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A large literature has examined early-life insult and later-life health outcomes. However, whether early-life exposure might persist into the outcomes of future generations remains unclear. Using data from the China Family Panel Studies, this study examines the intergenerational effects of early-life health shocks during the great famine in China, distinguishes the intergenerational effects of in utero and early-life famine exposure, and estimates whether there is a sex-specific transgenerational response. Difference-in-difference results show that first-generation male in utero famine exposure (1959–1961) is associated with a series of health and economic disadvantages in the second generation, compared with the unexposed post-famine-born cohort (1964–1965) in China. The effect persists in the third generation but attenuates, and there is no same-sex transgenerational response. These findings may suggest a novel source of multigenerational persistence in health and economic poverty and may point to a need to consider evidence of transgenerational mechanisms. [ABSTRACT FROM AUTHOR]

This study investigates what drives local variations when pursuing urban–rural equity in social welfare provision in China. We examine how internal features, top-down pressure and horizontal competition have shaped local governments' decisions to adopt a policy that unifies (yitihua) the urban and rural eligibility thresholds of the world's largest means-tested cash transfer programme (dibao). We collected and coded policies that unify urban–rural dibao thresholds in 336 prefecture-level divisions between 2011 and 2019. Event history analysis showed that internal fiscal constraint – primarily cost concerns – drove local policy adoption; top-down pressure from provincial governments with a high degree of coercive power in policy directives exerted a significant impact; and the horizontal competition's effect was insignificant. Our findings indicate that fiscal arrangements and top-down policy directives from superior governments with higher coercive power are potent tools to accelerate the adoption of a social welfare policy that would otherwise be unappealing for local officials. [ABSTRACT FROM AUTHOR]

This article contributes to the growing body of research on social assistance (SA) dynamics by analyzing patterns of SA receipt in China, a middle-income country with a large informal employment sector. Using national low-income household survey data and event history analysis, this study explored the mechanisms underlying exit from Dibao (formally known as Minimum Living Security) and changes in exit probability over time. We found that in the context of an informal economy, the 'explicit' change of individual characteristics and employment structure decisively affects receipt duration on the micro and macroeconomic levels, respectively. On the policy level, affected by the informal employment structure, employment services tend to be of low quality and fail to promote Dibao exit effectively. Although the specific Dibao payment strategy, which is used to address the difficulty in means tests, largely curbs the risks of declining working motivation, it considerably increases the possibility of prolonged Dibao use. With this systemic influence of informal employment, a unique pattern of SA receipt characterized by the combination of long-term use and a nondecreasing hazard rate has developed in China. [ABSTRACT FROM AUTHOR]

The decision of whether to grow old in one's home (also referred to as ageing in place (AIP)) or relocating to an institution is an ongoing negotiation process, which involves residential decisions and adaptation. This research aims to explore how childless older adults in rural China choose between AIP and institutionalisation. Through a qualitative study conducted in rural China among childless older adults, we explored the reasons why they make certain residential choices and how they adapted during the decision process. Twenty-five childless participants (aged 60–83) were interviewed. Findings suggested that they referred to the term ku (literally meaning 'bitterness'; and a metaphor referring to 'conducting farming and farm-related activities') to explain their residential decisions. If a person could endure ku – sustain food and basic living through farming and farm-related activities, they tended to choose to age in place; otherwise, they chose to relocate to institutions. Ku represents a sense of mastery, encompassing the stressfulness and suffering aspect that requires adaptation. Three adaptive strategies were identified: (a) positive reappraising of the negative aspect of ku , (b) routinising ku , and (c) transcending the narrative of ku into a toughness identity. Our findings suggest that childless older adults struggled to achieve residential mastery while making residential decisions, even though a sense of mastery was shaped by the individual and structural constrictions. [ABSTRACT FROM AUTHOR]

Background: Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China. Methods: Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions. Results: The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty. Conclusions: This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI. [ABSTRACT FROM AUTHOR]

