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• This paper estimates the relationship between the fertilizer application and medical expenditure. • We identify the effects of fertilizer by distinguishing the food crop and economic crop. • We found that drinking water is one of the channels for disease, and drinking safe water can reduce medical expenses by 0.032%. • We estimate that fertilizer pollution caused a social welfare loss of $678 million, approximately 13% of these economic benefits. Although fertilizer can help alleviate hunger, it can also lead to disease. Using data from the National Fixed-Point Survey spanning from 1998 to 2017, we aimed to determine the impact of fertilizer use on healthcare costs. Our findings indicate that a ten percent increase in fertilizer use is responsible for a 0.63 percentage point rise in medical service fees, which translates to a staggering $678 million in medical expenses. Through an analysis of the various channels of pathogenic exposure, we discovered that food crops and drinking water are the primary sources of contamination. This implies that different rural environments, including fertilizer types, villages, terrain, and water sources, can exacerbate the negative effects of fertilizer use. Our research underscores the need for policymakers to consider compensating farmers who suffer from fertilizer pollution and incur health-related losses. [ABSTRACT FROM AUTHOR]

Dynamic monitoring of building environments is essential for observing rural land changes and socio-economic development, especially in agricultural countries, such as China. Rapid and accurate building extraction and floor area estimation at the village level are vital for the overall planning of rural development and intensive land use and the "beautiful countryside" construction policy in China. Traditional in situ field surveys are an effective way to collect building information but are time-consuming and labor-intensive. Moreover, rural buildings are usually covered by vegetation and trees, leading to incomplete boundaries. This paper proposes a comprehensive method to perform village-level homestead area estimation by combining unmanned aerial vehicle (UAV) photogrammetry and deep learning technology. First, to tackle the problem of complex surface feature scenes in remote sensing images, we proposed a novel Efficient Deep-wise Spatial Attention Network (EDSANet), which uses dual attention extraction and attention feature refinement to aggregate multi-level semantics and enhance the accuracy of building extraction, especially for high-spatial-resolution imagery. Qualitative and quantitative experiments were conducted with the newly built dataset (named the rural Weinan building dataset) with different deep learning networks to examine the performance of the EDSANet model in the task of rural building extraction. Then, the number of floors of each building was estimated using the normalized digital surface model (nDSM) generated from UAV oblique photogrammetry. The floor area of the entire village was rapidly calculated by multiplying the area of each building in the village by the number of floors. The case study was conducted in Helan village, Shannxi province, China. The results show that the overall accuracy of the building extraction from UAV images with the EDSANet model was 0.939 and that the precision reached 0.949. The buildings in Helan village primarily have two stories, and their total floor area is 3.1 × 105 m2. The field survey results verified that the accuracy of the nDSM model was 0.94; the RMSE was 0.243. The proposed workflow and experimental results highlight the potential of UAV oblique photogrammetry and deep learning for rapid and efficient village-level building extraction and floor area estimation in China, as well as worldwide. [ABSTRACT FROM AUTHOR]

The development of introduced pulse varieties has made valuable contributions to the development of the global agricultural industry, and China is one of the largest pulse producers in the international market. A special type of pulse, the red kidney bean, has made a major contribution to improving the rural economy. Taking Kelan County, Shanxi Province, as an example, this paper expounds on the formation of the kidney bean industry and its impact on local development. The existing research used a qualitative case study (QCS) method to examine the driver and impact of kidney beans in the agricultural industry. This study found that (1) the development of the kidney bean industry has benefited from its adherence to a market demand-oriented strategy, focusing on breeding and retaining excellent varieties, and vigorously supporting the construction of technical systems and the cultivation of the main body of the industrial chain. Developing new varieties, creating brands, and industrial integration are the key driving forces for development. (2) The kidney bean industry promotes local development by increasing farmers' income, forming a more complete kidney bean supply chain, highlighting the brand effect, and promoting sustainable rural development. This study suggests that disease-resistant and mechanized-adapted varieties need to be developed in the future. Market and demand trends should be constantly monitored when determining reproductive paths. [ABSTRACT FROM AUTHOR]

