What determines mental health in China? The role of indebtedness, extracurricular activities and COVID-19

Pei, Yu (2022). What determines mental health in China? The role of indebtedness, extracurricular activities and COVID-19. University of Birmingham. Ph.D.

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Abstract

China’s population has been exposed to a high-pressure lifestyle, resulting a significant increase in mental health problems. To make matters worse, Chinese people are often reluctant to acknowledge that they are suffering from mental health problems due to the stigma surrounding symptoms of mental health illness in China, which may aggravate the symptoms. Under such background, this thesis investigates what determines mental health in China from three perspectives, which are indebtedness, extracurricular activities and COVID-19.

First of all, in light of the increasing trends of both household financial debt and the prevalence of mental health problems in China in recent years, we investigate the extent to which household financial debt may be associated with mental health. To this end, we employ data from the 2014, 2016, and 2018 waves of the China Family Panel Studies (CFPS). Our results indicate that the majority of Chinese families prefer to borrow money from their friends, relatives or other private loan institutions, rather than from banks. We also find that the more borrowing they undertake, the worse their mental health status. Specifically, compared with money borrowed from banks, money borrowed from friends/relatives, or from private loan institutions, has a greater impact on both life satisfaction and the likelihood of developing depression. Such an effect is notably stronger for household heads, compared to other household members, as household heads are usually the ones to make borrowing decisions and, thus, are more likely to suffer from the psychological burden of these decisions. Overall, these findings are robust to different measures of mental health and financial debt, as well as different estimators.

Moreover, using data from the China Education Panel Survey (CEPS), we study the peer effect in extracurricular activities and the link between extracurricular activities participation and mental health. We find that mean peer’s participation in extracurricular activities is associated with students’ own choices of after-school classes, even after controlling for endogenous peer groups. Specifically, compared with students whose performance ranked below average or above average in the class, middle-ranked students are more likely to be affected by their peers. We also find evidence confirming that participation in extracurricular activities has a significantly negative effect on students’ own mental health. By comparing students’ interests and the extracurricular activities that they actually pursue, we find that the majority of students participate in extracurricular activities which are not based on their own needs or interests. This may be a potential mechanism underpinning the link between extracurricular activities participation and psychological illness.

Lastly, the final chapter of this thesis evaluates the effect of COVID-19 on mental health. On January 23rd, 2020, China, the first country to report and respond to COVID-19 cases, announced internal city closures in an attempt to stop the spread of the COVID-19 virus. A growing body of literature has demonstrated that lockdown policies increase the level of pressure upon citizens’ mental health. Yet, the effect of the number of COVID-19 patients diagnosed each day on mental health has, thus far, been neglected. Given the largely unknown nature of the novel coronavirus, we investigate the extent to which daily confirmed cases increased the number of negative sentiments expressed on the social media platform (Weibo) from January 24th, 2020 to March 18th, 2020. We do this using high-frequency, real-time social media data and a semantic analysis approach. Additionally, considering that the rapid increase in confirmed cases exceeded the capacity of hospitals at the beginning of the outbreak, we further examine whether the number of local designated hospitals accepting COVID-19 patients, or the number of professionals registered with the provincial Center for Disease Prevention and Control (CDC), could mitigate the negative mental health effects of COVID-19. By using both linear fixed-effect and non-linear random-effect/correlated random-effect models, we find that an increase in the number of daily confirmed cases leads to more residents expressing negative emotions on Weibo, with women being more affected than men. Meanwhile, medical resources can mediate, to a certain extent, the positive association between COVID-19 confirmed cases and mental illness. Our results are robust when using different econometric techniques.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):