Amid rapid population ageing and the high-speed progress of information and communications technology, use of smart electronics can improve older people's quality of life by helping them to stay connected, active and independent, which may, in turn, increase their overall happiness and sense of social belonging. Taking a gender perspective, this paper aims to understand variations in digital exclusion among older people. Using data from the 2016 China Longitudinal Ageing Social Survey, it finds that digital exclusion seems to vary by gender, with rural female older people being most excluded, possibly because they have the lowest capital endowment. The gender difference in the digital divide is even more salient with all other things being equal. Digital exclusion in the information era may further exacerbate gender inequality, particularly for those who are already most vulnerable. Since digital inclusion is somewhat inherent in the concept of intelligent old-age support, it should be considered an urgent necessity to help older people, especially rural women, become familiar with smart electronic products. [ABSTRACT FROM AUTHOR]

Reminiscing contributes to the formulation of identity in later adulthood through integrating individuals' recomposed past, perceived present and envisioned future. Aiming to understand rural Chinese elders' identity construction through reminiscing, we conducted semi-structured interviews with 20 elders living in ShiGo, a village located in the south-west of China. Data analysis suggests the rural elders in this study constructed a hero–victim identity through telling stories about the hardships they went through and the sacrifices they made. The participants narrated suffering from lack of basic living needs in the past, in particular before the 1980s while they were involved in turmoil brought on by wars and national movements, from destructive relationships, from making sacrifices for the country and their families, and from adapting to challenges brought on by the hardships. The rural elders shared life experiences with other villagers in daily life through bitter-sweet telling and wanted their suffering and sacrifices to be witnessed. Witnessing connects suffering, sacrifice, hero and victim into a self-enforcing system that helps the elders maintain interdependence and defence against existential concerns like death anxiety. A hero–victim dialectic model was presented to capture the self-enforcing attribute of the hero–victim identity. Findings of this study could be used to make sense of rural ageing in China and benefit clinical professionals working with rural Chinese elders. [ABSTRACT FROM AUTHOR]

While it is increasingly recognized that shame is a pernicious component of the experience of poverty, the stigma generally associated with social assistance provision is less marked with respect to China's Minimum Living Security System, also known as dibao. This enigma is explored and illuminated drawing on two streams of indigenous Chinese scholarship and qualitative fieldwork in eight villages in Shanxi province. Economic and political changes prioritizing economic growth and individual wealth have increased the shame associated with poverty, manifest as loss of face, low mian (status) and lack of lian (integrity). However, this shame does not transfer to dibao because the scheme has been transformed locally into a universal age supplement that partially fulfils the demands of filial piety and which is seen to reflect and contribute to guanxi (social influence). [ABSTRACT FROM AUTHOR]

There is a large body of literature asserting that household asset holdings play a critical role in prospects of economic and social well-being. This study examines asset-poverty rates in China using the 2013 survey data from the Chinese Household Income Project (CHIP). The results indicate that asset-poverty rates in urban China were lower than those of developed countries, whereas rural and migrant households experienced more serious asset poverty than their counterparts in urban China. In addition, the asset-poverty rates were at least twice the income-poverty rates in China according to the different poverty lines used in the study. Several demographic characteristics were found associated with asset poverty. To assist the Chinese government in reaching its goal of eradicating absolute poverty by 2020 through targeted poverty alleviation, this study suggests including assets in the description and alleviation of poverty. [ABSTRACT FROM AUTHOR]

It has been one of the most debated puzzles in the study of political economy of terrorism whether economic development can curb terrorism. In Xinjiang, a multi-ethnic region in West China, it is widely believed that higher income levels can decrease the likelihood of terrorism conducted by Uyghur separatists or Islamic extremists. However, the county-level data for the year of 2013 show that better economic performance may not work as is expected. Instead, empirical evidence indicates that income is positively associated with the probability of terrorist attacks, and the effect is statistically significant. Projects that are aimed at boosting local economic growth result in a flood of migrants, and the local Uyghurs are disadvantaged in the employment market. Consequently, economic grievances will be generated. Some, but not all, Uyghurs have a shared motivation to resist, but tight social control in the region constrains the form of resistance, in the sense that neither mass protests nor armed rebellion are feasible. Terrorist attacks that come at a lower cost become a preferable choice. In addition to economic grievances and tight control, external factors also help to boost terrorist activities in Xinjiang, but more empirical and field research is needed before we could clarify how external factors, such as the international jihadist movement, interact with local conditions and result in terrorism in the region. [ABSTRACT FROM AUTHOR]

