Three Essays on Health and Macronutrient Consumption among Chinese Adults

The first chapter contains an in-depth analysis of the socioeconomic determinants of adult (twenty years of age or older) body mass index (BMI) in China using the China Health and Nutrition Survey (CHNS) 1989-1997. There is a dramatic increase in overweight and obesity among adult Chinese in this period (for men 6% to 17% and for women 11% to 21%). A clear theoretical framework was utilized and descriptive and multivariate reduced form and dynamic demand function analyses were undertaken to find a variety of factors affecting individual BMI. The key findings are that for women the effect of education is very strong and inversely U-shaped. Productive assets, food prices, water sources and sanitation conditions are all important determinants of adult BMI in China and these factors affect men and women in different age groups and across regions differently. With careful exposition of the socioeconomic determinants of adult BMI in China in the 1990s, the paper finds strong protective effects of education on BMI in women, particularly in rural areas. The knowledge of this relationship can assist public policy makers to identify target groups for improving their health status. As the Chinese economy undergoes rapid structural transition it is extremely important to find factors that can make such transition as smooth as possible. The second chapter studies the associations between adult food consumption and several socioeconomic factors such as education level, household resources, and community characteristics in the early 1990s in China. In the overall sample education does not have significant impact on calorie intakes but does affect percent of calories from fat, from protein and from carbohydrates differently in different region and at different age. The effect of productive assets is nonlinear and in inverted U-shape for male calorie, fat and protein intakes; whereas for women more productive assets are associated with more fat and protein intakes and more percents of calories from fat and from protein. In rural areas the effect of productive assets is stronger than that in the urban areas. Prices of foods, community water and sanitation conditions are also studied. The effects of prices on calorie, fat and protein intakes and the quality of diet measures can go in either direction. Improvements in sanitation are associated with more energy and protein intakes in urban areas. A simple health production function analysis on weight and BMI is carried out and both health measures in the short period of two years can be described as a random walk process. The third chapter presents identification of the shape of the age, cohort and time effect profiles of male and female BMIs in 1990s in China. The analysis is used to help pin down the model specification in the BMI demand functions later. The age profile for women is of inverse U-shape. The year effect for men is strong. There are not enough data to identify cohort effects due to the short length of the survey. In our main analysis for socioeconomic determinants of BMI we will be using the five-year cohort identification strategy.

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