In China, there's no freedom of movement, even between country and city

A man walks past a billboard in Beijing. Image: Getty.

In recent years, China has gained a global reputation for its juggernaut economy and breathtaking social change. Yet beneath this shining veneer, an outdated Maoist institution continues to define the life chances of Chinese citizens: it’s called “hukou”.

Hukou is a kind of passport system, which limits access to public services, based on the birthplace of the holder. It was first established in 1954 to immobilise China’s large rural population, as China’s Chairman Mao Zedong sought to contain any possible challenges to the Chinese Communist Party’s (CCP) new autocratic regime. The result was a highly segregated society.

Having an urban hukou allowed citizens to enjoy privileged access to public services such as education, health, housing and pensions. Meanwhile, citizens with a rural hukou were more or less deprived of access to the country’s limited welfare system, and unable to move freely to China’s more affluent urban centres along the east coast.

Rush to the city

After Mao died in 1976, realities on the ground gradually began to change. Young Chinese people who had been sent to the countryside during the Cultural Revolution (from 1966 to 1976) were returning to the cities. Throughout the 1980s and early 1990s, China’s economy picked up steam, drawing millions of rural migrants into urban industrial clusters to become low-wage labourers.

Rural dwellers were attracted by the new job opportunities, which promised an escape from abject poverty in China’s countryside. But migrating from the countryside to the city came with its own challenges. While it provided a pathway for social upward mobility, rural migrants routinely experienced discrimination at the hands of Chinese city-dwellers. Rural migrants mostly carried out dirty, dangerous and demeaning jobs, which urbanites were not willing to do.

Walking away. Image: Renato @ Mainland China/Flickr/creative commons.

To make matters worse, the strict hukou system made it almost impossible for rural migrants to bring their families with them to the city. As a result, China’s countryside is now populated primarily by elderly people, women and children. In fact, it’s estimated that more than 61m children have been left behind in China’s villages, to be looked after by older siblings or grandparents. Many suffer from psychological problems caused by the long-term separation from their parents.

The CCP has been mindful of these challenges, and has introduced economic policies – such as Building a New Socialist Countryside – to improve infrastructure and economic development in rural China. But these investments have neither stemmed the flow of rural-urban migration, nor addressed the core issue of increasing social inequality.

The road to reform

In recent years, the CCP has announced piecemeal reforms to the hukou system, to try to allow some of the 236m migrants living away from home to acquire an urban hukou and gain extra entitlements. A number of municipalities have introduced an Australian-style, points-based system, which means applicants who meet certain criteria become eligible for urban hukou.

The government has encouraged cities to relax their criteria, but requirements for first-tier cities such as Beijing and Shanghai remain far more onerous than those for second and third-tier cities in other parts of China. What’s more, additional caps on rural migrants means that in practice, only a fraction of those who are eligible are actually granted urban hukou.

Hukou reforms are also complicated by the fact that land reform has made little progress in China. Rural Chinese are wary of giving up their rural hukou, which entitles them to a small plot of land. Such land use rights provide a limited safety net for rural Chinese – particularly those who do not enjoy the benefits of an urban pension.

Tough choice: rural hukou (left) and Beijing temporary residence permit (right). Image: Rolex Dela Pena/EPA.

In China, the distinction between citizens with rural or urban hukou is increasingly seen as arbitrary. In 2008, some Chinese citizens called on the CCP to abolish the system in its entirety. Signatories of Charter 08 – a progressive manifesto for the future of China – said that an alternative system should be established, which “gives every citizen the same constitutional rights and the same freedom to choose where to live”.

So far, the CCP has ignored calls to abolish the hukou system. Some authors of Charter 08 have even been imprisoned. Meaningful reform of the hukou system will require the party to be more open to bottom-up, civil society initiatives and policy advice, to level the playing field for both rural and urban Chinese citizens.The Conversation

Andreas Fulda is assistant professor in the School of Politics & International Relations/Faculty of Social Sciences at the University of Nottingham.

This article was originally published on The Conversation. Read the original article.


 

 
 
 
 

What’s killing northerners?

The Angel of the North. Image: Getty.

There is a stark disparity in wealth and health between people in the north and south of England, commonly referred to as England’s “north-south divide”. The causes of this inequality are complex; it’s influenced by the environment, jobs, migration and lifestyle factors – as well as the long-term political power imbalances, which have concentrated resources and investment in the south, especially in and around London.