Background: Rural households in developing countries usually have severe medical debt due to high out-of-pocket (OOP) payments, which contributes to bankruptcy. China implemented the critical illness insurance (CII) in 2012 to decrease patients' medical expenditure. This paper aimed to explore the medical debt of rural Chinese patients and its influencing factors.Methods: A questionnaire survey of health expenditures and medical debt was conducted in two counties of Central and Western China in 2017. Patients who received CII were used as the sample on the basis of multi-stage stratified cluster sampling. Descriptive statistics and multivariate analysis of variance were used in all data. A two-part model was used to evaluate the occurrence and extent of medical debt.Results: A total of 826 rural patients with CII were surveyed. The percentages of patients incurring medical debt exceeded 50% and the median debt load was 20,000 Chinese yuan (CNY, 650 CNY = US$100). Financial assistance from kin (P < 0.001) decreased the likelihood of medical debt. High inpatient expenses (IEs, P < 0.01), CII reimbursement ratio (P < 0.001), and non-direct medical costs (P < 0.001) resulted in increased medical debt load.Conclusions: Medical debt is still one of the biggest problems in rural China. High IEs, CII reimbursement ratio, municipal or high-level hospitals were the risk determinants of medical debt load. Financial assistance from kin and household income were the protective factors. Increasing service capability of hospitals in counties could leave more patiemts in county-level and township hospitals. Improving CII with increased reimbursement rate may also be issues of concern. [ABSTRACT FROM AUTHOR]

Ensuring household access to affordable, reliable, sustainable and modern energy for all the people is one of the 17 United Nations Sustainable Development Goals (SDGs). China has achieved 100% electricity access, while the traditional solid fuels such as firewood are still widely used in its rural area. This paper, using a long-term and large micro dataset and multinomial logit model, investigates quantitatively the determinants of cooking fuel choice in rural China. The results show that in addition to the previous knowledge on household income, occupation is crucial to the cooking fuel transition. In average, if the head of household changes its occupation from farm to non-farm, the possibility of using firewood would reduce by around 14–21%. The impact of income is slightly small. A 10% increase in income may result in 0.5% of possibility of firewood use. These conclusions are robust after considering the possible energy ladders using ordered logit regressions (OLR) and generalized OLR. After controlling other factors such as income and occupation, we have not found concrete evidence on the influences of education and gender of the household head and household member numbers. To accelerate the fuel transition, in addition to increase the household income, the government should pay attention to create more non-farm work opportunities for the rural. • We use a large micro dataset covering 2 decades and 9 provinces in rural China. • We use a multinomial logit model to capture the choice on disorder fuels. • In addition to the income, occupation is crucial to the cooking fuel choice. • No evidence shows the influences of education and gender if other factors controlled. [ABSTRACT FROM AUTHOR]

Abstract In the late 1990s, China initiated the Conversion of Croplands to Forest Program (CCFP) and the Ecological Welfare Forest Program (EWFP) based on the Payments for Ecosystem Services (PES) principle. Positive socioeconomic outcomes of the programs are essential for the long-term success of eco-environment conservation. However, there is lack of understanding of their longer-term (over 10 years) impacts on rural livelihoods. In this paper, we examine income distribution and inequality of rural households under CCFP and EWFP in rural Anhui, China after 12 years of program implementation. Results show that CCFP-participating households have higher income inequality than non-participants, while the EWFP does not have a significant effect. Local off-farm work and out-migration with remittances are the two principal income sources and both add to inequality. A regression-based decomposition of inequality shows that the CCFP indirectly alters livelihoods by increasing out-migration with remittances, but it also adds to inequality from shifting livelihoods to non-agricultural activities. Meanwhile, EWFP payments positively affect agricultural incomes and contribute 16% to agricultural income inequality. Finally, human capital, natural capital and physical capital all play important roles in generating income and inequality, but the factors affecting inequality from agricultural and non-agricultural activities are different. Highlights • We examine rural household income distribution under two concurrent PES programs. • CCFP positively affects non-farm income via out-migration followed by remittances. • EWFP positively affects agricultural income and adds slightly to inequality. • Factors affecting agricultural and non-agricultural income distributions differ. [ABSTRACT FROM AUTHOR]

In the context of rural sustainability in the developing world, a dilemma facing government intervention is to recognise and properly use local (or indigenous, practical) knowledge. This paper sheds new light on government intervention by introducing a farmer innovation system (FIS), which is initiated by farmer innovator(s) with participation or support from government agencies and other stakeholders for technology improvement and diffusion. In relation to different understandings, attitudes and approaches to farmer innovation, we argue that different government intervention may lead to different project designs and results. The complexity of government intervention in farmer innovation can be seen from an empirical study of the development and diffusion of straw utilisation technology (SUT) in rural China. By analysing and comparing two cases - one successful and one failed - we reveal two types of government intervention, and features and conditions of project success. The major limitation is identified as leaving out other actors such as local business partners and non-government agencies. We suggest a balanced account between farmer innovator(s), government intervention and innovation platform in future research. [ABSTRACT FROM AUTHOR]

