Skip to main content Accessibility help
Hostname: page-component-55597f9d44-2qt69 Total loading time: 0.828 Render date: 2022-08-14T16:01:42.545Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

How Dynamics of Urbanization Affect Physical and Mental Health in Urban China*

Published online by Cambridge University Press:  20 November 2014

Juan Chen*
The Hong Kong Polytechnic University.
Shuo Chen
The Hong Kong Polytechnic University.
Pierre F. Landry
University of Pittsburgh.
Deborah S. Davis
Yale University.
Email: (corresponding author).


Using a 2011 national survey of urban residents, irrespective of their official hukou status, and the 2000–2009 night-time light data from the Defense Meteorological Satellite Program Operational Linescan System (DMSP-OLS), this paper goes beyond the simple dichotomy of migrant versus non-migrant or rural versus urban hukou to disentangle the processes of urbanization and migration and their complex associations with health, and assesses the impact of various levels and speed of urbanization on the physical and mental health of current residents in a city or town. By disaggregating urbanization into three discrete dimensions at sub-provincial levels, we find that while a higher absolute level of urbanization at the county level negatively impacted self-reported physical health, faster and accelerating urbanization had a positive impact which could be attributed to the demand-pull effect underlying the healthy migrant phenomenon. By contrast, all three dimensions of urbanization were associated with greater depressive distress and thus had an adverse effect on residents' mental health. Beyond demonstrating how variation in the process and location of urbanization affects individual health, we also illustrate more broadly the value of modelling locational parameters in analyses of individual outcomes based on national samples.


本文基于 2011 年全国城镇居民流动与生活质量调查和 2000–2009 年 DMSP-OLS 夜间灯光数据, 重新梳理了中国城镇化和人口流动的过程及其与居民健康的复杂关联, 并评估了不同的城镇化水平与速度对目前居住在城镇的居民身体和精神健康的影响。通过将城镇化的过程在县级分解成三个维度, 我们发现县级城镇化的绝对水平对居民的身体健康有负面影响, 而快速和加速度的城镇化则对居民的身体健康有正面影响, 但后者可能与健康移民现象有关。与对身体健康的影响相反, 城镇化的三个维度都与居民更多的抑郁症状相关联, 由此显示出城镇化对居民精神健康的负面影响。本文除了论证城镇化过程和地域对个人健康的影响, 同时也演示了将地域参数引入分析全国性的个人层面的变量模型中所具有的更广泛的价值。

Copyright © The China Quarterly 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)



The national Migration and Quality of Life Survey was funded by the General Research Fund of the Research Grants Council of Hong Kong (PolyU 5416/10H). The research undertaken for this article also received funding from the Hong Kong Polytechnic University (PolyU 5409/09H) and the Chiang Ching-Kuo Foundation for International Scholarly Exchange (RG022-P-09). We are grateful for the collaboration and support of the Research Center for Contemporary China at Peking University and the University Service Centre for China Studies at the Chinese University of Hong Kong. We appreciate the Barometer on China's Development (BOCD) project for allowing us to use their project shapefiles at the county level and the advice and help of Wu Puzhou on intersecting the raw data with the shapefiles. We thank the student participants of the 2012 Yale–CUHK summer seminar who made valuable contributions to the analysis.


