Abstract
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Due to long-term residence in unique geographical conditions of high altitude and cold climates, residents on the Tibetan Plateau face a higher likelihood of chronic illness and greater vulnerability to cardiovascular issues, with farmers and herders particularly at risk. Family, as the fundamental unit of life for these individuals, is closely linked to their health, with family structure playing a critical role in influencing well-being. This study categorizes family structures within the farming and herding communities on the plateau into three types—nuclear families, stem families, and joint families—based on intergenerational relationships and marital units within each generation. The analysis draws on theories of the family life cycle, health demand, and health ecology. Utilizing data from a 2021 survey on livelihood development in rural and pastoral areas of Lhasa and employing a generalized hierarchical linear model, the paper examines the impact of family structure on the health of Tibetan Plateau farmers and herders. Key findings include: first, health outcomes for farmers and herders vary by family structure. Second, compared to nuclear families, stem and joint families are detrimental to health. Third, for adult farmers and herders, cross-level interactions between family and individual dimensions indicate that family structure impacts health indirectly by influencing individual characteristics, though this effect is not observed among younger or older groups. Based on these conclusions, the paper proposes policy recommendations for promoting the health of farmers and herders at social, family, and individual levels.
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