Shorenstein APARC's annual overview for academic year 2017-18 is now available.
Download it for information on the wide variety of Center research from the the past academic year, Shorenstein APARC's educational activities, and major Center events like the Shorenstein Journalism Award.
How can we make sense of the tragedy in Syria? Northwestern University political scientist Wendy Pearlman has conducted open-ended interviews with more than 300 displaced Syrians across the Middle East and Europe from 2012 to 2017. She has brought together these personal stories in the acclaimed new book, We Crossed a Bridge and It Trembled: Voices from Syria (HarperCollins 2017). In a talk dated February 7, 2018, Pearlman shared a selection of voices from the book, along with her own commentary and analysis, to explain the origins and evolution of the Syrian conflict, as well as what it has been like for the ordinary people who have lived its unfolding. Co-hosted by the Program on Arab Reform and Democracy and the Abbasi Program in Islamic Studies, the talk offered a humanistic interpretation of the current conflict in Syria and how it has transformed those who have experienced it. The video of the talk is available through the link below.
We demonstrate the importance of intertemporal marginal propensities to consume (iMPCs) in disciplining general equilibrium models with heterogeneous agents and nominal rigidities. In a benchmark case, the dynamic response of output to a change in the path of government spending or taxes is given by an equation involving iMPCs, which we call the intertemporal Keynesian cross. Fiscal multipliers depend only on the interaction between iMPCs and public deficits. We provide empirical estimates of iMPCs and argue that they are inconsistent with representative- agent, two-agent and one-asset heterogeneous-agent models, but can be matched by models with two assets. Quantitatively, models that match empirical iMPCs predict deficit-financed fiscal multipliers that are larger than one, even if monetary policy is active, taxation is distortionary, and investment is crowded out. These models also imply larger amplification of shocks that involve private borrowing, as we illustrate in an application to deleveraging.
In Beijing’s bustling Chaoyang District stands a multi-story building known as the Gonghe Senior Apartments: a 400-bed nursing home for middle-income seniors who are disabled or suffer from dementia. Why is Gonghe unique and why is it worth considering? Because Gonghe is a public-private partnership (PPP), a collaborative organizational structure supported by the District Civil Affairs Bureau Welfare Division that donated the land and building and the nonprofit Yuecheng Senior Living that operates the facility. And because PPPs like Gonghe might just be the right model to address the challenges surrounding elderly care in China as well as in other nations that face a looming burden of population aging.
This was a core message shared by Alan Trager, founder and president of the PPP Initiative Ltd., who spoke at a special workshop organized by Shorenstein APARC’s Asia Health Policy Program (AHPP). Focused on PPPs in health and long-term care in China, the workshop was part of a two-day convening related to the Innovation for Healthy Aging project, a collaborative research project led by APARC Deputy Director and AHPP Director Karen Eggleston that identifies and analyzes productive public-private partnerships advancing healthy aging solutions in East Asia and other regions.
The Innovation for Healthy Aging project is driven by the imperative to respond to a world that is aging rapidly. This demographic transition, reminded Trager at the opening of his talk, is a defining issue of our time, as aging is a multisectoral issue that increases the demand for health care, long-term care, and a large number of other social services. The aging challenge is exacerbated by its convergence with the rising prevalence of non-communicable diseases (NCDs), also known as chronic diseases. For while NCDs affect all age groups, they account for the highest burden among the elderly.
China: Ground Zero for Global Aging
Alan Trager discusses health and long-term care in China in the GSB's Highly Immersive Classroom
Alan Trager discusses health and long-term care in China in the GSB's Highly Immersive Classroom (Photo: Noa Ronkin)
The need to advance healthy aging and NCD prevention is a matter of grave concern in China, whose older population is larger than in any other country. Moreover, the aging challenge in China is interwoven with unique social trends. In particular, filial piety—which, for thousands of years, has been a fundamental family value and a mainstay of health and elder care—is under pressure, as young people strive to balance the demands of careers, fewer children per family, and migrating to cities for school and work, without affordable housing or long-term care financing support for their parents and other elderly relatives, who often stay in rural areas.
