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This study analyzed the relationship between parents' son preference in a person's childhood and their health when they become older, and tested whether childhood educational opportunities, health level, and care resources play mediating roles in this relationship. China has entered a stage of aging population. The health of the elderly determines whether the government can successfully cope with the challenges brought about by the aging of the population. Chinese people are deeply influenced by Confucianism. The concept of "son preference" is related to residents' parenting strategies. Then, if one's parents exhibit a son preference in their childhood, will it affect one's health in old age? Based on the data of China Health and Retirement Longitudinal Study collected in 2014, this paper uses the least square method to analyze the impact of parents' preference in childhood for boys on the health of the elderly, and uses Karlson-Holm-Breen (KHB) to analyze the mediating effects of childhood educational opportunities, health level and care resources. This study found that parents' preference for boys had a positive impact on the health of male children when they became elderly but had a negative impact on the health of female children when they became elderly. Childhood educational opportunities, health level, and care resources mediated this relationship. It is necessary to analyze the impact of parents' preference for sons in one's childhood on the health of elderly, and intervene the adverse factors affecting the health, to improve the health level and quality of life of the elderly. • Parents' preference for boys had a significant impact on older people's health. • The effect relies on the mediating role of childhood education, health, and care resources. • The idea of prioritizing boys over girls be changed, to improve the health level of the elderly. [ABSTRACT FROM AUTHOR]

Informal payment for medical services is a common phenomenon in China. Patients make informal payments, in cash or in kind, to physicians in addition to official charges billed for medical services. This paper assesses the associations between patients' perceptions of the physician as an agent for the patient's interests (physician agency problem) and informal payment behavior. Using data of 24,000 and 6700 rural households respectively from the Health Development of Rural China Program database (collected in 2008) and Ningxia data source (collected in 2015), we find that patients' concern about physician agency problems is significantly associated with informal payments. The data shows that patients are more likely to make informal payments when they show low trust towards their physicians. For example, in the surgical cases, among patients who strongly distrusted the physicians, 17.9% (95% confidence interval [CI]:]: 13.5, 22.3) initiated informal payments, compared to 8.0% (95% CI: 5.1, 10.9) who expressed "strong trust" in their physicians. Poor communication was also significantly associated with an increase in the informal payment rate. For example, in the non-surgical setting, among the patients who rated the physicians' explaining skills as "poor," 5.9% (95% CI: 5.0, 6.9) of them made informal payments, significantly higher than the patients who rated "excellent" (of whom 1.8% made informal payments 95% CI, 0.9, 2.7). In this study, we provide an explanation for this finding: patients may initiate informal payments to physicians in order to mitigate the physician agency problem. It suggests that to mitigate informal payments, improving alignment between doctors' incentives and patients' interests would be essential. • Informal payments were directly related to patients' concerns about physicians' behavior. • Patients were more likely to make informal payments when they showed low trust towards their physicians. • Poor communication between patients and physicians was related to informal payment rate. • Informal payment might be viewed as an effort by the patients to align the physicians. [ABSTRACT FROM AUTHOR]