School of Economics, East China Normal University, Shanghai, China.
School of International and Public Affairs, Shanghai Jiaotong University, Shanghai, China.
Front Public Health. 2021 Nov 16;9:700024. doi: 10.3389/fpubh.2021.700024. eCollection 2021.
Based on the 2018 China Health and Retirement Longitudinal Study (CHARLS 2018), from the perspective of urban-rural disparity, this paper investigates how fertility affects Chinese elders' health. We exploit the enactment of the one-child policy in 1979 to construct instrumental variables capturing the health effect of having only one child rather than multiple children. The empirical results show that the health condition of rural elders having only one child is worse than elders having multiple children, while the negative health effect of lower fertility becomes statistically insignificant for urban elderly parents. After considering the selection on both levels and gains, the results are still robust in marginal treatment effect (MTE) estimation. We investigate the potential mechanism in four ways, the results suggest that having only one child instead of multiple children depresses the upstream intergenerational transfer payments more for rural parents; ameliorates offspring's educational attainment more for urban parents; improves housing conditions more for urban elders; and decreases the visit frequency of children to both urban and rural parents. Our findings have important implications, in the context of increasing population aging, the urban-rural inequality caused by the hukou system has been magnified by the declining fertility rate. The Chinese government should pay more attention to rural elders with only one child, and more public-funded socioeconomic resources are needed for one-child parents in rural areas to improve their health. Moreover, the empirical results also imply that urbanization in China may be able to soften the health deterrent effect of lower fertility.
基于 2018 年中国健康与养老追踪调查（CHARLS2018），本文从城乡差距的角度探讨了生育对中国老年人健康的影响。我们利用 1979 年实施的独生子女政策来构建工具变量，以捕捉只生育一个孩子而不是多个孩子对健康的影响。实证结果表明，农村只有一个孩子的老年人的健康状况比有多个孩子的老年人差，而低生育率对城市老年父母的健康负效应在统计上变得不显著。在考虑了两个层面的选择和收益后，边缘处理效应（MTE）估计的结果仍然稳健。我们通过四种方式考察了潜在的机制，结果表明，与有多个孩子的家庭相比，只有一个孩子的家庭对农村父母的代际转移支付上游产生了更大的抑制作用；对城市父母的子女教育程度提高作用更大；对城市老年人的住房条件改善作用更大；对城乡父母的子女探望频率降低作用更大。我们的研究结果具有重要意义，在人口老龄化加剧的背景下，户籍制度造成的城乡不平等因生育率下降而进一步扩大。中国政府应更加关注只有一个孩子的农村老年人，需要为农村地区的独生子女家庭提供更多的公共社会经济资源，以改善他们的健康状况。此外，实证结果还表明，中国的城市化进程可能能够缓解低生育率对健康的不利影响。
