Improving but unequal: Temporal trends in Chinese self-rated health, 1990-2012.

This study examines temporal trends in the self-rated health of Chinese adults from 1990 to 2012. Concentration on this particular period in Chinese history provides insights into the health implications of China's massive societal transformation induced by economic reform. A series of cross-classified random effects models were estimated predicting favorable health status across time periods and adjusted for age, cohort effect and individual-level covariates. Results show that more recent birth cohorts exhibit better health conditions than earlier birth cohorts. However, period effects had a more profound effect than that of birth cohort. Net of age, cohort and individual-level covariates, there is a significant and increasing trend in self-rated health since the early 1990s. The period pattern was non-monotonic, with health improvement in the early 1990s, a dip later in that decade, but more evidence of improvement by 2012. We also found that health disparities have widened over the past 20 years, particularly on the basis of income and educational attainment.