China’s health system is yet to adapt to the shift in the disease burden and health care needs driven by the aging population. Its existing health insurance programs are insufficient for outpatient management and care of chronic conditions, and as Trager emphasized, there is a lack of investment in training geriatric medicine professionals and incorporating geriatric principles into clinical practice.
How can China meet the high demand for elder care, increase workforce capacity, and promote healthy aging?
The answer, claims Trager, lies in developing multisector, integrated solutions to the challenges posed by population aging. While system-level efforts, such as building the social protection system and sustaining universal health coverage, continue to be led by the government, PPPs can play a major role in capacity building to ensure the sustainability of such systems through the advancement of technology, human resources, and innovation. Trager shared PPP Initiative Ltd.’s recent efforts to develop PPP solutions for aging populations in China and elsewhere. The workshop was held on October 10 at the Stanford GSB’s Highly Immersive Classroom, which is equipped with advanced video conferencing technology that allows participants in Palo Alto and at the Stanford Center at Peking University to collaborate in real-time. Experts from Beijing joined the discussion and followed Trager’s presentation with comments on how to move from awareness to action.
Private Efforts, Public Value
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From left to right: John Donahue, Karen Eggleston, Richard Zeckhauser. (Photo: Thom Holme)
Public-private collaborations—or rather collaborative governance–in China as well as in the United States is the subject of an upcoming volume co-authored by Eggleston with Harvard scholars Richard Zeckhauser and John Donahue. Both Zeckhauser and Donahue joined Eggleston the following day, October 11, at an AHPP-hosted seminar to discuss this upcoming publication, titled Private Roles for Public Goals in China and the United States: Contracting, Collaboration, and Delegation.
Eggleston, Donahue, and Zeckhauser define collaborative governance as private engagement in public tasks on terms of shared discretion, where each partner bears responsibilities for certain areas. Their upcoming book explores public-private collaborations in China and the United States, two countries where public needs require solutions that far outstrip the capacities of their governments alone. Beyond considering merely health and elderly care, the book features research into public and private roles in the governance of multiple other sectors, including education, transport infrastructure, affordable housing, social services, and civil society.
At the seminar, the three scholars reviewed different models of private efforts providing public value, outlined the justifications for collaborative governance, and explained some of the conditions that make such collaborative partnerships productive and valuable. They emphasized the need to account for the unique contexts in China and the United States and to steer clear of one-size-fits-all solutions.
Imperative for the Young Generation
One thing, they all agree, applies to both countries: government collaboration with private entities is inevitable if China and the United States are to achieve their articulated goals and meet rapidly increasing demand for high-end public services.
This sentiment echoed a claim Trager made the preceding day: a tidal wave of noncommunicable diseases in an aging world is approaching us quickly and governments cannot handle it alone. Young people must care about advancing creative solutions to this pressing problem because they will be the ones who will pay for the consequences if we get it wrong.
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Senior citizens relax on the Duolun Road in Shanghai, China.
Using rural household panel data from three Chinese provinces, this paper identifies determinants of long-term poverty and tests the duration dependence on the probability to leave poverty. Special emphasis is given to the selection of the poverty line and inter-regional differences across provinces. Results suggest that the majority of population seems to be only temporary poor. However, the probability to leave poverty for those who were poor is differently affected by poverty duration across provinces ranging from no duration dependence in Zhejiang to highly significant duration dependence in Yunnan. The number of nonworking family members, education, and several village characteristics seem to be the most important covariates.
