Impact of layoffs on mortality and physical health in transitional China 1989–2015

This study examines the long-term health impacts of massive layoffs from State-Owned Enterprises (SOEs) in transitional China, a period characterized by significant economic, cultural, and policy transformation. Utilizing the China Health and Nutrition Survey data from 1989 to 2014, we employ a life course framework to analyze how macro and interpersonal contexts influence mortality and physical health following job loss. Our analysis reveals that, despite short-term income disruptions and persistent income volatility, laid-off workers restored income and gained improved access to various types of health insurance over two decades. In the medium term, we observed increased mortality and cardiovascular diseases, which subsided after a decade. Notably, hypertension emerged as an outcome only after a decade of job loss. While the expansion of urban health insurance schemes contributed to reducing long-term mortality risks, the impact on other health outcomes was marginal. Contrary to patterns observed in Western developed countries, economic mechanisms in transitional China overall played only a minor role in the adverse effects on physical health outcomes. These findings highlight the importance of considering the temporal dynamics and the heterogeneity of impacts across evolving socio-cultural and policy contexts. We also discuss the social-psychological mechanisms that operate within the rich context of transitional China over several decades.