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Low-Income and Overweight in China: Evidence from a Life-Course Utility Model

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Low-Income and Overweight in China: Evidence from a Life-Course Utility Model A Service of Leibniz-Informationszentrum econstor Wirtschaft Leibniz Information Centre Make Your Publications Visible. zbw for Economics Ren, Yanjun; Castro Campos, Bente; Loy, Jens-Peter; Brosig, Stephan Article — Published Version Low-income and overweight in China: Evidence from a life-course utility model Journal of Integrative Agriculture Provided in Cooperation with: Leibniz Institute of Agricultural Development in Transition Economies (IAMO), Halle (Saale) Suggested Citation: Ren, Yanjun; Castro Campos, Bente; Loy, Jens-Peter; Brosig, Stephan (2019) : Low-income and overweight in China: Evidence from a life-course utility model, Journal of Integrative Agriculture, ISSN 2095-3119, Elsevier, Beijing, Vol. 18, Iss. 8, pp. 1753-1767, http://dx.doi.org/10.1016/S2095-3119(19)62691-2 This Version is available at: http://hdl.handle.net/10419/202528 Standard-Nutzungsbedingungen: Terms of use: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Documents in EconStor may be saved and copied for your Zwecken und zum Privatgebrauch gespeichert und kopiert werden. personal and scholarly purposes. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle You are not to copy documents for public or commercial Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich purposes, to exhibit the documents publicly, to make them machen, vertreiben oder anderweitig nutzen. publicly available on the internet, or to distribute or otherwise use the documents in public. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, If the documents have been made available under an Open gelten abweichend von diesen Nutzungsbedingungen die in der dort Content Licence (especially Creative Commons Licences), you genannten Lizenz gewährten Nutzungsrechte. may exercise further usage rights as specified in the indicated licence. https://creativecommons.org/licenses/by-nc-nd/4.0/ www.econstor.eu Journal of Integrative Agriculture 2019, 18(8): 1753–1767 Available online at www.sciencedirect.com ScienceDirect RESEARCH ARTICLE Low-income and overweight in China: Evidence from a life-course utility model REN Yan-jun1, 2, Bente Castro Campos1, Jens-Peter Loy1, Stephan Brosig2 1 Institute of Agricultural Economics, University of Kiel, Kiel 24118, Germany 2 Leibniz Institute of Agricultural Development in Transition Economies, Halle (Saale) 06120, Germany Abstract Previous literature has demonstrated that low-income people are more likely to settle for poor health choices in developed countries. By using income as a budget constraint and signal for future wellbeing in a life-course utility model, we examine the association amongst income and overweight. The data used for this study are from the China Health and Nutrition Survey (CHNS). Estimations are conducted for overweight initiation, cessation, and participation mirroring a decision to begin and a past decision to not terminate. Our findings propose that body weight and the likelihood of overweight commencement rise with additional income but at a diminishing degree, representing a concave relation; while the likelihood of overweight discontinuance declines with additional income but at an accelerating degree, suggesting a convex relation. We presume that, as opposed to developed countries, low-income people are less inclined to be overweight in China, a country in transition. This could be explained by an income constraint for unhealthy foodstuff. Nevertheless, it will switch when income surpasses the critical threshold of the concave or inverted U-shape curve indicating that low-income people appear to receive not as much utility from future health. Specifically, this adjustment seems to occur earlier for females and inhabitants of urban areas. Keywords: low-income, overweight, life-course utility, China relationship between low-income and health worldwide. In developed countries, it has been well documented that the 1. Introduction overall health risk behaviors are more prevalent for low- income individuals compared with other socioeconomic In recent decades, a growing number of studies have groups (see Lantz et al. et al. 1998). Income generally has investigated the effect of income on individuals’ health, a positive association with “good” health-related behaviors and policymakers are increasingly concerned about the (Benzeval et al. 2000; Binkley 2010; Jolliffe 2011). Lower- income people tend to make less healthy consumption choices. Consequently, they are more likely to suffer from Received 25 July, 2018 Accepted 24 April, 2019 nutrition-related health problems such as overweight and REN Yan-jun, E-mail: [email