While, on paper, mainland China has had a 75-year commitment to universal health coverage from 1949 to 2024, in practice, access to health insurance and care has been a privilege closely related to one’s position in China’s formal economy. When studying a century of tuberculosis control in Shanghai, I discovered variation with respect to access to health insurance and care, even in an industrially advanced city at the height of the Mao Era. I present my findings in a monograph, Tuberculosis Control and Institutional Change in Shanghai, 1911–2011, published in 2023 by Hong Kong University Press. As the most widespread and deadly infectious disease in China and throughout Asia, tuberculosis (TB) and indicators such as TB prevalence and mortality are important variables for evaluating the effectiveness of health provision. The book draws upon archival documents, public health posters, newspaper articles, academic journals, gazetteers, and interviews with 88 providers and recipients of healthcare to examine how the rise and decline of the socialist work-unit system affected access to social services, including public health programming and health care access.
