Treading Through COVID-19: Can Village Leader-Villager Relations Reinforce Public Trust Toward the Chinese Central Government?

Can village leaders' performance impact villagers' trust in the central government? Using village leader-villager relations at the village level as the explanatory variable, we examine a previously ignored source of public trust toward the Chinese government: face-to-face interactions with local leaders. We argue that, as the party-state's first point of contact with villagers, villagers use their interactions with village leaders as a proxy to determine the trustworthiness of China's central government. By analyzing the latest Guangdong Thousand Village Survey from 2020, we find that when villagers report better relations with village leaders, they also express greater trust in the Chinese central government. We find additional evidence for this relationship through open-ended interviews of villagers and village leaders. These findings advance our understanding of hierarchical political trust in China.

Measurement and Spatial Differentiation of Farmers' Livelihood Resilience Under the COVID-19 Epidemic Outbreak in Rural China.

Livelihood resilience is the ability of individuals, families or communities to withstand external shocks based on existing resources. It is an important research paradigm in sustainable development studies. The outbreak of COVID-19 and strict epidemic prevention policies have greatly impacted the production and life of rural farmers in China. The resilience of farmers' livelihoods during the epidemic is crucial to the sustainable development of their livelihoods and regional stability. This study uses classic buffer capacity, self-organization ability, and the capacity for learning a three-dimension livelihood resilience framework using the comprehensive index, OLS, and geographical detector methods based on Hubei province and neighboring Anhui and Chongqing. Rural household survey data investigate the background of epidemic hit the livelihood of farmers resilience and its spatial distribution pattern and identify the key influencing factors. The results show that the livelihood shock faced by farmers was higher than the risk of disease, and the overall level of livelihood resilience was low after the pandemic. Financial capital and social capital can effectively help farmers to eliminate livelihood difficulties. In contrast, natural capital has a limited driving force, and physical and human capital have no obvious impact. The spatial agglomeration differentiation is obvious, indicating that the impact of COVID-19 on livelihoods was closely related to the degree of local socio-economic development and geographical location. The results of this study provide targeted recommendations for the development of epidemic prevention and livelihood resilience policies tailored to local conditions, emphasizing the importance of boosting livelihood recovery at both the government and household levels.

Does online food shopping boost dietary diversity? Application of an endogenous switching model with a count outcome variable.

Increasingly, rural households in developing countries are shopping for food online, and the COVID-19 pandemic has accelerated this trend. In parallel, dietary guidelines worldwide recommend eating a balanced and healthy diet. With this in mind, this study explores whether online food shopping boosts dietary diversity-defined as the number of distinct food groups consumed-among rural households in China. Because people choose to shop for food online, it is important to account for the self-selection bias inherent in online food shopping. Accordingly, we estimate the treatment effects of online food shopping on dietary diversity using the endogenous switching model with a count outcome variable. The results indicate that online food shopping increases dietary diversity by 7.34%. We also find that education, asset ownership, and knowing the government's dietary guidelines are the main factors driving rural households' decisions to shop for food online.

Impact of the COVID-19 Outbreak on the Antibiotic Use Patterns among a Rural Community Population in Eastern China.

There are growing concerns that the coronavirus disease of 2019 (COVID-19) pandemic may change antibiotic use patterns and accelerate antibiotic resistance, but evidence from the community level is lacking. This study aims to estimate the impact of the COVID-19 outbreak on the antibiotic use patterns among a community population in Eastern China. A self-administered medicine diary was used to collect information on antibiotic use from July 2019 to June 2021 among a rural community in Eastern China. We analyzed the changes in antibiotic use patterns over five months from August to December 2019 and the corresponding months in 2020. The risk of antibiotic use and its changes were measured with the incidence rate (IR) and relative risk (RR). In total, 1111 participants were eligible for the final analysis (440 in 2019 and 671 in 2020). After the COVID-19 outbreak, antibiotic use increased by 137% (5.43 per 100 person months in the 2019 vs. 12.89 per 100 person months in the 2020), and after the adjustment of covariates, the adjusted RR was 1.72 (95% CI: 1.10~2.34). It was higher among those who were women (RR = 2.62), aged 35-59 years old (RR = 2.72), non-farmers (RR = 2.75), had less than six years of education (RR = 2.61), had an annual household income over CNY 100,000 (USD 14,940) (RR = 2.60), and had no history of chronic diseases (RR = 2.61) (all p < 0.05). The proportion of cephalosporins consumed increased from 54.29% in 2019 to 64.92% in 2020 (p = 0.011). Among those aged 35 years and older, the proportion of antibiotics obtained from medical facilities increased, while the proportion obtained from retail pharmacies, homes, and other sources decreased (all p < 0.05). The COVID-19 outbreak changed antibiotic use patterns in this study population (Eastern China) significantly. More efforts to monitor and enhance antibiotic stewardship activities at the community level are needed in future.

