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The Wealthier, the Healthier? Public Pension and Obesity Risks Among Older Adults in Rural China

Friday, November 14, 3:30 to 5:00pm, Property: Grand Hyatt Seattle, Floor: 1st Floor/Lobby Level, Room: Portland A

Abstract

Obesity is a prominent challenge among ageing populations, particularly prevalent among older adults in rural China. It is associated with increased risks of mortality, cardiovascular disease, and type 2 diabetes. Previous research has identified factors such as depression, diet, physical labor, and chronic diseases as key contributors to obesity. However, existing research pays little attention to how obesity among older adults is affected by non-health policies. This study examines whether China's public pension affects obesity in older adults and explores the mechanisms through which this impact occurs. We focus on the New Rural Pension Scheme (NRPS), a public pension policy initiated by the Chinese government to provide universal coverage for older adults in rural areas. This study incorporates the Body Mass Index (BMI) and the Body Roundness Index (BRI), which is a more accurate measurement of obesity among older adults. We explore how pension income affects obesity indicators through economic and behavioral pathways, including reduced physical labor intensity, improved dietary expenditure patterns, and the change in health-related behaviors such as smoking and alcohol consumption. The study exploits the natural experiment of the eligibility for receiving the NRPS. We employ a regression discontinuity design (RDD) to address endogenous bias, using age 60 as the cutoff for pension receipt. Furthermore, we apply quantile regression to examine the effects of pension income at various points in the distribution of obesity indicators. This study uses data from the China Health and Retirement Longitudinal Study (CHARLS), which is a nationally representative sample of older adults in China. The findings indicate that receiving a pension from the NRPS significantly alleviating obesity-related risks, as measured by BMI and BRI. Quantile regression results suggest significant improvements in obesity indicators at lower quantiles, while effects at higher quantiles are not significant. This suggests that the NRPS does not increase the risks of obesity but rather promotes healthier and more normative weight levels. Mediation analysis further reveals that these effects occur through two channels: income pathways, i.e., increases in food expenditure, as well as behavioral pathways, i.e., adoption of healthy habits, reduction of unhealthy behaviors and physical labor. Moreover, heterogeneity analysis demonstrates gender and regional differences. These findings suggest that public pension policies have beneficial impacts on reducing obesity risks among ageing populations. By integrating BRI and BMI measurements, we offer a more accurate assessment of obesity among the ageing population in rural China. The study shows income and behavioral pathways for the health impacts of public pension policy. The findings offer empirical foundation and policy insights for improving public pension policies and advancing health equity among aging populations.

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