Social determinants of child malnutrition outcomes, health human capital and economic growth in China

Child malnutrition outcomes (CMOs) pose a threat to children's survival, development, and thriving worldwide, causing profoundly detrimental effects on health throughout their lives. Due to China’s regional and urban-rural disparities in CMOs, this is still an enormous challenge for China to reach sustainable development goals (SDGs). This thesis aims to examine the social determinants of CMOs; the impact of CMOs on health human capital; the impact of health human capital and economic growth. The first objective examines the social determinants of CMOs (measured by stunting, wasting and overweight) by employing fixed-effects (FE) models and using China Health and Nutrition Survey (CHNS) data from 1991 to 2015. The findings show that significant factors of child stunting (4012 observations) include whether the child is insured, maternal education level, maternal employment, and maternal working days, household income per capita, household assets, community urbanization, and living area. Meanwhile, the significant factors of child wasting (4229 observations) are maternal employment, maternal working days, living regions and areas. For overweight (4429 observations), significant factors are maternal with low-middle school, maternal employment, maternal working days, household income per capita, maternal with medical insurance, and living regions. The second objective examines the impact of CMOs on health human capital using the same period of CHNS. Based on FE models and logit models (1612 observations), the findings show the persistent impact of CMOs, including early-life and mid-to-late childhood, on health human capital in adulthood. CMOs measured by child stunting has been significantly influencing health human capital measured by height, BMI, self-rated health (SRH), and whether have been sick in the last four weeks (SH). CMOs measured by overweight significantly influences adult health human capital measured by body mass index (BMI), blood pressure (1165 observations), and perceived pressure (PP). Finally, the third objective examines the impact of health human capital on economic growth using the 29 province-level data from 1990 to 2020 in China. By employing FE model, panel correction standard error (PCSE model), and feasible generalized least square (FGLS model) estimation method, findings consistently demonstrate a statistically significant positive relationship between health human capital and economic growth in China. Overall, the study reveals significant social determinants influencing CMOs; its long-term impact on health human capital; and positive association of health human capital on economic growth. To attain SDGs, the Chinese government can prioritize reducing the number of stunting and wasting among 5-year-olds in the western region by improving mothers' education and feeding knowledge, and providing financial subsidies. Meanwhile, emphasis should be placed on controlling overweight among children in the eastern region. By doing so can reduce the disease burden on the nation and increase the stock of health human capital for future population. Moreover, preventive healthcare and mental health intervention policies targeting young children should be explicitly drafted. At the macro-level, to narrow down the regional disparities, an explicit recommendation is to focus on health human capital, particularly increased health investment in the central and western region is highlighted.

Text 125465 - Full Text.pdf Download (3MB) Text SPE 2024 18 - Declaration Form.pdf Restricted to Repository staff only Download (419kB) Text SPE 2024 18 - Full Text.pdf Restricted to Repository staff only Download (3MB) Official URL or Download Paper: http://ethesis.upm.edu.my/id/eprint/18886

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