Social Stratification of Health and Well-Being in a Transitional Society -- Evidence from Contemporary China

Abstract

Existing research has shown that inequalities of health and well-being have deep roots in social stratification structures, and a large body of literature has shown that an individual's social class position has a positive association with their health status and level of well-being. However, most previous studies have adopted a static perspective, focusing mainly on the impact of an individual's current social class position in the current social context. Yet very little is known about whether individual-level changes in social class position and societal-level changes in resource disparities between different social classes may affect people's health and well-being. This research has comprehensively examined how changes in social class position, i.e. social mobility, may affect people's health and well-being in inter- and intra-generational mobility trajectories, how the impact may differ across institutional sectors, and how the individual-level findings may vary in a changing social context, especially in a dynamic social stratification structure. The empirical analysis is based on contemporary China, which has experienced rapid social changes on a monumental scale in the past few decades, and has witnessed a high social mobility rate at the individual level along with observable changes in the social stratification structure. By using data from both cross-sectional and longitudinal surveys in China, and by employing various statistical models in empirical analysis, the research shows that the impact of social position and mobility depends on at least three factors. First, it depends on mobility trajectories -- while upward social mobility is beneficial in general, the influence of downward mobility is rather different in inter- and intra-generational mobility contexts; second, it depends on institutional sectors -- even upward mobility does not bring much benefit to people without local citizenship; third, it depends on resource disparities in the social stratification structure -- the individual-level association needs to be embedded within a dynamic social context, as the relationship between social positions per se may also change over time. Theoretically, this thesis contributes to the existing literature by employing a dynamic perspective on both the individual level and the societal level in examining how an individual's social position may affect their health and well-being. Methodologically, this study employs diagonal reference models to meet the challenge of the multicollinearity problem of position effect and mobility effect, uses propensity score matching to reduce potential bias in group comparisons, and uses a repeated longitudinal design to deal with the age, period, and cohort conundrum. Empirically, this research focuses on the case of China, a society that has been experiencing decades of rapid social change, which sheds light on both academic research in the field and on future public policy in China.

Date of Award	1 Aug 2018
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Nicholas Shryane (Supervisor), Yaojun Li (Supervisor) & Anthony Heath (Supervisor)