China’s 2010 census revealed a population of 1.34 billion, 50 percent urban, 13.3 percent above age sixty, and with 118.06 boys born for every 100 girls. In this article, we discuss how gender imbalance, population aging, and their interaction with rapid urbanization have shaped China’s reform era development and will strongly shape China’s future. These intertwined demographic changes pose an unprecedented challenge to social and economic governance, contributing to and magnifying the effects of a slower rate of economic growth. We organize the analysis according to the proximate determinants of economic growth: first, labor input and its productivity; second, capital investment and savings; and finally, multi-factor productivity, including social stability and governance. We argue that the economic, political, and social context that turns labor and capital inputs into economic outputs is perhaps the most important and least understood arena in which demographic change will shape China’s rise.
The education of poor and disadvantaged populations, particularly those from minority subgroups, has been a long-standing challenge to education systems in both developed and developing countries (e.g., World Bank 2001, 2004; Glewwe and Kremer 2006; Planty et al. 2008). For example, over the past decade in the United States the high school dropout rate of Hispanic students has remained at least twice as high as that of white students (Aud et al. 2011). Using data from the German Microzensus and the German Socio-Economic Panel, Alba, Handl, and Müller (1994) found that, relative to young Germans with identical sociodemographic characteristics, Italian, Turkish, and Yugoslav children are overrepresented in the lowest academic track of the German school system.
Abstract: The goal of the present paper is to examine how the expansion of the economy from 2000 has affected rural off-farm labor market participation. Specifically, we seek to determine whether off-farm labor increased after 2000, what forms of employment are driving trends in off-farm labor and whether gender differences can be observed in off farm employment trends. Using a nationally representative dataset that consist of two waves of surveys conducted in 2000 and 2008 in six provinces, this paper finds that off farm labor market participation continued to rise steadily in the early 2000s. However, there is a clear difference in the trends associated with occupational choice before and after 2000. In addition, we find that rural off-farm employment trends are different for men and women. Our analysis also shows that the rise of wage-earning employment corresponds with an increasing unskilled wage for both men and women.
Background: Empty-nest elderly refers to those elderly with no children or whose children have already left home. Few studies have focused on healthcare service use among empty-nest seniors, and no studies have identified the prevalence and profiles of non-use of healthcare services among empty-nest elderly. The purpose of this study is to compare the prevalence of non-use of healthcare services between empty-nest and non-empty-nest elderly and identify risk factors for the non-use of healthcare services among empty-nest seniors.
Methods: Four thousand four hundred sixty nine seniors (60 years and above) were draw from a cross-sectional study conducted in three urban districts and three rural counties of Shandong Province in China. Non-visiting within the past 2 weeks and non-hospitalization in previous year are used to measure non-use of healthcare services. Chi-square test is used to compare the prevalence of non-use between empty-nesters and non-empty-nesters. Multivariate logistic regression analysis is employed to identify the risk factors of non-use among empty-nest seniors.
Results: Of 4469 respondents, 2667(59.7 %) are empty-nesters. Overall, 35.5 % of the participants had non-visiting and 34.5 % had non-hospitalization. Non-visiting rate among empty-nest elderly (37.7 %) is significantly higher than that among non-empty-nest ones (32.7 %) (P = 0.008). Non-hospitalization rate among empty-nesters (36.1 %) is slightly higher than that among non-empty-nesters (31.6 %) (P = 0.166). Financial difficulty is the leading cause for both non-visiting and non-hospitalization of the participants, and it exerts a larger negative effect on access to healthcare for empty-nest elderly than non-empty-nest ones. Both non-visiting and non-hospitalization among empty-nest seniors are independently associated with low-income households, health insurance status and non-communicable chronic diseases. The nonvisiting rate is also found to be higher among the empty-nesters with lower education and those from rural areas.
Conclusions: Our findings indicate that empty-nest seniors have higher non-use rate of healthcare services than non-empty-nest ones. Financial difficulty is the leading cause of non-use of health services. Healthcare policies should be developed or modified to make them more pro-poor and also pro-empty-nested.
Alan Trager discusses health and long-term care in China in the GSB's Highly Immersive Classroom