Adams, Jennifer, and Hannum, Emily. 2005. “Children's social welfare in China 1989–1997.” The China Quarterly 181, 100122.CrossRefGoogle Scholar
Boey, Kamweng. 1999. “Help-seeking preference of college students in urban China after the implementation of the ‘open-door’ policy.” International Journal of Social Psychiatry 45(2), 104116.CrossRefGoogle ScholarPubMed
Chan, Kam Wing. 2013. “China, internal migration.” In Ness, Immanuel and Bellwood, Peter (eds.), The Encyclopedia of Global Human Migration. Wiley-Blackwell.Google Scholar
Chen, Juan. 2011. “Internal migration and health: re-examining the healthy migrant phenomenon in China.” Social Science & Medicine 72(8), 12941301.CrossRefGoogle Scholar
Chen, Juan. 2012. “Seeking help for psychological distress in urban China.” Journal of Community Psychology 40(3), 319341.CrossRefGoogle Scholar
Chen, Juan. 2013. “Perceived discrimination and subjective well-being among rural-to-urban migrants in China.” Journal of Sociology & Social Welfare 40(1), 131156.Google Scholar
Chen, Juan, Chen, Shuo and Landry, Pierre F.. 2013. “Migration, environmental hazards, and health outcomes in China.” Social Science & Medicine 80, 8595.CrossRefGoogle Scholar
Escobar, Javier I., Hoyos Nervi, Constanza and Gara, Michael A.. 2000. “Immigration and mental health: Mexican Americans in the United States.” Harvard Review of Psychiatry 8(2), 6472.CrossRefGoogle ScholarPubMed
Fennelly, Katherine. 2007. “Health and well-being of immigrants: the healthy migrant phenomenon.” In Walker, Patricia Frye and Barnett, Elizabeth Day (eds.), Immigrant Medicine: A Comprehensive Reference for the Care of Refugees and Immigrants. New York: Elsevier Press.Google Scholar
Friedmann, John. 2005. China's Urban Transition. Minnesota: University of Minnesota Press.Google Scholar
Frisbie, W. Parker, Cho, Youngtae and Hummer, Robert A.. 2001. “Immigration and the health of Asian and Pacific Islander adults in the United States.” American Journal of Epidemiology 153(4), 172180.Google ScholarPubMed
Fyhri, Aslak, and Aasvang, Gunn Marit. 2010. “Noise, sleep and poor health: modeling the relationship between road traffic noise and cardiovascular problems.” Science of the Total Environment 408(21), 4935–42.CrossRefGoogle ScholarPubMed
Galea, Sandro, Freudenberg, Nicholas and Vlahov, David. 2005. “Cities and population health.” Social Science & Medicine 60(5), 1017–33.CrossRefGoogle ScholarPubMed
Gee, Gilbert C., and Takeuchi, David T.. 2004. “Traffic stress, vehicular burden and well-being: a multilevel analysis.” Social Science & Medicine 59(2), 405414.CrossRefGoogle ScholarPubMed
Gong, Peng, Liang, Song, Carlton, Elizabeth J., Jiang, Qingwu, Wu, Jianyong, Wang, Lei and Remais, Justin V.. 2012. “Urbanisation and health in China.” The Lancet 379(9818), 843852.CrossRefGoogle Scholar
Griffiths, Sian M., and Tang, Jingling. 2011. “Healthcare reform in China and the challenges for public health education.” Public Health 125(1), 35.CrossRefGoogle ScholarPubMed
Harpham, Trudy. 1994. “Urbanization and mental health in developing countries: a research role for social scientists, public health professionals and social psychiatrists.” Social Science & Medicine 39(2), 233245.CrossRefGoogle ScholarPubMed
He, Chunyang, Ma, Qun, Li, Tong, Yang, Yang and Liu, Zhifeng. 2012. “Spatiotemporal dynamics of electric power consumption in Chinese mainland from 1995 to 2008 modeled using DMSP/OLS stable nighttime lights data.” Journal of Geographical Sciences 22(1), 125136.CrossRefGoogle Scholar
Henderson, J. Vernon, Storeygard, Adam and Weil, David N.. 2012. “Measuring economic growth from outer space.” American Economic Review 102(2), 9941028.CrossRefGoogle ScholarPubMed
Hesketh, Therese, Jun, Yexue, Lu, Li and Mei, Wongwang. 2008. “Health status and access to health care of migrant workers in China.” Public Health Reports 123(2), 189197.CrossRefGoogle Scholar
Hu, Xiaojiang, Cook, Sarah and Salazar, Miguel A.. 2008. “Internal migration and health in China.” The Lancet 372(9651), 1717–19.CrossRefGoogle Scholar
Jones-Smith, Jessica, and Popkin, Barry M.. 2010. “Understanding community context and adult health changes in China: development of an urbanicity scale.” Social Science & Medicine 71(8), 1436–46.CrossRefGoogle ScholarPubMed
King, Ronald P., and Davis, Jeffrey R.. 2003. “Community noise: health effects and management.” International Journal of Hygiene and Environmental Health 206(2), 123131.CrossRefGoogle ScholarPubMed
Landry, Pierre F., Davis, Deborah and Wang, Shiru. 2010. “Elections in rural China: competition without parties.” Comparative Political Studies 43(6), 763790.CrossRefGoogle Scholar
