Moving out of Poverty: the health effects of the Poverty Alleviation relocation program in Rural China

Poor health and poverty reinforce each other, creating a vicious cycle, consequently hindering sustainable development. Existing research focuses on sector-specific interventions; little is known about the health impacts of integrated strategies such as relocation. This study evaluates the health impacts of China’s Poverty Alleviation Relocation (PAR) program using a difference‑in‑differences framework and survey data comprising 13,156 observations from 2016 to 2021. We find that the PAR program significantly improves health: the probability of being healthy increases by more than 6% points for the elderly (aged 60 and above) and by about 2% points for minors (aged 0–17), while no significant effect is observed for working-age adults (18–59). This pattern is consistent when using the Callaway and Sant’Anna estimator with not-yet-treated controls, PSM-DiD, and Probit marginal effects. Heterogeneity analysis shows larger benefits for ethnic minorities, low‑income households, and those with limited land. Both centralized and dispersed modalities yield positive effects. Mechanism analysis reveals that relocation enhances spatial access to healthcare across all levels, shifting utilization towards higher‑tier hospitals. Upgrades in housing conditions may help explain health gains over time among vulnerable groups. This article provides valuable insights for policy efforts aimed at improving the health of the poor.