The Study On Public Health Crisis And Middle-age And Older People’ Health Human Capital

Public health crisises caused by emerging infectious diseases,such as 2003 severe acute respiratory syndrome(SARS)outbreak and coronavirus disease 2019(COVID-19)pandemic,cause substantial damage to public health and the global economy.Middle-age and older people were at a higher risk of SARS or COVID-19 infection,partly because they were more likely to have severe underlying medical conditions such as heart conditions,respiratory disease,and diabetes than younger people.So the epidemics,such as SARS,may have a far-reaching impact on Middle-age and older people.At the same time,the population is rapidly ageing,how to achieve the goals of healthy aging is an urgent and important things for China.Cognitive abilities is a crucial component of the health human capital for middle-aged and elderly.Cognitive impairment is a leading cause of disability and demand for long-term care worldwide,and could result in the inability to live independently.The increasing trend of dementia prevalence imposes a substantial burden for families,caregivers,and health care systems in China.Therefore,how to preserve the cognitive abilities of the middle-aged and elderly is a crucial key to achieving the goals of healthy aging.With the backgrounds of COVID-19 pandemic and aging population,This paper puts forward three research questions form the perspective of health human capital:(1)Does the public health crisis have an impact on the cognitive abilities of the middle-aged and elderly?(2)Does the public health crisis have an impact on individual health behaviors?(3)Does the public health crisis have an impact on government supply of medical resources?The three research questions above is not isolated,but correlated.Following the three research questions,and based on the theoretical framework of Post-traumatic Growth theory,this paper examines the long-term association between exposure to the severe acute respiratory syndrome(SARS)outbreak,which is similar to the COVID-19 pandemic,and middle-age and older Chinese adults’ cognition.This paper also exploit the spatial and temporal variation of the 2003 SARS outbreak,and show that areas with a higher incidence of SARS experienced better health behaviors and larger increases in the supply of medical resources.Finally,this paper put forward policy recommendations to reduce the negative health impact of public health crisises for middle-aged and elderly people,and to achieve the goals of healthy aging.The main body of this paper consists of seven chapters.The first Chapter is the introduction.The second and third chapters is the basis for the analysis of this paper,which are literature reviews and theoretical framework analysis respectively.The fourth Chapter is to explore the long-term association between exposure to the SARS outbreak and middle-age and older Chinese adults’ cognition.The Chapter 5is to exploit the relationship between exposure to the SARS outbreak and health behaviors.The Chapter 6 is to exploit the relationship between exposure to the SARS outbreak and the supply of medical resources.The Chapter 7 are the conclusions and policy recommendations.The main contents of each chapter are as follows:The second chapter is literature reviews,which systematically reviews and combs the relevant domestic and foreign literature,including the determinants of cognitive level,health effects of exogenous shock,health effects of epidemics and the mechanisms between epidemics and health.This paper expounds the main innovation and marginal contribution by refining the shortcomings of existing literature.The third chapter is the background of SARS outbreak and the theoretical framework of post-traumatic growth theory,which detailedly introduces the background of SARS outbreak,reviews post-traumatic growth theory,and proposes research hypothesis to be tested by the following empirical researches.The fourth chapter uses the nationally representative longitudinal survey data of CHARLS to investigate the impact of community exposure to SARS outbreak on middle-age and older adults’ cognition by using the methods of linear regression models.In the robust analysis,this paper uses growth curve model and instrumental variable method to test the robustness of the results.This paper also explores the heterogeneity of the impacts of community exposure to SARS on the cognition of the middle-aged and elderly,and investigates the mechanism between exposure to SARS and cognition from the perspective of social engagement.Based on the perspective of health behaviors to explore the mechanism between exposure to SARS and cognition,the fifth chapter uses the administrative data of UHS to investigate the impacts of exposure to SARS on health behaviors by using DID model.This paper also explores the heterogeneity of the impacts of exposure to SARS on health behaviors.The results show that exposure to SARS could facilitate the adoption of health behaviors,such as increasing expenditure on health care,and doing more exercise.Based on the perspective of health services of government to explore the mechanism between exposure to SARS and cognition,the sixth chapter uses the prefecture-level data to investigate the impacts of exposure to SARS on the supply of medical resources by using FE model.This paper also explores the heterogeneity of the impacts of exposure to SARS on the supply of medical resources.The results show that exposure to SARS has a positive impacts on supply of medical resources,such as increasing the supply of hospital beds.Through the above analysis,this paper draws the following main conclusions:Firstly,community exposure to SARS was associated with increased levels of social engagement(making contacts with adult children and participation in social activities),which in turn were associated with better cognitive functioning in middle-age and older Chinese adults.Moreover,this paper finds that the impacts of community exposure to SARS on cognition has obvious heterogeneity in terms of age,gender,and urban-rural type of residence.Secondly,in terms of health behaviors,exposure to SARS has significantly increased the household expenditure for health cares and physical exercises of urban residents,and also significantly increased the ratio of expenditure for health cares and physical exercises to consumption expenditure of urban residents.That is,the public health crisis has raised the health awareness and improved the health behavior of urban residents.Moreover,this paper finds that the impacts of exposure to SARS on health behaviors has obvious heterogeneity in terms of age and education.Therefore the improvements of health behaviors may be one of mechanism between exposure to SARS and the cognitive fitness.Finally,in terms of health services of government,the impacts of seriously exposure to SARS has significantly increased the supply of medical resources,such as the supply of hospital beds.This paper also finds that impacts of exposure to SARS on supply of medical resources has obvious heterogeneity in terms of area and extents of urbanization.Therefore the increasing supply of medical resources may be one of mechanism between exposure to SARS and the cognitive fitness.Public health crisis,such as SARS outbreak and COVID-19 pandemic,has had devastating impacts on population health,human lives,global economy,and social inequalities,among others.Nevertheless,our findings suggest that at least for pandemic survivors,post-traumatic growth is possible.An important challenge that lies ahead is how to seize the momentum of positive changes in health and social behaviors to make them last.