【正文】 panel data from 1991, 1993, 1997, 2021 and 20214. The CHNS is a large scale longitudinal survey conducted in 9 provinces in China: Leaning, Shandong, Kiangs, Henna, Heilongjiang, Huber, Hunan, Ganglia and Gizmo. Although the CHNS is not representative of all China, these provinces vary substantially in terms of geography, urbanization and economic development. While the CHNS provinces span some of the relatively more urbanized regions of China, Beijing and Shanghai, the two largest mega cities in China, are not covered. Urbanization rates vary considerably within each province. There have been some changes in the position of the CHNS sample across time. Liaoning province was added in 1997 when Heilongjiang Province was unable to participate. Heilongjiang returned to the study in 2021 (and Liaoning remained as well). New households in original munities were added to replace households no longer participating in the study in 1997 and in 2021. In 1997, new munities in original provinces were added to replace sites no longer participating in the The CHNS collects information on a wide range of individual, household and munity characteristics. A munity, which is the primary sampling unit (PSU), is a governmentdesignated administrative district. The munity interview is held with the munity head for questions related to public facilities and infrastructure, and with munity health workers for questions related to health care provision. In total, there are about 200 munities in each wave (see Appendix – Table A1)。 Champion and Hugo, 2021。 Weng et al, 2021). But urbanization clearly has positive, as well as negative, consequences for population health. Closer proximity to health care facilities, particularly hospitals, equipped with modern technology and staffed by highly trained doctors is an obvious advantage of living in towns and cities. In China, urbanrural differences in access to health care, and in health insurance cover, have been marked and widening in recent decades (Liu et al, 1999). Access to schools and to health education initiatives confer a strong advantage on urban areas in the field of preventative health care. Urban populations can also use higher ines to invest in health through health care, a nutritious diet or by reducing strenuous work effort(Moore et al, 2021).In this paper, we estimate the effect of urbanization on health using longitudinal data from the China Health and Nutrition Survey (CHNS). Besides being a household panel, this survey also collects data on the characteristics of munities, making it possible to identify what happens to individuals? health when the environment in which they live bees more urbanized. This identification strategy avoids the selection biases that arise from parisons between the health of urban and rural populations, or from monitoring the health of migrants, which is difficult or impossible in any case with most panel data. A dichotomous urbanrural classification, most often done on the basis of population density, does not capture the variation in living and health conditions across areas at different stages of urbanization (McDade and Adair, 2021。 Popkin and Du, 2021). Urbanization inevitably implies a shift in work patterns from physical, agricultural labor towards more sedentary occupations (Monda et al, 2021). In China, it is claimed that these transitions have contributed to stark increases in the prevalence of obesity and hypertension (Liu et al, 2021。 Wang and Smith, 2021。 Cutler et al, 2021。 Woods, 1985, 2021). The most likely explanation for this difference in the urbanrural health disparity over time and space is the marked decline in the prevalence of infectious diseases, in lowine as well as highine countries (Riley, 2021), prompted, in large part, by public health measures built on the germ theory of disease (Preston, 1975, 1980。s urbanization rate has been forecast to reach 75% (Yusuf and Saich, 2021). In the space of just a few decades, China will plete the urbanization process that lasted hundreds of years in the West. The noneconomic consequences of such rapid urbanization, including those for health, as well as more obviously for the environment, will determine the true welfare effects of development and the extent to which it is sustainable. The consequences for population health are not obvious. On the one hand, urban living offers improved access to modern medicine (particularly in China) and gains in ine that can be invested in health. On the other, the health of city dwellers is threatened by air pollution, more sedentary and possibly more stressful work, social detachment, and Western, highfat diets. This paper uses panel data from China covering the period 19912021 to estimate the health impact of urbanization. On average, health outes are found to be better in urban parts of the developing world (Van de Poel et al, 2021。The Health Penalty of China’s Rapid Rapid urbanization could have positive and negative health effects, such that the impact on population health is not obvious. It is, however, highly pertinent to the human welfare consequences of development. This paper uses munity and individual level longitudinal data from the China Health and Nutrition Survey to estimate the health impact of China?s unprecedented urbanization. We construct an index of urban city from a broad set of munity characteristics and define urbanization in terms of movements across the distribution of this index. We use differenceindifferences estimators to identify the treatment effect of urbanization on the selfassessed health of individuals. The results reveal important, and robust, negative causal effects of urbanization on health. Urbanization increases the probability of reporting fair or poor health by 5 to 15 percentage points, with a greater degree of urbanization