Jan 24, 2021

Effectiveness of health service/investment interventions aimed at reducing inequalities in health among older people in China: a longitudinal study


Photo by Jaddy Liu on Unsplash

This project will investigate the effects of health service/investment on non-communicable diseases (NCDs) prevention initiatives and health inequalities among elderly people in China. China has the largest ageing population in the world. NCDs are common among older people and have been found to increase the risks of health and mortality.

China has achieved nearly universal coverage of health insurance for elderly people since 2011; however, insufficient provision of health insurance and its unequal distribution according to different health insurance schemes among elderly people in China are likely to have considerable impact on the health outcomes of its fast-growing aging population. In addition, the quality and availability of health services and health investments vary greatly among provinces as a result of the provinces’ different levels of economic development. Investigating the efforts of health service/investment from the government have NCDs prevention initiatives and reduced the inequalities in health could help to understand the effectiveness of health investment in the last few years.

This project will use the micro-level (individual) from the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014 (16,840 respondents) and macro-level (province) data from the Chinese Statistics Yearbook. During these 6 years, the Chinese government has achieved universal coverage of health insurance as well as growth in the investment of health services. Multilevel models will be used to investigate the effects of health service/investment (macro-level) on health inequalities among elderly people (individual level) in China spatially and temporally.

We expect to submit two academic publications. These papers will have the results and the discussions of current health policy. The discussions will feed into policy implications for future health care reform under the National Strategy “Healthy China 2030”, launched by the Chinese State Council in October 2016.



Academic Publications

  • Feng, Z., Jones, K., & Phillips D.R. (2019). Social exclusion, self-rated health and depression among older people in China: evidence from a national survey of older persons. Archives of Gerontology and Geriatrics. 82, 238-244.
  • Lei, P.,Feng, Z.,Ding, J., Duan, R., Yu, H., & Liu, Q. (2019). Evaluation of the status of medical resource allocation and service utilization in China. Health Economics Research,36(5), 50-55. (In Mandarin)


Academic Publications

  • Feng, Phillips and Jones have published a paper named “A geographical multivariable multilevel analysis of social exclusion among older people in China: Evidence from the China Longitudinal Aging Social Survey ageing study”.
  • Lei, Feng, Ding, Jing & et al  have a paper titled “Evaluation of the current allocation of healthcare resources and service utilization in China” which is accepted to publish in Health Economics Research (in Chinese).

Scholarly events

  • 4-6 July 2018, Feng presented “Can state health investment prevent chronic diseases among older people in China?” at the British Society of Gerontology annual conference in Manchester, UK
  • 29 -30 October 2018, the workshop “Health Service, Investment and Health Equality in China” was held at Zhejiang University, China.
  • 14-18 November 2018. Feng presented a poster “The Effectiveness of Health Investment on Non-Communicable Diseases Among Older People in China: A Multilevel Study” at the Gerontological Society of America annual conference in Boston, US.