Reproductive Health in the Context of Foreign Direct Investment and Export Production: The Case of China.

Abstract

More than half of the world’s workers in export processing zones are in China and the majority of those are women. Work environments with high occupational stress, such as production line jobs typical in export processing zones have been associated with adverse reproductive health outcomes. This dissertation analyzes the prevalence of and risk factors associated with pelvic pain and urogenital infection among women working in three electronics factories in Tianjin, China, as well as the association of infant mortality rates with foreign direct investment and indicators of women’s employment at China’s province and prefecture levels.

A survey designed to examine occupational stress, pelvic pain, and symptoms of urogenital infection was implemented in three electronic factories in the Tianjin Economic-Technological Development Area in 2010 with responses from 744 female factory workers. Infant mortality was evaluated using year 2000 data from the China Census and the China Statistical Yearbook.

Results from the Tianjin survey indicate that nearly one quarter of all factory workers experience job strain, 80.7% any dysmenorrhea, 18.9% often or usually experiencing dysmenorrhea, 15.7% non-cyclic pelvic pain, 26.5% any dyspareunia, and 30.9% any urogenital infection symptom. Survey results suggest associations between occupational stress, pelvic pain, and urogenital infection symptoms in adjusted analyses. Results from the aggregate China data show that a higher foreign direct investment, higher proportion of the gross domestic product from manufacturing, and lower proportion of exports from total trade are associated with lower infant mortality rates. A higher proportion of women working in manufacturing relative to all women working or to all men and women working in manufacturing was associated with lower infant mortality rates and the effect was modified by gross domestic product and foreign direct investment.

This dissertation provided an initial examination of the associations of aggregate level economic indicators and infant mortality rates, as well as of individual level occupational risk factors and reproductive health outcomes. Future research to better understand the causes for poor reproductive outcomes and public health programs to improve reproductive health among women factory workers in China’s export processing zones are crucial to improving the health of China’s labor force.