Estimating rural–urban disparities in self-rated health in China: Impact of choice of urban definition

OBJECTIVE AND METHODS We use the 2014 China Family Panel Studies (CFPS), which includes anchoring vignettes, to provide an up-to-date assessment of rural–urban health disparities as measured by self-rated health (SRH) in China. Our analysis is based on multiple definitions (hukou and the two different residence-based definitions) of rural–urban and migration status; previous research was inconclusive due to the use of different definitions and concerns about status-based differential health expectations (reporting heterogeneity). RESULTS AND CONCLUSIONS We find a nonlinear difference between rural and urban Chinese in how they self-assess health status, regardless of the urban definition used. Urban respondents do not always hold a higher standard for self-assessment of health. Instead, their rating styles depend on the level of latent health. After controlling for the reporting heterogeneity, we find on average a slight urban advantage in SRH, but it is most pronounced when using the statistical (density dependent) definition of urban. CONTRIBUTION We study rural–urban health disparities based on three different urban definitions and migration status. Although we examine the urban definitions that are specific to China, we demonstrate a mindful approach when multiple definitions exist and caution against any simplistic approach that ignores context-specific urban definition. We also provide clear illustrations of the different types of reporting heterogeneity, as well as a way to visualize the cut-points, thresholds, and latent health estimates.