New Evidence on the Health-Status Gradient from Imperial China

Wolfgang Keller, Carol H. Shiue and Karen Eggleston

No 35396, NBER Working Papers from National Bureau of Economic Research, Inc

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.

JEL-codes: I14 J1 N35 (search for similar items in EconPapers)
Date: 2026-07
Note: CH DAE EH
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Working Paper: New Evidence on the Health-Status Gradient from Imperial China (2026)
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