Can Mobile Payment Increase Household Income and Mitigate the Lower Income Condition Caused by Health Risks? Evidence from Rural China.

China has moved into a new stage of its fight against poverty, where the further raising of rural household income is of great importance. Health risk is one of the biggest obstacles to the poverty reduction progress. Therefore, how to cope with the negative effects of health risks has attracted the attention of scholars, especially in the background of the global outbreak of COVID-19. In this paper, we try to explore whether mobile payment, a new form of payment, can improve the income of rural households and mitigate the lower income condition caused by health risks in China. Using data from the 2017 China Household Finance Survey, we found: (1) mobile payment can substantially increase rural household income; (2) health risks will lower the income of rural residents, but mobile payment can lessen this negative effect. Mechanism analysis indicates that mobile payment is likely to ease liquidity constraints, increase social interaction, and stimulate entrepreneurship for rural households. We advised the government to promote mobile payment adoption in rural areas and enhance its design. Additionally, better medical resources should also be made available to rural households.

What catalyzes the proactive recovery of peasants from the COVID-19 pandemic? A livelihood perspective in Ningqiang County, China.

The livelihood recovery strategy is utilized for peasants during the COVID-19 pandemic. This strategy serves a salient role to help them recover from the relevant hazardous impacts. Disaster risk has been a major concern among hazards for the increasing likelihood of exposure and vulnerability, especially in the process of poverty alleviation in China. However, few studies have discussed the factors and mechanisms that influence peasants to adopt livelihood recovery strategies in the context of the COVID-19 pandemic in China. Based on a case study of Ningqiang County, China, this study explores the mechanisms that catalyze the proactive recovery of peasants from the COVID-19 pandemic from a livelihood perspective. Methodologically, the study proposes a framework that integrates the modified pressure-state-response (PSR) framework and the sustainable livelihoods approach (SLA), and it employs structure equation modeling (SEM) approach to examine how specific factors affect peasants to proactively adopt livelihood strategies to recover from the COVID-19 pandemic. The results indicate that the COVID-19 pressure significantly increases the risk perception of peasants and decreases their livelihood capital. Further, the decreased livelihood capital, the improvement of risk perception and supportive policy will promote peasants to adopt livelihood recovery strategies. Moreover, the results specify that risk perception and supportive policy mediate the relation between livelihood capital and recovery strategy. The findings will be beneficial for policymakers and researchers to understand the mechanisms that peasants adopt livelihood strategies to recover from disasters, and can serve as references for formulating disaster risk reduction and resilience policies.

Does the Application of ICTs Improve the Efficiency of Agricultural Carbon Reduction? Evidence from Broadband Adoption in Rural China.

Based on the Environmental Kuznets Curve (EKC) hypothesis, this paper examines whether rural broadband adoption affects agricultural carbon reduction efficiency (ACRE), using panel data from 30 Chinese provinces from 2011 to 2019. This paper achieves a measurement of ACRE by taking the carbon sink of agricultural as one of the desired outputs and using a Slacks-Based Measure (SBM) model and the global Malmquist-Luenberger (GML) index. The results show that: (1) Rural broadband adoption has a positive effect on ACRE. The relationship between the income of rural residents and ACRE was an inverted U-shaped, which confirms the EKC hypothesis. (2) Land transfer has a significant promoting effect on the relationship between rural broadband adoption and ACRE. When the land transfer rate is high, the positive effect of broadband adoption is obvious. (3) The positive effect of broadband adoption on ACRE was more obvious when farmers invested more in production equipment, that is to say, it has a significant positive moderating effect. As farmers in many developing countries suffer from increasingly frequent and severe extreme weather events, we believe that the results of this study also have implications for the implementation of agricultural carbon reduction and smart agricultural equipment roll-out in many countries.

Impacts of COVID-19 on Nutritional Intake in Rural China: Panel Data Evidence.

