State-led regional development strategy and multidimensional health poverty of the residents: Evidence from the China’s great western development program

Abstract

This study systematically examines the impact of China's Great Western Development (GWD) program on residential multidimensional health poverty from an institutional beneficiary perspective. Using macro and micro data, we employ a spatial regression discontinuity (SRD) approach to identify causal effects. The results indicate that the GWD program reduces both health poverty incidence and intensity, with findings remaining robust across multiple tests. However, the program shows no significant effects on rural residents, the elderly, residents of small- and medium-sized districts, or those in non-priority districts, likely due to size, urban, political, and efficiency biases. Mechanism analysis suggests that education, social security, healthcare, employment, transportation, energy and environmental management, and economics (at the macro level) drive the program's impact on health poverty. Finally, we identify higher education and physician supply as areas for further improvement. Given these findings, we recommend continued promotion of the GWD program to address its limitations and advance the goal of common prosperity.