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New Evidence on the Effect of Medical Insurance on the Obesity Risk of Rural Residents: Findings from the China Health and Nutrition Survey (CHNS, 2004–2011)

Author

Listed:
  • Jian Zhao

    (National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China)

  • Chang Su

    (National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China)

  • Huijun Wang

    (National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China)

  • Zhihong Wang

    (National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China)

  • Bing Zhang

    (National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China)

Abstract

The obesity rate in China has risen significantly in the past few decades. While a number of causes for the rise in obesity have been explored, little attention has been paid to the role of health insurance per se. This study aims to investigate the impact of health insurance on the risk of obesity in rural China using longitudinal data from the China Health and Nutrition Survey (CHNS). We employed pooled ordinary least squares (OLS), probit estimation, and pooled two-stage least squares (2SLS) for an instrumental variable (IV). The IV model revealed that New rural cooperative medical insurance (NRCMS) participation had a significant positive impact on people’s tendency towards unhealthy lifestyles, for instances, high-fat food (8.01% for female and 7.35% for male), cigarette smoking (25% for male), heavy drinking (25% for female), sedentary activity (6.48 h/w for female and 6.48 h/w for male), waist circumference (1.97 cm for female and 1.80 cm for male), body mass index (0.58 kg/m 2 for female), which in turn leads to an elevated probability of general obesity (51% for female) and abdominal obesity (24% for female and 20% for male). An “ex ante moral hazard” is prevalent in rural China, which should not be ignored by policymakers so as to minimize the related low efficiency in the process of promoting the universal coverage of insurance.

Suggested Citation

  • Jian Zhao & Chang Su & Huijun Wang & Zhihong Wang & Bing Zhang, 2018. "New Evidence on the Effect of Medical Insurance on the Obesity Risk of Rural Residents: Findings from the China Health and Nutrition Survey (CHNS, 2004–2011)," IJERPH, MDPI, vol. 15(2), pages 1-20, February.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:2:p:383-:d:132889
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    References listed on IDEAS

    as
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    2. Qian Ren & Chang Su & Huijun Wang & Zhihong Wang & Wenwen Du & Bing Zhang, 2016. "Change in Body Mass Index and Its Impact on Incidence of Hypertension in 18–65-Year-Old Chinese Adults," IJERPH, MDPI, vol. 13(3), pages 1-9, February.
    3. Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 25-46, July.
    4. Dhaval Dave & Robert Kaestner, 2009. "Health insurance and ex ante moral hazard: evidence from Medicare," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 367-390, December.
    5. Xuezheng Qin & Tianyi Lu, 2014. "Does Health Insurance Lead to Ex ante Moral Hazard? Evidence from China’s New Rural Cooperative Medical Scheme," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 39(4), pages 625-650, October.
    6. Ming-Juan Jin & Bing-Bing Chen & Ying-Ying Mao & Yi-Min Zhu & Yun-Xian Yu & Yin-Yin Wu & Ming-Wu Zhang & Shan-Kuan Zhu & Kun Chen, 2013. "Prevalence of Overweight and Obesity and Their Associations with Socioeconomic Status in a Rural Han Chinese Adult Population," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
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