The COVID-19 pandemic introduced risks and challenges to global food and nutrition security. In this paper, we examine the impact of the COVID-19 pandemic on the nutritional intake of China's rural residents using panel data and a fixed effects model. The data were collected in 2019 and 2020 and covered nine provinces and 2631 households in rural China. The results reveal that an increase of 100 confirmed cases in a county resulted in a 1.30% (p < 0.01), 1.42% (p < 0.01), 1.65% (p < 0.01), and 1.15% (p < 0.01) decrease in per capita intake of dietary energy, carbohydrates, fats, and proteins, respectively. Moreover, the COVID-19 pandemic had a significant and negative effect on dietary macronutrient intake in the low-income group at the 5% level of significance. Our study indicates that the potential insufficient nutrition situation, nutritional imbalance, and dietary imbalance of low-income rural residents should be addressed appropriately.

Resource Allocation Equity in the China's Rural Three-Tier Healthcare System.

The rural three-tier healthcare system is an essential part of the Chinese healthcare service system. To ensure rural residents' equal access to such healthcare services, it is necessary to examine the current status of the healthcare system in rural China and formulate corresponding improvement suggestions. This study therefore collects the data from the China Health Statistics Yearbook, the China Health Yearbook and the China Statistical Yearbook between the years 2004 and 2021 to calculate the Gini coefficient (G), health resource density index (HRDI) and Theil index (T) first, and then perform the Mann-Kendall test afterwards to evaluate the equity of healthcare resource allocation comprehensively. This series of analysis helps in drawing the following conclusions: (1) county and county-level city medical and health institutions (CMHIs) show a higher development trend in comparison with township hospitals (THs) and village clinics (VCs); (2) VCs have higher institutional fairness, while for beds and personnel, CMHIs and THs are more fairly positioned; (3) more specifically for CMHIs and THs, personnel allocation is more fair than beds and institution allocations; (4) the density of healthcare resources in the eastern and central regions is higher than that in the western part, while the intra-regional distribution of beds and personnel in the west and central regions is better than that in the eastern region; (5) intra-regional differences are more significant than inter-regional differences and the fairness according to population distribution is higher than that of geographical area allocation. The results of this study provide theoretical basis for further optimizing the allocation of healthcare resources and improving the fairness of healthcare resources allocation from a macro perspective.

AIR QUALITY ASSESSMENT OF IMMIGRANT RURAL COMMUNITIES BASED ON THE THEORY OF HEALTHY AND SUSTAINABLE DEVELOPMENT - A CASE STUDY OF IMMIGRANT COMMUNITIES IN HUBEI, CHINA

In the context of the global outbreak of COVID-19, health issues have attracted worldwide attention. Building a healthy ecological environment is particularly important for human beings, and among the ecological environmental factors, air quality is particularly prominent. The study takes the air quality of newly-built immigrant relocation communities in Western China as the research object, and adopts a number of technical methods, such as professional laboratory test report, instrument test, calculation test and so on. Obtain the data of regional ambient air quality and building indoor air quality, and comprehensively judge the regional environment and building ventilation efficiency of the experimental point. So as to comprehensively grade the air quality of the experimental point. A number of technologies and methods are studied and integrated to form a comprehensive three-dimensional air quality detection technology integration. From the perspective of air quality inspection, provide technical support for the healthy and sustainable development of relocated new rural communities. It is of great practical significance to supervise and urge the construction of a healthy and sustainable new township village.

Cost-Utility Analysis of the Integrated Care Models for the Management of Hypertension Patients: A Quasi-Experiment in Southwest Rural China.

