illiteracy 3 674 27.94
Can read 2 361 17.96
Primary school 2 948 22.42
Junior high school and above 4 166 31.68
Marital status
Married 11 624 88.31
Other 1 538 11.69

Table 3

Incidence of healthy behaviors (Year 2011 to 2015)"

Variables Year 2011 Year 2013 Year 2015
Smoking cessation/% 21.44 23.43 31.66
Drinking/% 33.43 34.16 35.33
Sleep quality/% 65.78 66.54 64.39
Exercise/% 90.06 89.77 88.24

Table 4

Descriptive statistics of urbanization indicators (Year 2011 to 2015)"

Indicators Year 2011 Year 2013 Year 2015
n Median IQR n Median IQR n Median IQR
Population density/(people/km2) 411.96 443.72 425.66 442.73 425.14 457.09
Low (<200) 75 129.72 71.64 72 130.14 71.08 69 128.12 71.49
Mid-low (<400) 112 298.56 113.36 100 301.09 116.13 100 301.58 95.47
Middle (<600) 90 488.18 110.35 90 469.47 104.96 99 477.99 125.6
Mid-high (<800) 86 677.18 102.05 89 683.04 83.94 77 698.38 55.50
High (≥800) 50 940.21 136.71 59 990.94 182.95 65 932.90 160.23
GDP per capita/thousand yuan 22.07 18.99 36.42 24.68 44.30 31.17
Low (<15) 117 11.24 3.55 27 14.38 1.92 9 12.04 1.06
Mid-low (<25) 138 21.06 4.42 81 19.82 0.46 57 21.52 4.38
Middle (<35) 61 30.38 4.55 87 28.91 0.08 81 30.70 4.90
Mid-high (<45) 45 38.91 4.98 82 39.84 0.48 63 39.33 6.38
High (≥45) 52 63.43 19.56 133 65.08 1.45 200 61.51 43.06
The output value of secondary and tertiary
industries in GDP/%
85.83 13.02 87.55 10.76 88.22 9.58
Low (<80) 114 75.81 6.31 90 74.52 5.74 63 75.30 3.15
Mid-low (<85) 81 81.60 2.54 72 83.75 0.96 75 83.56 1.91
Middle (<90) 72 87.99 1.88 72 86.09 2.98 81 87.62 2.40
Mid-high (<93) 57 95.51 1.13 78 91.72 1.68 75 91.95 1.83
High (≥93) 89 95.51 3.71 98 95.73 3.45 110 96.02 4.02

Table 5

Relationship between urbanization and health behaviors (Year 2011 to 2015)"