Landry, Pierre F., and Shen, Mingming. 2005. “Reaching migrants in survey research: the use of the global positioning system to reduce coverage bias in China.” Political Analysis 13(1), 122.CrossRefGoogle Scholar
Lei, Xiaoyan, and Lin, Wanchuan. 2009. “The new cooperative medical scheme in rural China: does more coverage mean more service and better health?Health Economics 18(S2), 2546.CrossRefGoogle ScholarPubMed
Li, Lu, Wang, Hongmei, Ye, Xuejun, Jiang, Minmin, Lou, Qinyuan and Hesketh, Therese. 2007. “The mental health status of Chinese rural–urban migrant workers.” Social Psychiatry and Psychiatric Epidemiology 42(9), 716722.CrossRefGoogle ScholarPubMed
Li, Xiaoming, Stanton, Bonita, Fang, Xiaoyi, Xiong, Qing, Yu, Shuli, Lin, Danhua, Hong, Yan et al. 2009. “Mental health symptoms among rural-to-urban migrants in China: a comparison with their urban and rural counterparts.” World Health and Population 11(1), 2438.CrossRefGoogle Scholar
Li, Xinhu, Wang, Cuiping, Zhang, Guoqin, Xiao, Lishan and Dixon, Jane. 2012. “Urbanisation and human health in China: spatial features and a systemic perspective.” Environmental Science and Pollution Research 19(5), 1375–84.CrossRefGoogle Scholar
Lin, George C.S. 2007. “Reproducing spaces of Chinese urbanization: new city-based and land centered urban transformation.” Urban Studies 44(9), 1829–55.CrossRefGoogle Scholar
Lin, Wanchuan, Liu, Gordon G. and Chen, Gang. 2009. “The urban resident basic medical insurance: a landmark reform towards universal coverage in China.” Health Economics 18(S2), 8396.CrossRefGoogle Scholar
Ling, Rebecca, Liu, Fen, Lu, Xiaoqin and Wang, Wei. 2011. “Emerging issues in public health: a perspective on China's healthcare system.” Public Health 125(1), 914.CrossRefGoogle ScholarPubMed
Macintyre, Sally, Ellaway, Anne and Cummins, Steven. 2002. “Place effects on health: how can we conceptualise, operationalise and measure them?Social Science & Medicine 55(1), 125139.CrossRefGoogle Scholar
McDonald, James Ted, and Kennedy, Steven. 2004. “Insights into the ‘healthy immigrant effect’: health status and health service use of immigrants to Canada.” Social Science & Medicine 59(8), 1613–27.CrossRefGoogle ScholarPubMed
Ministry of Civil Affairs of China. 2001. Handbook of Administrative Divisions of the People's Republic of China 2001. Beijing: China Society Press.Google Scholar
Ministry of Civil Affairs of China. 2011. Handbook of Administrative Divisions of the People's Republic of China 2011. Beijing: China Society Press.Google Scholar
Ministry of Housing and Urban–Rural Development of China. 2012. China's Urban Construction Statistical Yearbook 2011. Beijing: China Planning Press.Google Scholar
Monda, Keri L., Gordon-Larsen, Penny, Stevens, June and Popkin, Barry M.. 2007. “China's transition: the effect of rapid urbanization on adult occupational physical activity.” Social Science & Medicine 64(4), 858870.CrossRefGoogle ScholarPubMed
Moore, Melinda, Gould, Philip and Keary, Barbara S.. 2003. “Global urbanization and impact on health.” International Journal of Hygiene and Environmental Health 206(4), 269278.CrossRefGoogle ScholarPubMed
Mou, Jin, Cheng, Jinquan, Zhang, Dan, Jiang, Hanping, Lin, Liangqiang and Griffiths, Sian. M.. 2009. “Health care utilisation amongst Shenzhen migrant workers: does being insured make a difference?BMC Health Services Research 9, 214.CrossRefGoogle Scholar
Mou, Jin, Griffiths, Sian M., Fong, Hildy and Dawes, Martin G.. 2013. “Health of China's rural–urban migrants and their families: a review of literature from 2000 to 2012.” British Medical Bulletin 106(1), 1943.CrossRefGoogle ScholarPubMed
National Bureau of Statistics of China. 2002. The 2000 Population Census of the People's Republic of China. Retrieved from China Data Online.Google Scholar
National Bureau of Statistics of China. 2012a. China Statistical Yearbook 2011. Beijing: China Statistical Press.Google Scholar
National Bureau of Statistics of China. 2012b. Tabulation on the 2010 Population Census of the People's Republic of China. Beijing: China Statistics Press.Google Scholar
Peek, M. Kristen, Cutchin, Malcolm P., Freeman, Daniel, Stowe, Raymond P. and Goodwin, James S.. 2009. “Environmental hazards and stress: evidence from the Texas city stress and health study.” Journal of Epidemiology and Community Health 63(10), 792798.CrossRefGoogle ScholarPubMed
Peng, Yingchun, Chang, Wenhu, Zhou, Haiqing, Hu, Hongpu and Liang, Wannian. 2010. “Factors associated with health-seeking behavior among migrant workers in Beijing, China.” BMC Health Services Research 10, 69.CrossRefGoogle ScholarPubMed
