Research On The Influencing Factors Of Health Risk Behavio

Although China is a developing country,modifiable risk factors and chronic diseases have increasingly grown as an important part of work in the disease control and prevention.As the main cause of chronic diseases,health behaviors do matters for people’s long-term health,and thus studies concerning what determines risky behaviors are of great significance.We focus on the mid-and long-term effects of the change in external risk as well as offsprings’ high-level human capital accumulation within the family structure on individuals’ health behaviors,so as to privide some new evidence.First,by exploiting the introduction of the hepatitis B vaccination campaign in China in 1992 and the data from the nationally representative longitudinal social survey project China Family Panel Studies(CFPS)in 2018,this paper investigates the long-term impact of the positive external risk change(the introduction of the hepatitis B vaccine)on individuals’ risky behaviors,and we pay particular attention to individuals’ alcohol use during adulthood.We combine the variation of individuals’ age when the campaign was launched with the regional differences in the pre-campaign HBV infection risks and contruct a cohort difference-in-differences(DD)model,finding that an increase of 1percentage point in the exposure intensity,measured as the initial HBV-infection risk,reduces the likelihood of regular alcohol use by about 0.91 percentage points(6.89%)and as large as 1.83 percentage points(7.72%)among men.These results are robust to a series of tests.We further find some heterogeneous effects: individuals from more-educated families and people who live in the urban areas experience a larger decline in the likelihood to be regular alcohol users.Human capital accumulation and dissemination of HBV-related knowledge are potential contributors to the reduction in regular alcohol use.This is essential for policy evaluation of the hepatitis B vaccination campaign since we have confirmed that most people have not exhibited “moral hazard” behaviors.Instead,individuals are more likely to reinforce the effectiveness of the vaccination by reducing health risky behaviors,like reducing alcohol consumtion,after vaccination.Therefore,promoting vaccination during early life is likely to have long-term health benefits.Second,to provide evidence about how negative external risk change would affect individuals’ health risky behaviors,we take as an example the COVID-19 pandemic which has been profoundly influencing people’s health,lives and work,and examine the midand long-term effects of the sudden increase in external risk on individuals’ health behaviors.Based on the balanced panel data of CFPS 2010–2020,we combine the regional differences in the severity of the COVID-19 pandemic before individuals were interviewed with the temporal variation,and rely on a novel approach,namely “synthetic differencein-differences”,finding that people do modify their lifestyle after the first peak of the epidemic,albeit the great threat that the pandemic has posed to the public health in the short-run.Specifically,the extremely serious pandemic increases the likelihood of smoking cessation by about 9.5 percentage points(36.7%)for all and 8.86 percentage points(34.9%)for men,reduces the likelihood of regular alcohol use by about 4.69 percentage points(28.2%)for all and 9.83 percentage points(30.6%)for men,and increases the likelihood of regular exercise by 11.66 percentage points(or 32.9%)for women.The heterogeneity analyses,based on individuals’ educational attainment,suggest that the aforementioned effects for smoking cessation and regular alcohol consumption among appear mainly on the higher-educated men,while instead the effects for regular physical activities primarily occur on the lower-educated women.Specifically,after the peak of the pandemic,the likelihood of smoking cessation for the higher-educated individuals and men respectively was observed to increase by 35.8 percentage points(129%)and 32.3 percentage points(119%),with the likelihood of regular alcohol consumption for the same groups decreasing by 6.65 percentage points(38.1%)and 14.4percentage points(48.9%),while instead the likelihood of regular physical activities for the lower-educated increases by 15.4 percentage points(48.9%).Mechanism exploration suggests that the income reduction or unemployment induced by the pandemic,a decline in social interaction especially for the eating and drinking social activities,as well as the promotion of health consciousness are important contributors.Although the severe epidemics have caused people great psychological stress,this study documents that the majority of individuals have not persistently exhibited risky behaviors even after they suffered the extreme pandemic.Instead,individuals tend to take self-controllable measures,such as implementing more stringent health protection,reducing smoking and alcohol use,taking regular exercise,so as to boost their immunity and enhance the resistance against the virus in the long-run.Third,by instrumenting individuals’ educational attainment with the exposure to the massive higher education expansion in 1999 in China,this paper examines the intergenerational spillover effects of offprings’ high-level human capital accumulation on their parents’ health behaviors.Based on the pooled sample of CFPS 2010–2018,this paper finds that offsprings’ high-level education promotion significantly improves parents’ health behaviors in their mid or late life,especially for smoking behaviors.Specifically,one increase in offsprings’ years of schooling reduces the likelihood of smoking initiation and participation for parents by 3.8 percentage points(8.4%)and 5.2 percentage points(15.8%),respectively,and increases the likelihood of smoking cessation by 6.3 percentage points(22.9%),while there is no positive effects on parental regular alcohol use and physical exercise as well as weight control status.Among the results,offsprings’ highlevel educational promotion not only does not modify but instead further increases the likelihood of their parents’ regular alcohol consumption.Nonetheless,because of the weak significance and the lack of robustness,we cautiously decide not to make a conclusion in the affirmative.The heterogeneity analyses suggest that offsprings’ high-level increases in education predominantly improves fathers’ risky behaviors,and that the ameliorative effects appear almost only in rural families,as well as that it is sons’ accumulation in highlevel education that play a more important role in the modifying process.On the basis of the above results,we further discuss the potential mechanisms and verify that parents’ better living conditions,more health-related knowledge,less psychological stress(less labor supply)as well as a larger extent of social integration are likely the primary factors through which offsprings’ high-level educational promotion leads to improved parental health behaviors.This part of research not only affirms the important role of education in public health improvement,but also provide some enlightening significance to improving older parents’ later-life health and reducing the nation’s burden of aging diseases.At the meantime,unlike the previous studies that use the exogeneity of the compulsory education law to identify the causal effects of offsprings’ primary or medium education promotion on parental lifestyle,among which most failed to find significant effects,our findings suggest that offsprings’ high-level human capital accumulation actually reduce their parents’ risky behaviors.Therefore,this study is conducive to completely understanding the differential effects on parents’ health risky behaviors as a result of the increases at different levels of offsprings’ educational attainment.