Public health insurance and enrollees' diet structure in rural China

Heliyon. 2022 May 9;8(5):e09382. doi: 10.1016/j.heliyon.2022.e09382. eCollection 2022 May.

Abstract

This study examines the consumption-stimulation function of public health insurance (PHI) programs from the perspective of food consumption. We estimate the impact of enrollment in rural China's PHI program, the New Cooperative Medical Scheme (NCMS), on the insured's diet diversity and diet balance using panel data from the China Health and Nutrition Survey. Exploiting temporal and spatial variations in the program's local implementation, our difference-in-differences estimation (combined with propensity score matching in some analyses) reveals significant increases in the insured's diet diversity, overall diet balance, and nutrition intakes. However, the program's consumption-stimulation function is not entirely beneficial. While NCMS enrollment reduced the incidence of under-consumption of animal products and fruits, it raised that of over-consumption of grains, imposing potential health risks on the insured.

Keywords: Diet balance; Diet diversity; Difference-in-differences; Public health insurance; Rural China.