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in the reform period raise important concerns about behavioral health issues, especially sexual health and smoking.


The transition to markets in China in the late 1970s marked the beginning of a political focus on promoting economic modernization and growth. In rural areas, the transition meant decollectivization of agriculture and implementation of the household responsibility system, in which farmland and resources were contracted to individual households whose earnings were linked to output.1 In urban settings, the privatization of state-owned enterprises and the emergence of a labor market were important elements of growth-promoting reforms. Reforms brought unprecedented growth and poverty reduction, but also rising economic inequality and a deteriorating social safety net.2 Reforms in the education and health sectors decentralized administration and finance, increasing the diversity of services and the costs to individuals. Layoffs and unemployment heightened the economic insecurity of urban residents in the wake of labor reforms. Rural residents faced rising costs for education and health in the context of new pressures for self-sufficiency in agriculture.

These changes have dramatically modified the context of adolescence over the past two decades. For many of China’s youth, the market reform period has improved living standards and increased life choices in education, work, and family formation. However, adolescents and young adults face new risks as a result of diversified choices, and disadvantaged groups continue to experience problems characteristic of youth in developing countries, such as difficulty obtaining access to basic nutrition, health, and education. The experiences of China’s youth are significant in the global context, as 18 percent of the world’s 15- to 24-year-old youth reside in China, as do 21 percent of the total youth population in developing countries (see Table 8-1).

This chapter outlines major reform-era patterns and trends in adolescents’ pathways into adulthood, focusing on the realms of education, work, family, and health. The chapter is structured as follows: after briefly intro-


Experiments with such contracting began in 1978, and by 1983 nearly all of China’s farmers had adopted the responsibility system (Lin, 1988; Powell, 1992).


For example, World Bank estimates indicate that the number of people living in poverty declined from 398.3 million in 1985 to 269.3 million in 1995; the head-count index for the same period fell from 37.9 to 22.2 percent (World Bank, 1997). At the same time, recent household income surveys indicate that interprovincial income inequality increased markedly between 1988 and 1995; the urban-rural gap in income and living standards remains large, by some estimates wider than anywhere in the developing world (Carter, 1997; Khan and Riskin, 1998).

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