On the Public Health Risks of Urbanization

Jaffe points out that the hukuo two-tiered population structure described recently by Nate Berg is a major barrier to access to adequate health care for newly urbanized migrants. This presents a potential crisis both for rural-born migrants and their city-dwelling neighbors.

"In 2006, for instance, only about 28 percent of the entire urban population were covered by the country's primary basic urban health-care insurance - with migrant workers the bulk of those without coverage."

As Jaffe notes, "Urbanization typically results in a number of public health risks. The city environment can lead to injury (say, through increased motorization or new occupations) or illness. When the process connects places that were typically isolated, as is the case with rural-urban migration in China, the chances of spreading communicable diseases increase. Moving to a city also carries risks of non-communicable illnesses, including psychiatric disorders."

The study authors report that community health centers are being utilized to offer basic health services to migrants in Beijing, but that elsewhere, "progress has been slow."

With the hukou system seen as a barrier to addressing the root causes of many health issues by preventing upward economic mobility for rural migrants, and as a barrier to access to adequate treatment for those health problems once they arise, perhaps it is time for Chinese officials to address the problem at its root with comprehensive hukou reform.