Items Smoking cessation
(1, Yes; 0, No)
Drinking
(1, Yes; 0, No)
Sleep quality
(1, Good; 0, Poor)
Exercise
(1, Yes; 0, No)
Population density
Low 1 1 1 1
Mid-low -0.021 2 0.027 3 0.021 9 -0.031 1
Middle 0.037 5 0.017 1 0.028 9 -0.052 0*
Mid-high -0.012 4 0.025 0 0.025 4 -0.044 1
High 0.065 1 0.008 6 -0.006 6 -0.077 0**
GDP per capita
Low 1 1 1 1
Mid-low 0.051 2*** 0.004 5 -0.020 5** 0.001 7
Middle 0.112 3*** 0.000 8 -0.026 4** -0.032 6**
Mid-high 0.124 2*** 0.017 0 -0.021 1* -0.023 6
High 0.190 1*** 0.024 9* -0.037 1*** -0.037 3**
The output value of secondary and tertiary industries in GDP
Low 1 1 1 1
Mid-low 0.047 0*** -0.024 8* -0.009 8 -0.009 6
Middle 0.107 9*** -0.016 6 -0.009 7 0.004 0
Mid-high 0.162 3*** -0.067 5 -0.005 5 -0.001 3
High 0.237 4*** -0.039 6 -0.017 3 -0.106 8***
[1] 程明梅, 杨朦子. 城镇化对中国居民健康状况的影响: 基于省级面板数据的实证分析[J]. 中国人口·资源与环境, 2015, 25(7):89-96.
[2] Hou B, Nazroo J, Banks J, et al. Are cities good for health? A study of the impacts of planned urbanization in China[J]. Int J Epidemiol, 2019, 48(4):1083-1090.
doi: 10.1093/ije/dyz031 pmid: 30887030
[3] Liu Y, Wang RY, Feng ZX, et al. Exploring the association between urbanisation and self-rated health of older adults in China: evidence from a national population sample survey[J]. BMJ Open, 2019, 9(6):e029176.
doi: 10.1136/bmjopen-2019-029176
[4] Li XH, Song JC, Lin T, et al. Urbanization and health in China, thinking at the national, local and individual levels[J]. Environ Health, 2016, 15(Suppl 1):32.
[5] Miao J, Wu XG. Urbanization, socioeconomic status and health disparity in China[J]. Health Place, 2016, 42:87-95.
doi: S1353-8292(16)30271-4 pmid: 27750075
[6] Poel EV, O’Donnell O, Doorslaer EV. Urbanization and the spread of diseases of affluence in China[J]. Econ Hum Biol, 2009, 7(2):200-216.
doi: 10.1016/j.ehb.2009.05.004
[7] Attard SM, Herring AH, Mayer-Davis EJ, et al. Multilevel examination of diabetes in modernising China: What elements of urbanisation are most associated with diabetes?[J]. Diabetologia, 2012, 55(12):3182-3192.
doi: 10.1007/s00125-012-2697-8 pmid: 22923063
[8] 世界卫生组织. 2010年世界卫生统计中文版 [M]. 日内瓦: 世界卫生组织出版社, 2011.
[9] 陈晓玲, 彭云, 柏品清, 等. 浦东新区城镇化农民的营养干预效果分析[J]. 现代预防医学, 2013, 40(13):2412-2414.
[10] 程莉, 周宗社. 人口城镇化与经济城镇化的协调与互动关系研究[J]. 理论月刊, 2014(1):119-122.
[11] 耿桂灵, 尹志勤. 社区老年人日常生活行为方式及影响因素[J]. 中国老年学杂志, 2015, 35(24):7191-7193.
[12] 杨敏. 城市社区老年人健康促进生活方式影响因素分析与对策[J]. 中国实用医药, 2011, 6(11):266-267.
[13] 沈振敏, 江朝强, 张维森, 等. 基于广州生物库的广州市中老年人饮酒行为改变及其影响因素的前瞻性队列研究[J]. 中国慢性病预防与控制, 2018, 26(3):161-166.
[14] 丁宏, 成前, 倪润哲. 城镇化的不平等、市民化与居民健康水平[J]. 南开经济研究, 2018, 204(6):20-35.
[15] 刘国峰, 孙美平, 王智勇, 等. 城镇化水平与慢性病及健康相关行为的关联分析[J]. 北京大学学报(医学版), 2016, 48(3):478-482.
[16] 高其法. 新型城镇化过程中预防控制慢性病的挑战与机遇[J]. 医学与哲学(人文社会医学版), 2014, 35(9):37-39.
[17] Poel EV, O’Donnell O, Doorslaer EV. Is there a health penalty of China’s rapid urbanization?[J]. Health Econ, 2012, 21(4):367-385.
doi: 10.1002/hec.v21.4
[18] 2014年中国睡眠指数发布[J]. 统计科学与实践, 2014(3):63.
[19] 沈宏超, 洪功翔. 新型城镇化质量测度指标体系及实证研究: 以安徽省为例[J]. 农业现代化研究, 2015, 36(3):412-417.
[20] Monda KL, Gordon-Larsen P, Stevens J, et al. China’s transition: The effect of rapid urbanization on adult occupational physical activity[J]. Soc Sci Med, 2007, 64(4):858-870.
pmid: 17125897
[21] Beenackers MA, Oude Groeniger J, Kamphuis CBM, et al. Urban population density and mortality in a compact Dutch city: 23-year follow-up of the Dutch GLOBE study[J]. Health Place, 2018, 53:79-85.
doi: S1353-8292(18)30088-1 pmid: 30056264
[22] Grandner MA, Patel NP, Gehrman PR, et al. Who gets the best sleep? Ethnic and socioeconomic factors related to sleep complaints[J]. Sleep Med, 2010, 11(5):470-478.
doi: 10.1016/j.sleep.2009.10.006 pmid: 20388566
[23] Choi K, Chen-Sankey JC. Will Electronic Nicotine Delivery System (ENDS) use reduce smoking disparities? Prevalence of daily ENDS use among cigarette smokers[J]. Prev Med Rep, 2019, 17:101020.
[24] Lindson N, Chepkin SC, Ye WY, et al. Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation[J]. Cochrane Database Syst Rev, 2019, 4(4): CD013308.
[25] Frey SM, Burkard T, Meienberg A. Smoking cessation in peri-pheral peripheral artery disease “It always pays to stop smoking!”[J]. Gefasschirurgie, 2020, 25(3):172-178.
doi: 10.1007/s00772-020-00627-2
[26] 王林峰, 晏峻峰, 吴世雯. 睡眠障碍的社会经济环境影响因素分析[J]. 现代医药卫生, 2019, 35(18):2865-2869.
[27] 付桂玲. 睡眠健康教育中的改善睡眠环境教育[J]. 世界睡眠医学杂志, 2016, 3(3):148-151.
[28] 叶孙岳, 郭静. 中国成年人的体育锻炼、静态行为流行状况、趋势及影响因素[J]. 首都体育学院学报, 2016, 28(4):365-369, 375.
[29] 崔佳彬, 那龙, 孙宁, 等. 酒精依赖综合征及戒酒措施[J]. 中国医学前沿杂志: 电子版, 2019, 11(6):19-23.
[1] LIU Sheng-lan, NA He-ya, LI Wei-hao, YUN Qing-ping, JIANG Xue-wen, LIU Jing-nan, CHANG Chun. Effectiveness of self-management behavior intervention on type 2 diabetes based on self-determination theory#br# [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 474-481.
[2] LIU Guo-feng, SUN Mei-ping, WANG Zhi-yong, JIAN Wei-yan. Association analysis between urbanization and non-communicable diseases and health-related behavior [J]. Journal of Peking University(Health Sciences), 2016, 48(3): 478-482.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!