The Impact of Higher Education on Health Literacy: A Comparative Study between Urban and Rural China

Health China 2030 calls for health equity. The strict household registration system, known as Hukou , results in an uneven distribution of social resources between urban and rural China. Higher education can promote social mobility and narrow health inequality. Health literacy is a significant indicator to predict health status. Drawing on national representative data recently collected, this study examines the impact of higher education on health literacy in urban and rural China. Propensity score matching was used to address potential selection bias. Ordinary least squares regressions and Oaxaca–Blinder decomposition techniques were conducted to explore urban-rural disparities in health benefits from higher education. The findings indicate that there are existing gaps in health literacy, higher education attainment, household income, and healthcare coverage between urban and rural China. Higher education attainment can significantly promote health literacy both in urban and rural China, after controlling for a series of demographic, socio-economic, and individual characteristics. Moreover, this study highlights a negative heterogenous treatment effect pattern: those who are less likely to attend college can obtain more health benefits from higher education than those who are more likely to be admitted into college. Public education and health programs, policies, and goals should be further optimized to promote integrated development in urban and rural China.