Popkin, Barry M. 2004. “The nutrition transition in the developing world.” Development Policy Review 21(5–6), 581597.CrossRefGoogle Scholar
Qiu, Peiyuan, Yang, Yang, Zhang, Juying and Ma, Xiao. 2011. “Rural-to-urban migration and its implication for new cooperative medical scheme coverage and utilization in China.” BMC Public Health 11, 520.CrossRefGoogle Scholar
Rabinowitz, Peter M. 2005. “Is noise bad for your health?The Lancet 365(9475), 1908–09.CrossRefGoogle ScholarPubMed
Sun, Rui, Zhang, Xia and Wang, Wen. 2009. “Urban expansion analysis of the Huang-Huai-Hai Plain region by DMSP/OLS nighttime light data.” Paper presented at the 2009 Urban Remote Sensing Joint Event, Shanghai, 20–22 May 2009.Google Scholar
Tong, Yuying, and Piotrowski, Martin. 2012. “Migration and health selectivity in the context of internal migration in China, 1997–2009.” Population Research and Policy Review 31(4), 497543.CrossRefGoogle Scholar
Van de Poel, Ellen, O'Donnell, Owen and van Doorslaer, Eddy. 2009. “Urbanization and the spread of diseases of affluence in China.” Economics & Human Biology 7(2), 200216.CrossRefGoogle Scholar
Van de Poel, Ellen, O'Donnell, Owen and van Doorslaer, Eddy. 2012. “Is there a health penalty of China's rapid urbanization?Health Economics 21(4), 367385.CrossRefGoogle Scholar
Wagstaff, Adam, Lindelow, Magnus, Jun, Gao, Ling, Xu and Qian, Junchen. 2009. “Extending health insurance to the rural population: an impact evaluation of China's new cooperative medical scheme.” Journal of Health Economics 28(1), 119.CrossRefGoogle ScholarPubMed
Wang, Lei, Li, Congcong, Ying, Qing, Cheng, Xiao, Wang, Xiaoyi, Li, Xueyan, Hu, Luanyun et al. 2012. “China's urban expansion from 1990 to 2010 determined with satellite remote sensing.” Chinese Science Bulletin 57(22), 2802–12.CrossRefGoogle Scholar
Weng, Xiaoping, Liu, Youxue, Ma, Jiemin, Wang, Wenjuan, Yang, Gonghuan and Caballero, Benjamin. 2007. “An urban–rural comparison of the prevalence of the metabolic syndrome in Eastern China.” Public Health Nutrition 10(2), 131–36.CrossRefGoogle ScholarPubMed
WHO (World Health Organization). 2008. Our Cities, Our Health, Our Future: Acting on Social Determinants for Health Equity in Urban Settings. Report to the WHO Commission on Social Determinants of Health from the Knowledge Network on Urban Settings, Accessed 16 October 2014.Google Scholar
WHO and UN-Habitat (United Nations Human Settlements Programme). 2010. Hidden Cities: Unmasking and Overcoming Health Inequities in Urban Settings. Kobe, Japan: World Health Organization Centre for Health Development (WHO Kobe Centre), and Nairobi, Kenya: United Nations Human Settlements Programme (UN-HABITAT).Google Scholar
Yang, Hongmei, Li, Xiaoming, Stanton, Bonita, Chen, Xinguang, Liu, Hongjie, Fang, Xiaoyi, Lin, Danhua and Mao, Rong. 2005. “HIV-related risk factors associated with commercial sex among female migrants in China.” Health Care for Women International 26(2), 134148.CrossRefGoogle Scholar
Yeh, Anthony G.O., Xu, Jiang and Liu, Kaizhi. 2011. “China's post-reform urbanization: retrospect, policies and trends.” International Institute for Environment and Development (IIED) and United Nations Population Fund (UNFPA).Google Scholar
Yip, Winnie, and Hsiao, William C.. 2009. “Non evidence-based policy: how effective is China's new cooperative medical scheme in reducing medical impoverishment?Social Science & Medicine 68(2), 201–09.CrossRefGoogle ScholarPubMed
Zhang, Baoshan, Fokkema, Marjolein, Cuijpers, Pim, Li, Juan, Smits, Niels and Beekman, Aartjan. 2011. “Measurement invariance of the center for epidemiological studies depression scale (CES-D) among Chinese and Dutch elderly.” BMC Medical Research Methodology 11(1), 74.CrossRefGoogle ScholarPubMed
Zhao, Dahai, Rao, Keqin and Zhang, Zhiruo. 2011. “Coverage and utilization of the health insurance among migrant workers in Shanghai, China.” Chinese Medical Journal 124(15), 2328–34.Google ScholarPubMed
Zhou, Yixing, and Ma, Laurence J.C.. 2003. “China's urbanization levels: reconstructing a baseline from the fifth population census.” The China Quarterly 173, 176196.Google Scholar
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

How Dynamics of Urbanization Affect Physical and Mental Health in Urban China*
Available formats

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

How Dynamics of Urbanization Affect Physical and Mental Health in Urban China*
Available formats

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

How Dynamics of Urbanization Affect Physical and Mental Health in Urban China*
Available formats

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *