Poverty, Parental Ill Health and Children’s Access to Schooling in Rural Gansu, China

As reforms to China's health care system have raised costs to users in recent decades, studies suggest that ill health has become intimately tied to social stratification as both a precipitant and a consequence of poverty. The problem may be particularly pronounced in China’s poorest rural populations. Focusing on Gansu Province, one of China’s poorest, this paper investigates the possibility that the ill health of adults also carries cross-generational consequences, through interfering with the education of children. Analyzing a survey of children in 100 rural villages, we find that parental illness is experienced disproportionately by the most economically vulnerable children. Moreover, parental illness can be linked to children’s educational access and experience in several ways. Children with an ill father are less likely to be enrolled than others; prior parental ill health is associated with lower household educational spending; and ill parents are more likely to report borrowing for their children’s education. Children with ill mothers are more likely to be absent and to work longer in the household. Children with ill mothers perform more poorly in math, and those with ill mothers and ill fathers are more likely to work for wages, on average, but these effects are accounted for by the deeper impoverishment of households with ill parents, compared to other households. Results suggest that ill health may have a ‘spillover’ effect on the long-term educational (and thus economic) prospects of the next generation. A change in this situation depends heavily on the success of new government initiatives to reduce health care and education cost burdens on the poor.