It has been shown that food insecurity is associated with poor diet quality and unfavourable health outcomes. However, little is known about the potential effects of food insecurity on the overall malnutrition status among children. In this study, we investigated the prevalence of food insecurity among 1583 elementary school students, aged 6–14 years, living in Chinese rural areas and examined its association with four malnutrition signs, including rickets sequelae, anaemia, stunting and wasting. Information on food security was collected via questionnaires. Rickets sequelae were assessed by an experienced paediatrician during the interview. Anaemia was determined by the WHO Hb thresholds adjusted by the local altitude. Weight and height were measured during the interview. Stunting and wasting were then evaluated according to WHO child growth standards (2007). We examined the association between food insecurity and the number of malnutrition signs (total number=4), and the likelihood of having severe malnutrition (presence of 3+ signs), after adjusting for potential confounders, such as age, social-economic status and dietary intakes. During the previous 12 months, the overall prevalence of food insecurity was 6·1 % in the entire studied population and 16·3 % in participants with severe malnutrition. Participants with food insecurity had a slightly higher number of malnutrition signs (1·14 v. 0·96; P=0·043) relative to those who were food secure, after adjusting for potential confounders. Food insecurity was also associated with increased likelihood of having severe malnutrition (adjusted OR 3·08; 95 % CI 1·47, 6·46; P=0·003). In conclusion, food insecurity is significantly associated with malnutrition among Chinese children in this community. [ABSTRACT FROM PUBLISHER]

Using a household sample survey for 2006, this article shows that the Hui population in the rural part of Ningxia Autonomous Region in China is disadvantaged compared to the Han majority as regards length of education and household per capita wealth. Yet, there is no gap in average disposable incomes between the two ethnic groups and poverty rates are very similar. This paradox is owing to members of Hui households earning more off-farm income than members of Han households. In particular, young Hui males living in poor villages have a remarkably high likelihood of migrating, thereby bringing back income to their households. [ABSTRACT FROM PUBLISHER]

A correction to the article "Poverty, Shame and Ethics in Contemporary China" that was published in the August 13, 2019 issue is presented.

Aims: This systematic review compiled evidence on interventions to reduce mental health-related stigma among medical and nursing students in low- and middle-income countries (LMICs). Primary outcomes were stigmatising attitudes and discriminatory behaviours., Methods: Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, professional students in medicine and nursing, and LMICs. A qualitative analysis of all included full texts was done with the software MAXQDA. Full texts were analysed with regard to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a methodological quality assessment was undertaken., Results: A total of nine studies from six countries (Brazil, China, Malaysia, Nigeria, Somaliland and Turkey) were included. All studies reported significant results in at least one outcome measure. However, from the available literature, it is difficult to draw conclusions on the most effective interventions. No meta-analysis could be calculated due to the large heterogeneity of intervention content, evaluation design and outcome measures. Studies with contact interventions (either face-to-face or video) demonstrated attitudinal change. There was a clear lack of studies focusing on discriminatory behaviours. Accordingly, training of specific communication and clinical skills was lacking in most studies, with the exception of one study that showed a positive effect of training interview skills on attitudes. Methods for cultural adaptation of interventions were rarely documented. The methodological quality of most studies was relatively low, with the exception of two studies., Conclusions: There is an increase in studies on anti-stigma interventions among professional students in LMICs. Some of these studies used contact interventions and showed positive effects. A stronger focus on clinical and communication skills and behaviour-related outcomes is needed in future studies.