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Youths of the Chinese Cultural Revolution: A Study on Early Life Sent-down Experience and Later Life Health



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Li, Liming 


The study of health inequalities has increasingly recognised that experiences in early life may have consequences for health problems in later life that unfold across the life course. Despite the accumulating evidence in the life course study on the early origins of adult health, the nature and strength of associations vary considerably. This thesis adds to existing literature by focusing on aversity in adolescence during the quasi-experiment of the Chinese Cultural Revolution (CR, 1966-1976), which led to the temporary shut-down of the national educational system and approximately 17 million urban youths being “sent-down” to do manual labour in rural China.

I use data from the 2010 China Family Panel Studies to examine the early origins of later adult health, by integrating inter- and intra-cohort analysis and intergenerational perspectives. First, I quantify the impact of the sent-down experience on later life health by comparing the CR cohort (born in 1947-1960) and their adjacent cohorts (born in 1935-1946 and 1961-1972), using a regression discontinuity design. I find no causal evidence that the sent-down experience influenced older adult health. Second, I explore intra-cohort heterogeneity by analysing three subgroups of the CR cohort: those never sent-down (stayers), those sent-down for no more than 5 years (early-returners) and those sent-down who returned home after 5 or more years (late-returners). Using regression analysis, I find a significant negative health penalty of send down for late- returners. However, propensity score matching indicates that such disadvantages are due to the selection of coming from politically unfavourable family backgrounds during the CR in the first place. Third, I examine intergenerational reverse transfer of children’s education on parents’ health, with the surprising finding that children’s higher education is negatively associated with parental health for parents with sent-down experience. Instrumental variable analysis based on educational expansion reform indicates that the health impact of children’s education is due to the selection effects of parental midlife circumstances.

Taken together, these findings uncover the complex nature of the associations between early adversity and later life health in post-CR China, a society that continues to feature rapid social and institutional change and high levels of family integration. The absence of health penalty from sent-down experience in the CR case also indicates that late adolescence may not be as critical or sensitive as earlier life stages when studying long- term health consequences from adverse experiences.





Scott, Jacqueline


Early life experience, later life health, China


Awarding Institution

University of Cambridge