Background: Hypertension has become the second-leading risk factor for death worldwide. However, the fragmented three-level "county-township-village" medical and healthcare system in rural China cannot provide continuous, coordinated, and comprehensive health care for patients with hypertension, as a result of which rural China has a low rate of hypertension control. This study aimed to explore the costs and benefits of an integrated care model using three intervention modes-multidisciplinary teams (MDT), multi-institutional pathway (MIP), and system global budget and performance-based payments (SGB-P4P)-for hypertension management in rural China. Methods: A Markov model with 1-year per cycle was adopted to simulate the lifetime medical costs and quality-adjusted life-years (QALYs) for patients. The interventions included Option 1 (MDT + MIP), Option 2 (MDT + MIP + SGB-P4P), and the Usual practice (usual care). We used the incremental cost-effectiveness ratio (ICER), net monetary benefit (NMB), and net health benefit (NHB) to make economic decisions and a 5% discount rate. One-way and probability sensitivity analyses were performed to test model robustness. Data on the blood pressure control rate, transition probability, utility, annual treatment costs, and project costs were from the community intervention trial (CMB-OC) project. Results: Compared with the Usual practice, Option 1 yielded an additional 0.068 QALYs and an additional cost of $229.99, resulting in an ICER of $3,373.75/QALY, the NMB was -$120.97, and the NHB was -0.076 QALYs. Compared with the Usual practice, Option 2 yielded an additional 0.545 QALYs, and the cost decreased by $2,007.31, yielding an ICER of -$3,680.72/QALY. The NMB was $2,879.42, and the NHB was 1.801 QALYs. Compared with Option 1, Option 2 yielded an additional 0.477 QALYs, and the cost decreased by $2,237.30, so the ICER was -$4,688.50/QALY, the NMB was $3,000.40, and the NHB was 1.876 QALYs. The one-way sensitivity analysis showed that the most sensitive factors in the model were treatment cost of ESRD, human cost, and discount rate. The probability sensitivity analysis showed that when willingness to pay was $1,599.16/QALY, the cost-effectiveness probability of Option 1, Option 2, and the Usual practice was 0.008, 0.813, and 0.179, respectively. Conclusions: The integrated care model with performance-based prepaid payments was the most beneficial intervention, whereas the general integrated care model (MDT + MIP) was not cost-effective. The integrated care model (MDT + MIP + SGB-P4P) was suggested for use in the community management of hypertension in rural China as a continuous, patient-centered care system to improve the efficiency of hypertension management.

Off the COVID-19 Epicentre: The Impact of Quarantine Controls on Employment, Education and Health in China's Rural Communities

This study documents the COVID-19 disease-control measures enacted in rural China and examines the economic and social impacts of these measures. We conducted two rounds of surveys with 726 randomly selected village informants across seven provinces. Strict disease-control measures have been universally enforced and appear to have been successful in limiting disease transmission in rural communities. The infection rate in our sample was 0.001 per cent, a rate that is near the national average outside of Hubei province. None of the villages reported any COVID-19-related deaths. For a full month during the quarantine, the rate of employment of rural workers was essentially zero. Even after the quarantine measures were lifted, nearly 70 per cent of the villagers still were unable to work owing to workplace closures. Although action has been taken to mitigate the potential negative effects, these disease-control measures might have accelerated the inequality between rural and urban households in China.

Health, economic, and social implications of COVID-19 for China's rural population.

This study examines the effects of local and nationwide COVID-19 disease control measures on the health and economy of China's rural population. We conducted phone surveys with 726 randomly selected village informants across seven rural Chinese provinces in February 2020. Four villages (0.55%) reported infections, and none reported deaths. Disease control measures had been universally implemented in all sample villages. About 74% of informants reported that villagers with wage-earning jobs outside the village had stopped working due to workplace closures. A higher percentage of rural individuals could not work due to transportation, housing, and other constraints. Local governments had taken measures to reduce the impact of COVID-19. Although schools in all surveyed villages were closed, 71% of village informants reported that students were attending classes online. Overall, measures to control COVID-19 appear to have been successful in limiting disease transmission in rural communities outside the main epidemic area. Rural Chinese citizens, however, have experienced significant economic consequences from the disease control measures.

Pit latrines may be a potential risk in rural China and low-income countries when dealing with COVID-19.

According to the latest reports, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which caused coronavirus disease 2019 (COVID-19), was successfully isolated from the excreta (stool and urine) of COVID-19 patients, suggesting SARS-CoV-2 could be transmitted through excreta contaminated water. As pit latrines and the use of untreated excreta as fertilizer were common in rural China, we surveyed 27 villages of Jiangxi and Hubei provinces and found that pit latrines could be a potential source of SARS-CoV-2 water pollution. Recently, bats have been widely recognized as the source of SARS-CoV-2. There were many possible intermediate hosts of SARS-CoV-2, including pangolin, snake, bird and fish, but which one was still not clear exactly. Here, we proposed a hypothesis to illustrate the mechanism that SARS-CoV-2 might spread from the excreta of infected humans in pit latrines to potential animal hosts, thus becoming a sustainable source of infection in rural China. Therefore, we believe that abolishing pit latrines and banning the use of untreated excreta as fertilizer can improve the local living environment and effectively prevent COVID-19 and other potential waterborne diseases that could emanate from the excreta of infected persons. Although this study focused on rural areas in China, the results could also be applied to low-income countries, especially in Africa.