Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. Christine Moser

Second Advisor

Dr. Wei-chiao Huang

Third Advisor

Dr. Paul Clements


Health and education, randomized controlled trial, inequality, shadow education, China, nutrition and rural China


The increasing inequality between rural and urban China has raised many concerns for Chinese scholars. A large gap exists not only in income but in health and education. The rural-urban disparities in health and education may contribute to greater income inequality in the future, thus leading to a vicious cycle. This study explores the factors that contribute to the increasing inequality in health and education between rural and urban China.

Using a randomized controlled trial in Shaanxi province, the first chapter studies the effectiveness of a supplemental meal program in improving students’ development outcomes. This study also compares the impact of the supplemental meal program on students’ health and educational outcomes with other nutritional interventions: the parent training program and the vitamin supplement program. Using a fixed effects model, I find that the supplement breakfast program is effective in improving students’ health outcomes, but not their educational performances. Compared with other intervention methods, it has similar impacts to a vitamin supplement program. All three nutritional interventions are ineffective in improving students’ educational performances. The parent training program has no impact on any student development outcome.

The second chapter uses the China Family Panel Survey (CFPS), a nationally representative survey to investigate net impact of parental migration on left children’s health and nutrition outcomes. My measurements of children’s health outcomes are height-for-age z-score (HAZ), weight-for-age z-score (WAZ) and self-perceived health rating. The results show that absence of both parents has a significant negative impact on children’s health outcomes in terms of HAZ and self-rated health status. These findings suggest that left-behind children are worse off in terms of physical development and self-perceived health status when compared to their peers who live with their parents. Furthermore, there is a gender disparity in the effect of parental absence on children’s health outcomes. The adverse impact is more prominent for boys than girls, indicating that boys are in a more disadvantaged position than girls under the trend of increasing internal migration in China.

The third chapter uses CFPS to study the social economic determinants of shadow education and its impact on student’s academic performance. Moreover, it uses a logistic regression model to study what social-economic factors determine the participation of shadow education. Findings reveal that children’s nutrition conditions, family income, mother’s education, parent’s expectation, whether living in a rural or urban area and whether attending a key school all have a positive impact on the shadow education participation. As for the effectiveness of shadow education in improving children’s academic performance, the results are mixed. I find no significant impact of shadow education on children’s standardized test scores, when using the private tutoring participation dummy variable in the regression alone. After including the time and money spent on shadow education to control for variation in shadow education’s quantity and quality, I find that shadow education has a significant positive impact on children’s math test scores but not word test scores.

Access Setting

Dissertation-Open Access

Included in

Economics Commons