protected]; Correspondence obesity (Sobal and Stunkard 1989; Ball and Crawford 2005). Bente Castro Campos, E-mail: [email protected] From an economic perspective, the budget constraint © 2019 CAAS. Published by Elsevier Ltd. This is an open plays an important role in determining poor food consumption access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/). behaviors among low-income individuals (see Binkley 2010). doi: 10.1016/S2095-3119(19)62691-2 In the nutrition-related literature, notably, many researchers 1754 REN Yan-jun et al. Journal of Integrative Agriculture 2019, 18(8): 1753–1767 argue that low-income people cannot afford to purchase The body mass index (BMI) as an outcome of food healthy foodstuff, as healthy foodstuff is comparatively more consumption is a complicated health measure because it expensive (Drewnowski and Darmon 2005; Drewnowski and is related to a number of diseases (Jolliffe 2011); and it is Eichelsdoerfer 2010). Notwithstanding, Stewart et al. (2003) often used to determine whether an individual is overweight indicate that low-income households would not purchase or obese. According to the NHLBI (1998), being overweight more fruits and vegetables with additional income; even or obese may yield some potential health consequences, though most vegetables and fruits are fairly priced (Kuchler e.g., being at increased risk of morbidity from hypertension, and Stewart 2008). This evidence implies that income type 2 diabetes, stroke, osteoarthritis, respiratory problems, as a role of the budget constraint may not be the most and breast, colon, and prostate cancers. Furthermore, crucial determinant for interpreting differences in unhealthy overweight and obesity are also found to be associated with food consumption or health outcomes among individuals increases in medical expenditure (Konnopka et al. 2011; situated at different income levels in developed countries. Mora et al. 2015). Thus, we use overweight to examine Based upon a life-course utility model, Binkley (2010) puts individuals’ unhealthy food consumption behaviors in this forward another hypothesis: Low-income people have a study. comparatively higher direct utility from present consumption Based on the life-course utility model proposed by but a less intense desire for longevity in the future utility; Binkley (2010) for unhealthy food consumption, the main thus, they have a higher likelihood to consume unhealthy contribution of this study is to shed light on the relationship food or to have poor consumption habits. between income and overweight in the transitional economy However, the opposite is true for developing countries. of China through estimating overweight initiation, cessation, For instance, many studies show that overweight is relatively and participation. Using the data from the CHNS, we find more widespread among high-income individuals (Popkin that body weight and the likelihood of overweight initiation 1999; Monteiro et al. 2004a; Fernald 2007). With the rise with additional income but at a diminishing degree, development of the economy and increasing incomes, representing a concave relation; while the likelihood of total calories consumed has been enhanced accordingly overweight cessation declines with additional income but at (Ogundari and Abdulai 2013). As a result, overweight and an accelerating degree, suggesting a convex relation. Thus, obesity have risen and become a major health challenge we conclude that as opposed to developed countries, low- in many developing countries (Popkin 1999; Popkin and income people are less inclined to be overweight in China, Ng 2007). In China, dietary preference has changed a country in transition. dramatically from high-carbohydrate food towards high- The remainder of the paper is organized as follows. The energy food (Du et al. 2004; Batis et al. 2014), which theoretical framework regarding Binkley’s (2010) life-course increases the risk of overweight. One recent study by utility model, the empirical model, and the data used are Tafreschi (2015) indicates that approximately 30% of presented in Section 2. Estimation results are discussed in individuals are overweight or obese in contemporary China. Section 3, and the last section concludes. In a transitional economy like China, the relation between unhealthy food consumption and income might be a situation 2. Methods and data that lies in-between developing and developed societies. The income effect on body weight might change from a 2.1. Theoretical framework positive sign to negative with economic development and rising income. However, to the best of our knowledge, very In neoclassical demand analysis, the base of a rational few studies have examined this transition (Pampel et al. consumer’s decision on what to consume is the utility 2012; Hruschka
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