Residential energy consumption level, structure, and potentiality are crucial indices reflecting economic and social development. In rural China, energy poverty is still prevalent, and economic poverty is a critical factor that deteriorates energy poverty. This paper combines income- and asset-based measures of wealth to provide a more dynamic perspective on the effects of economic poverty on energy poverty. Results show that for the household which in an average asset or income level, when its assets and income increase by 10%, the probability of a household choosing clean fuels increases by 0.007 and 0.002, respectively. Rural household prefers gas than electricity when household income and assets increase. To solve the energy poverty problem in rural areas, governments need to take measures to improve the accumulation of wealth, raise the infrastructure level and increase the employment rate. [ABSTRACT FROM AUTHOR]

Abstract: This paper focuses on a detailed analysis of the current situation, characteristics and, most important of all, the decision-making process of sustainable consumption behaviors (SCB) of the rural residents in China. Data were gathered from surveys conducted in 35 different municipalities or counties, with a total of 1403 questionnaires randomly distributed in 50 villages among these 35 selected regions. Based on the descriptive analysis, we reveal the current situation of the rural residents' SCB and the affecting factors, including behavioral intention, environmental knowledge, perception of consequence, environmental responsibility, environmental value, perceived behavioral control, response efficacy, environmental sensitivity and also the contextual factors. The paper also uses the path analysis to clarify the decision-making process of SCB. The results show that behavioral intention plays the most important role in explaining the behaviors, while the explanatory power of the psychological variable is low in the explanation of the overall SCB and its sub-categories. Furthermore, implications for public policy and the directions of future researches are discussed. [Copyright &y& Elsevier]

Unclean cooking fuel is widely used in the developing world, and it is the main indication of energy poverty in rural China. In this paper, we investigate the situation, transition, and determination of fuel choice in China's rural household cooking. Using the large scale micro-survey data of China Health and Retirement Longitudinal Study (CHARLS), we find that there is a big gap in using commercial cooking fuels between rural and urban households: 60% of the rural households adopt traditional biomass resource as their main fuel for cooking in 2011, while this figure is less than 5% in the urban. We also identify a significant spatial divide in fuel choice: in southeastern coastal areas, about 40% of the rural households prefer solid fuels, while this figure jumps to over 80% in northeastern areas. The longitudinal data also reveal a significant transition from traditional to modern fuels from 2008 to 2012. Moreover, the distance to the most commonly used farmer's market, education background, coal price and female labor participation are all influential in determining the households' choices. [ABSTRACT FROM AUTHOR]

China's rural elderly strongly feel the tension between the life patterns they had expected to follow and the risks and possibilities presented by a more dynamic and individualised society. This paper discusses how the elderly react to the rapid changes in intergenerational relations. The focus is on their strategies towards the two most common types of living arrangements during old age: maintaining an independent household, and living with a son's family. Earlier generations of elderly perceived cohabitation with a son as the only natural arrangement, but interviews indicate that living in an independent household has become an accepted alternative. This illustrates how China's rural elderly are able to create and accept changes in family relations and new life patterns. Their problems are generated by the lack of social services in rural areas rather than by any culturally determined resistance to change. The last part of the paper discusses recent social engineering projects aimed at reintegrating the elderly into society. By looking at how the elderly adapt to changing family relations and how others imagine their reintegration, the paper highlights the complicated patterns of social change that have emerged in China's villages in the wake of decollectivisation. [ABSTRACT FROM AUTHOR]

Background: In low- and middle-income countries, many women continue working later into pregnancy. In our recent study on some areas in rural China, most women stopped working already during the first trimester (≤3 months) of pregnancy. In this paper we aimed to explore whether stopping work during early pregnancy has changed over an 8 year period (between 2001-03 and 2009); we also studied whether the reasons for stopping work early were the same in the two time periods.Methods: A population-based cross-sectional survey with a representative sample of new mothers was carried out in one rural county in Anhui Province in 2001-03 (N = 1479 respondents) and in two other rural counties in 2009 (N = 1574 respondents). Both surveys were used to evaluate prenatal care interventions not related to work behavior. The surveys targeted all women who had recently given birth. Multilevel logistic regression analysis was used to examine the determinants of work behavior in the two time periods.Results: There was a big change in the working behavior between the two survey years: in the period 2001-03 6 % and in 2009, 53 % of pregnant women stopped working at ≤3 months (percentage change 839, 95 % CI -15.90 to 1694.49). In 2001-03, 30 % and in 2009, 23 % of pregnant women worked the same as before pregnancy (percentage change -22.30, 95 % CI -90.28 to 45.68). In both time periods women with two children were less likely to stop work at ≤3 months of pregnancy. Non-farmers were more likely in 2001-03 but less likely in 2009 to stop work at ≤3 months of pregnancy. Women with medium township-level income were more likely to maintain the same level of work as before pregnancy in 2001-03, while in 2009 women with high township-level income were less likely to work the same.Conclusion: Stopping work very early during pregnancy appeared to have become very common from 2001-3 to 2009 in rural Anhui, China and was not explained by women's background characteristics. [ABSTRACT FROM AUTHOR]

