Abstract:

For Chinese people, the choice between traditional Chinese medicine (TCM) and Western medicine is a common decision faced when seeking treatment or maintaining health. Although previous studies have explored the mechanisms underlying the "educational gradient in health" from individual, family, and social perspectives, findings based on the Western medical paradigm have largely overlooked the potential influence of TCM preferences in healthcare behavior. Using data from the Chinese General Social Survey and an ordered chain mediation model, this study finds that the behavior of "seeking TCM" (i.e., a stronger preference for TCM over Western medicine) can serve as a mediating variable between educational attainment and self-rated health. This result remains robust after conducting both robustness and endogeneity tests. Regarding the explanatory mechanisms, the self-assessed perception of health among Chinese people, coupled with the increasingly sensitive physical awareness associated with higher education levels, makes highly educated individuals more prone to perceive themselves as unhealthy and to engage in healthcare-seeking behaviors. Compared to Western medicine, TCM's philosophy of "preventing illness before it occurs" and its relational model of collaborative patient-doctor care can more effectively address self-assessed health concerns. Therefore, individuals with higher levels of education are more likely to choose TCM, and ultimately experience an improvement in their self-rated health due to the effective response to self-diagnosis. The research results provide empirical support for the formulation of health policies tailored to China's context to promote high quality national health.

Key words: education gradient in health, self-rated health, "seeing a TCM doctor", ordered chain model