A social determinant of health in China is economic status. Even though China has been deemed as a miracle economy, there are clear disparities in income and wealth between the urban and rural areas, between the eastern and regions, and between households. The level of income inequality in China is very similar to the United States now, and is comparable to other countries (such as Philippines and Thailand). Income inequality has very damaging effects for China as a society. Societies with large income inequalities generally generate more damaging psychosocial stress levels throughout the population, especially for those who possess lower income and are considered lower-class. In the case of women who experience sexual trauma in China, it is a lot harder for those who are poor to afford the treatment necessary to heal from their abuse.
The decline in health (both psychological and physical) is a result of limited investments in such public programs as health and education, which are very important to low-income individuals. (Lynch, 2000) From 1981-2001 , the proportion of those living in extreme poverty declined from 53% to 8%. Most of the decline in poverty came from one-off agricultural reforms placed in rural areas in the early 1980s and lower taxes on farmers. However, the speed of this decline slowed down in the early 90s, and again in the late 90s. Living conditions vary greatly between different area in China. Although safe drinking water is readily available to 90% of the population of large cities, it is only available to less 30% of poor rural areas. The difference in access to effective sanitation is even greater, with 90% of citizens in large cities having effect sanitation, in comparison to less that 10% in poor rural areas. The struggles of China’s growing rural migrant population is also cause for concern. A survey in 2000 found that 14% of rural migrants (about 20 million people) were living in poverty. These migrant workers were subjected to wrose living conditions than urban residents. This also affects the high maternal mortality rates in migrant women who are pregnant. (Tang, Meng, Chen, Bekedam, Evans, Whitehead)
Poverty is a huge social determinant. Poverty in the form of material deprivation (dirty water, poor nutrition) along with the lack of quality medical care can account for shortened life spans all over the world. However, solving the problem of poverty isn’t as easy as giving individuals clean water and food. It is socially determined who gets these resources. (Marmot, 2005). If you come from a long line of farmers and you live in a rural environment with less access to health care, you a less likely to get treated for diseases and illnesses as someone who lives in an urban area with more funding being put into hospitals and clinics. On the other hand, those who are poor and experience sexual trauma usually can not afford costly doctor’s visits and therapy sessions. Although these types of services are needed to improve the overall health of these individuals, they often must go without them because of the lack of access to them.
Lynch JW, Smith GD, Kaplan GA, House JS. Income inequality and mortality; importance to health of individual income, psychosocial environment, or material conditions. BMG 2000; 320: 1200-1204
Marmot, M. (2005). Social determinants of health inequalities.
Retrieved from http://anthropology.msu.edu/anp270-us18/files/2015/05/Social-determinants-of-health-inqualities-Marmot-2005.pdf
Tang, Shenglan, et al. “Tackling the challenges to health equity in China.” The Lancet 372.9648 (2008): 1493-1501.