Based on household-level survey data collected from Qinghai Province of China, we estimated the greenhouse gas (GHG) and air pollutant emissions from spatial perspectives, including household energy consumption in pastoral, agropastoral, and agricultural zones. The findings suggest that the total annual GHG and pollutant emissions per capita in the area was 2296.32 kg per year. The highest amount of pollutants was emitted from the pastoral zones, followed by the agropastoral and agricultural zones. CO 2 is the primary GHG emitted by household energy consumption. Dung burning was the cause of the high PM 2.5 emissions in the pastoral areas, while the use of coal was the primary cause of GHG and pollutant emissions in the agropastoral and agricultural zones. • We used empirical data from rural households in Qinghai, China. • This paper indicates the reliance of local energy consumption on non-commercial energy. • We estimate greenhouse gas and pollutant emissions resulting from solid-fuel combustion. • We compare indoor pollutant emissions from pastoral, agropastoral, and agricultural zones spatially. • This paper provides policy recommendations for energy transition towards clean energy. Energy consumption in the household sector has become an important issue in China's energy consumption and an important unit of China's clean energy transformation. Currently, the potential air pollution, carbon emissions and health risks caused by energy consumption in many areas cannot be ignored, and refined and regionalized index-based research data necessary to support decision making are lacking. Based on household-level survey data collected from Qinghai Province, China, we estimated greenhouse gas (GHG) and air pollutant emissions from spatial perspectives, including household energy consumption in pastoral, agropastoral, and agricultural zones. The findings suggest that the total annual GHG and pollutant emissions per capita in the area was 2296.32 kg per year. The highest amount of pollutants was emitted from the pastoral zones, followed by the agropastoral and agricultural zones. CO 2 is the primary GHG emitted by household energy consumption. Dung burning was the cause of the high PM 2.5 emissions in the pastoral areas, while the use of coal was the primary cause of GHG and pollutant emissions in the agropastoral and agricultural zones. These findings highlight the need to integrate household energy policies with rural development to enable a complete transition towards cleaner fuels. [ABSTRACT FROM AUTHOR]

This paper calculates energy efficiency and exergy efficiency of household energy utilization in rural China. Provincial energy efficiencies and exergy efficiencies for space heating sector, cooking sector and hot water sector are calculated and analyzed. Result shows that national energy efficiencies in space heating, cooking and hot water sector are 27.43, 15.32 and 13.11%, respectively. Exergy efficiencies are 1.63, 4.42 and 1.16%, respectively. Energy efficiencies in Xinjiang, Tianjin, Beijing and Shanxi are higher than other provinces because of the wide utilization of coal. In eastern China like Shanghai, Jiangssu, Fujian, the proportion of biomass is quite large which results in a low efficiency. Furthermore, exergy efficiencies in southern China are much higher than those of northern China because of the climate differences. [ABSTRACT FROM AUTHOR]

Small-scale bio-energy projects have been launched in rural areas of China and are considered as alternatives to fossil-fuel energy. However, energetic and environmental evaluation of these projects has rarely been carried out, though it is necessary for their long-term development. A village-level biomass gasification project provides an example. A hybrid life-cycle assessment (LCA) of its total nonrenewable energy (NE) cost and associated greenhouse gas (GHG) emissions is presented in this paper. The results show that the total energy cost for one joule of biomass gas output from the project is 2.93 J, of which 0.89 J is from nonrenewable energy, and the related GHG emission cost is 1.17 × 10-4 g CO2-eq over its designed life cycle of 20 years. To provide equivalent effective calorific value for cooking work, the utilization of one joule of biomass gas will lead to more life cycle NE cost by 0.07 J and more GHG emissions by 8.92 × 10-5 g CO2-eq compared to natural gas taking into consideration of the difference in combustion efficiency and calorific value. The small-scale bio-energy project has fallen into dilemma, i.e., struggling for survival, and for a more successful future development of village-level gasification projects, much effort is needed to tide over the plight of its development, such as high cost and low efficiency caused by decentralized construction, technical shortcomings and low utilization rate of by-products. [ABSTRACT FROM AUTHOR]

