来自中国帝制时期的健康梯度新证据
New Evidence on the Health-Status Gradient from Imperial China
NBER Working Papers · 2026 · [{"name": "Wolfgang Keller", "affiliation": []}, {"name": "Carol H. Shiue", "affiliation": []}, {"name": "Karen Eggleston", "affiliation": []}]
中文摘要
我们使用14至19世纪中国的族谱数据研究健康与社会地位之间的关系。该数据覆盖了广泛的人口群体，将丈夫、妻子与儿子相互关联，使我们得以考察地位是否不仅与成年男性的存活相关，也与家庭内部和代际层面的存活相关。在一个以18世纪初为中心的样本中，已婚男性的典型寿命为52岁，但差异很大。高地位男性活过50岁的概率比低地位男性高22%，由此带来七年的寿命优势。高地位还与妻子和子女的显著存活优势相关。高地位男性之妻相对于平民之妻的寿命溢价超过10年，而高地位男性之子在10岁前死亡的概率不到低地位男性之子的一半。直到17世纪，寿命优势在很大程度上局限于最高地位者，而跨所有地位层级的健康—地位梯度则在18世纪出现。这些发现为一个鲜有研究的情境中的健康—地位不平等提供了新证据，并表明从家庭和代际视角分析健康—地位不平等是有益的。
Abstract
We study the relationship between health and social status in China using genealogical data from the 14th to 19th centuries. The data covers broad segments of the population linking husbands, wives, and sons, allowing us to examine whether status was associated with survival not only for adult men but also across households and generations. In a sample centered on the early 1700s, the typical lifespan of married men is 52, but varies widely. High-status men have a 22 percent higher probability of living past 50 than low-status men, resulting in a lifespan advantage of seven years. High status is also associated with significant survival advantages for wives and children. The lifespan premium of the wife of a high-status man over the wife of a commoner exceeds 10 years, and the chance that the son of a high-status man dies before reaching 10 years is less than half that of a low-status man’s son. Up to the 17th century the lifespan advantage is largely confined to those with top status, while the health-status gradient across all status levels emerges during the 18th century. The findings provide new evidence on health-status inequality in a less-studied setting, and suggest that health-status inequality is usefully analyzed from a family and intergenerational perspective.