Ruoding Shi: From China to the United States, she is committed to helping vulnerable populations

The following story was written in April 2019 by Britney Gonzalez in ENGL 4824: Science Writing as part of a collaboration between the English department and the Center for Communicating Science.

This photo shows two women standing in front of a dark maroon wall and on either side of a laptop screen. On the left is a a white woman with gray hair. On the right is a younger Asian woman with black hair. Both are professionally dressed, smiling, and wearing name tags. — Ruoding Shi (right) and her advisor, Susan Meacham. (Photo courtesy of Ruoding Shi)

What does a health insurance program in China have in common with coal-mining areas in Appalachia? Virginia Tech graduate student Ruoding Shi is interested in vulnerable populations in both places.

Shi grew up in a small city in China and got her economics degree from one of the country’s top universities, the Central University of Finance and Economics. She later went abroad and obtained her master’s degree at the University of Florida. Today, Shi is a fifth-year Ph.D. student in the Department of Agricultural and Applied Economics.

Shi is currently researching two projects: 1) elevated respiratory mortality risk in Appalachian coal-mining areas and 2) the benefit design of a nationwide health insurance program called the New Cooperative Medical Scheme (NCMS) that the Chinese government implemented.

Shi's passion for health disparities and program evaluations started at a young age. She grew up always reading about how to improve an individual’s health. She’s also always been passionate about helping vulnerable populations because they have limited resources (lower levels of education, low income, etc.) and wants to help governments develop better policies for these populations.

In the first project, Shi partnered with Dr. Susan Meacham from the Edward Via College of Osteopathic Medicine to study the mortality risk in Appalachian coal-mining areas. Because people living in those communities usually have a higher risk of lung, heart, and kidney problems, Meacham and Shi are working together to find a way to help those communities and lower the mortality risk.

This image is a map of Virginia showing the coal-mining counties in the far southwest corner of the state, Lee, Scott, Wise, Dickenson, Russell, Tazewell, and Buchanan; the adjacent-coal counties, Washington, Smyth, and Bland; and the tobacco counties in the central-eastern south part of the state, Buckingham, Cumberland, Amelia, Prince Edward, Pittsylvania, Halifax, Charlotte, Mecklenburg, Lunenburg, Brunswick, and Nottoway. — Map of Appalachian coal-mining counties in Virginia.

The datasets of mortality rates were provided by Meacham, and Shi collected her data from secondary sources, such as the Area Health Resources Files (AHRF). The goal of this study is to find if there is an association between coal mining and local people’s health. This is challenging for Shi because people’s record of their health is confidential unless the individual gives their doctor permission to share their health history. Since there is a limitation on public data regarding the coal miner’s health, Shi can only show that there is a positive correlation between coal mining and higher mortality risk but not the causal effect. The illustration shows the location of the coal-mining counties in Virginia that Shi and Meacham are currently researching.

For her second research project, Shi started studying the effectiveness of the New Cooperative Medical Scheme (NCMS) because previous studies have found that this insurance program failed to provide enough financial protection for local individuals. Her study aims to find the service-level distortion in NCMS benefit design and to improve its effectiveness. Economists define service-level distortion as measuring the falsification of the performance of a system; in this case the distortion is the inefficient coverage of the Chinese government's health insurance policy. When governments set the benefit design in an insurance plan, they have little knowledge about what people need. For example, some people may need more out-patient care while others need more in-patient care, and the government may send out reimbursement rates without even considering what the people need.

As previously stated, in health economics it is usually difficult for researchers to collect primary data by themselves because a lot of health information is confidential. So, to evaluate the NCMS, Shi had to use a publicly available household survey called the China Health and Nutrition Survey. This survey provides data on the effects of the health, nutrition, and family planning policies and programs implemented by national and local governments. The purpose of the survey is to see how the transformation of Chinese society is affecting the health and nutritional status of its population. Shi’s overall goal is to combine what people need with the government benefit design to see whether the policy design of the insurance program can be adjusted so it can meet more of the residents' needs.

Shi understands that vulnerable populations often have health conditions that are worsened by insufficient healthcare. As her work ethic in her two research projects shows, she is determined to make a difference in their lives by helping governments develop better policies.