Background: The rate of caesarean delivery (CD) in rural China has been rapidly increasing in recent decades. Due to the exorbitant costs associated with CD, paying for this expensive procedure is often a great challenge for the majority of rural families. Since 2003, the Chinese government has re-established the New Cooperative Medical Scheme (NCMS), aimed to improve the access of essential healthcare to rural residents and reduce financial burden owing to high out of pocket payments. This paper seeks to test the hypothesis that NCMS may provide service users and providers with financial incentives to select CD. It also assesses the effect of different health insurance reimbursement strategies of NCMS on CD rates in rural China. Methods: Mixed quantitative and qualitative methods were adopted for data collection. Two cross-sectional household surveys were conducted with women having babies delivered in 2006 and 2009; 2326 and 1515 women, respectively, from the study sites were interviewed using structured questionnaires, to collect demographic and socio-economic data, maternal and child care characteristics and health-related expenditures. Focus group discussions (FGDs) and in-depth key informant interviews (KIIs) were undertaken with policy makers, health managers, providers and mothers to understand their perceptions of the influence of NCMS on the choices of delivery mode. Results: The CD rates in the two study counties were 46.0 percent and 64.7 percent in 2006, increasing to 63.6 percent and 82.1 percent, respectively, in 2009. The study found that decisions on the selection of CD largely came from the pregnant women. Logistic regression analysis, after adjusting for socio-economic, maternal and fetal characteristics, did not indicate a significant effect of either proportional reimbursement or fixed amount reimbursement on the choice of CD for both study years. Interviews with stakeholders reflected that different reimbursable rates for CD and vaginal deliveries did not have a significant effect on controlling the rising CD rate in the study countries. Conclusion: NCMS reimbursement strategies adopted in the study counties of China did not have a significant effect on the selection of CD for baby deliveries. The rapid rise of the CD rates of rural China has remained a serious issue. Other effective measures, such as health education to increase awareness of mothers' knowledge, and improving training of health staff in evidence-based delivery care, maybe could do more to promote rational baby delivery in rural China. [ABSTRACT FROM AUTHOR]

Abstract: Microcredit has gained worldwide acceptance in recent years as a flexible mechanism to expand individuals’ (especially the poor''s) access to financial services, which is considered as an efficient way to achieve poverty reduction and other social development. A large number of empirical studies have been done to examine the welfare effects of microcredit on the borrowers and such effects are well documented in many other countries such as Bangladesh. However, the impacts of microcredit on China rural households’ livelihood are not well documented. This paper attempts to empirically evaluate the impact of microcredit on household welfare outcomes such as income and consumption in rural China. The estimation is based on the difference-in-difference approach which is an increasingly popular method of tackling the selection bias issue in assessing the impacts of microcredit. The study uses a two-year panel dataset, including both primary and secondary data collected through a household survey in rural China. Our empirical results favour the wide belief in the literature that joining microcredit programme helps improve households’ welfare such as income and consumption. Despite the optimistic findings on how microcredit has changed the rural households’ living conditions, our results show that the vast majority of the programme participants are non-poor, which casts some doubts on the social potential (such as poverty reduction) of China''s microcredit programmes. [Copyright &y& Elsevier]

This paper uses data from a survey in Songzi county of Hubei province to analyze the relationship between a couple's marriage form and their duration of postmarital co-residence with their parents. The results show that, after controlling for important factors, a couple's marriage form has a significant influence on the duration of their postmarital co-residence with their parents. Among couples, the duration of co- residence increases in the order: virilocal marriage, institutional type and contingent type uxorilocal marriages. Moreover, for all couples, the first five years after marriage is the period with the highest hazard of ending this postmarital co-residence status with their parents. Causes and social implications of this phenomenon are also discussed. [ABSTRACT FROM AUTHOR]

This paper presents a study of the influence of children's marriage form and other characteristics on whether married couples in three villages in rural China establish a family separate from the joint family of their natal kin. The results reveal that, for children with a brother, sons in virilocal marriages are more likely than daughters in uxorilocal marriages to establish a family separate from that of their parents and do so earlier than these daughters. However, among children without a brother, sons and daughters do not differ significantly in whether or when they divide off from their extended family and set up a new family. The majority of family division occurs in the first 5 years after marriage for sons and daughters. Number of siblings and other characteristics also affect the likelihood of family division. We discuss demographic, socio-economic, and cultural causes underlying this phenomenon as well as its social implications. [ABSTRACT FROM AUTHOR]