Life expectancy is also lower in the north, mainly because the region is more deprived. But new analysis of national mortality data highlights a shockingly large mortality gap between young adults, aged 25 to 44, living in the north and south of England. This gap first emerged in the late 1990s, and seems to have been growing ever since.

In 1995, there were 2% more deaths among northerners aged 25 to 34 than southerners (in other words, 2% “excess mortality”). But by 2015, northerners in this age group were 29% more likely to die than their southern counterparts. Likewise, in the 35 to 44 age group, there was 3% difference in mortality between northerners and southerners in 1995. But by 2015, there were 49% more deaths among northerners than southerners in this age group.

Excess mortality in the north compared with south of England by age groups, from 1965 to 2015. Follow the lines to see that people born around 1980 are the ones most affected around 2015.

While mortality increased among northerners aged 25 to 34, and plateaued among 35 to 44-year-olds, southern mortality mainly declined across both age groups. Overall, between 2014 and 2016, northerners aged 25 to 44 were 41% more likely to die than southerners in the same age group. In real terms, this means that between 2014 and 2016, 1,881 more women and 3,530 more men aged between 25 and 44 years died in the north, than in the south.

What’s killing northerners?

To understand what’s driving this mortality gap among young adults, our team of researchers looked at the causes of death from 2014 to 2016, and sorted them into eight groups: accidents, alcohol related, cardiovascular related (heart conditions, diabetes, obesity and so on), suicide, drug related, breast cancer, other cancers and other causes.

Controlling for the age and sex of the population in the north and the south, we found that it was mostly the deaths of northern men contributing to the difference in mortality – and these deaths were caused mainly by cardiovascular conditions, alcohol and drug misuse. Accidents (for men) and cancer (for women) also played important roles.

From 2014 to 2016, northerners were 47% more likely to die for cardiovascular reasons, 109% for alcohol misuse and 60% for drug misuse, across both men and women aged 25 to 44 years old. Although the national rate of death from cardiovascular reasons has dropped since 1981, the longstanding gap between north and south remains.

Death and deprivation

The gap in life expectancy between north and south is usually put down to socioeconomic deprivation. We considered further data for 2016, to find out if this held true for deaths among young people. We found that, while two thirds of the gap were explained by the fact that people lived in deprived areas, the remaining one third could be caused by some unmeasured form of deprivation, or by differences in culture, infrastructure, migration or extreme weather.

Mortality for people aged 25 to 44 years in 2016, at small area geographical level for the whole of England.

Northern men faced a higher risk of dying young than northern women – partly because overall mortality rates are higher for men than for women, pretty much at every age, but also because men tend to be more susceptible to socioeconomic pressures. Although anachronistic, the expectation to have a job and be able to sustain a family weighs more on men. Accidents, alcohol misuse, drug misuse and suicide are all strongly associated with low socioeconomic status.

Suicide risk is twice as high among the most deprived men, compared to the most affluent. Suicide risk has also been associated with unemployment, and substantial increases in suicide have been observed during periods of recession – especially among men. Further evidence tells us that unskilled men between ages 25 and 39 are between ten and 20 times more likely to die from alcohol-related causes, compared to professionals.

Alcohol underpins the steep increase in liver cirrhosis deaths in Britain from the 1990s – which is when the north-south divide in mortality between people aged 25 to 44 also started to emerge. Previous research has shown that men in this age group, who live in the most deprived areas, are five times more likely to die from alcohol-related diseases than those in the most affluent areas. For women in deprived areas, the risk is four times greater.


It’s also widely known that mortality rates for cancer are higher in more deprived areas, and people have worse survival rates in places where smoking and alcohol abuse is more prevalent. Heroin and crack cocaine addiction and deaths from drug overdoses are also strongly associated with deprivation.

The greater number of deaths from accidents in the north should be considered in the context of transport infrastructure investment, which is heavily skewed towards the south – especially London, which enjoys the lowest mortality in the country. What’s more, if reliable and affordable public transport is not available, people will drive more and expose themselves to higher risk of an accident.

Deaths for young adults in the north of England have been increasing compared to those in the south since the late 1990s, creating new health divides between England’s regions. It seems that persistent social, economic and health inequalities are responsible for a growing trend of psychological distress, despair and risk taking among young northerners. Without major changes, the extreme concentration of power, wealth and opportunity in the south will continue to damage people’s health, and worsen the north-south divide.

The Conversation

Evangelos Kontopantelis, Professor in Data Science and Health Services Research, University of Manchester

This article is republished from The Conversation under a Creative Commons license. Read the original article.