The effect of health on urban-settlement intention of rural-urban migrants in China

Social-emotional problems in 3-to 5-year-old children: a cross-sectional study of highly educated migrants in a Chinese urban area

Background

Previous research has primarily examined the mental well-being of children from labor migrant families, yet there is a lack of understanding regarding the mental well-being of children from highly educated migrant backgrounds. This study investigated the social-emotional problems of 3-5-year-olds from highly educated migrant families residing in an urban area of China, as well as explored potential differences in demographic variables.

Methods

A cross-sectional study was conducted in Qiantang District, Hangzhou, China, with 1,494 (53.3% boys) children selected via a convenient sampling method. The Ages & Stages Questionnaires: social-Emotional, Second Edition (ASQ:SE-2) was used to measure social-emotional problems.

Results

The results showed that 23.6% of the children were at risk for social-emotional problems. More boys (26.7%) than girls (20.1%) had scores above the cut-off. Additionally, more children in the low socioeconomic status (29.9%) had scores above the cut-off than those in the high socioeconomic status (18.9%). There were three common issues among all age groups: "being more active than others," "excessive attachment to parents," and "being overly friendly with strangers.

Conclusion

The social-emotional development of children from highly educated migrant families is a significant aspect that deserves recognition, contributing valuable insights to the existing literature on this topic.

How does mobility and urban environment affect the migrants' settlement intention? A perspective from the intergenerational differences

Introduction

With China embracing a new people-centered urbanization stage, the problem of migrants "flowing without moving" has become increasingly prominent, and settlement intention has gradually garnered attention.

Methods

Our research, based on questionnaire data from the China Labor Force Dynamic Survey 2016, uses a multilevel linear regression model to explore the influence of mobility, social environment, built environment, and demographics characteristics on settlement intention in the migrants and discusses differences between settlement intention of new and old generations and their internal influence mechanism.

Results

The findings are as follows: (1) Compared to the old generation, the new migrant generation generally has higher settlement intention. (2) The migrants' settlement intention is influenced mainly by mobility, social environment, built environment, and demographic characteristics. (3) For the new migrant generation, social and demographic characteristics significantly influence their settlement intention. (4) The floating and built environment of the old generation significantly influence their settlement intention.

Discussion

Finally, this paper argues that there are differences in the influence mechanism of the same factors on the settlement intention of the new and old generations of migrants. It proposes differentiated policy suggestions for the migrants to promote city social integration. Finally, this paper argues that there are differences in the influence mechanism of the same factors on the settlement intention of the new and old generations of migrants. It proposes differentiated policy suggestions for the migrants to promote city social integration.

The Effect of Health Status on Urban Adaptation of the Rural Elderly after Migration

As urbanization accelerates in China, more and more rural elders are moving to cities to live with their children. However, they face challenges in overcoming cultural, social, and economic disparities and maintaining health in urban life, and health is important human capital that may have a significant impact on the urban adaptation of rural elderly migrants (REMs). Based on the 2018 China Health and Retirement Longitudinal Study (CHARLS), this paper constructs an indicator system to measure the level of urban adaptation of REMs. The health level and urban adaptation of REMs are studied in depth, and how to better help them adapt to urban life in order to provide a healthy living environment and a good lifestyle is explored. The empirical analysis finds the following: (1) good health helps REMs achieve a better level of urban adaptation. (2) REMs with good health status are more likely to go to community clubs for activities and do physical activities and thus improve their urban adaptation level. (3) There are significant differences in the effects of health status on urban adaptation among REMs with different characteristics. REMs with better health status in the central and western regions have significantly higher levels of urban adaptation than those in the eastern regions, and men have higher levels of urban adaptation than women. Therefore, the government should construct classification measures according to the differentiated characteristics of rural elderly migrants' urban adaptation, and guide and support their stratified and orderly adaptation to urban society.

Perceived social cohesion and depressive symptoms among internal migrants in China: The mediating role of social adaptation

Background

Internal migrants are exposed to higher risks of depressive symptoms due to migration-related stress. It has been recognized that perceived neighborhood social cohesion has direct and indirect associations with depressive symptoms. However, the pathway from perceived social cohesion to internal migrants' depressive symptoms was less discussed.

Objectives

To assess mental health disparities among internal migrants. To investigate the association between social cohesion and depressive symptoms among urban-to-urban and rural-to-urban migrants and to examine the mediating role of social adaptation.

Methods

Data from the "2017 Urbanization and New Migrant Survey" was used, including 2,584 internal migrants age 18-65 from 10 cities in China. Social cohesion was measured by a six-item modified Community-level Cohesion Scale. Depressive symptoms was measured using the Center for Epidemiological Studies Depression Scale, and social adaptation was assessed by a single-item question of migrants' adaptation to local life. Multivariate linear regression models were used to examine the association between social cohesion and depressive symptoms. Baron and Kenny's mediation tests were conducted to examine the mediating role of social adaptation on the association. All analyses were adjusted using sampling weights to account for this survey's sampling design.

Results

Rural-to-urban migrants were found to have more clinically significant depressive symptoms, lower perceived social cohesion, and fair or low social adaptation than urban-to-urban migrants (all p < 0.001). Being rural-to-urban migrants as compared with urban-to-urban migrants [Odds Ratio (OR) = 1.46, 95% Confidence Interval (CI) = 1.456, 1.461, p < 0.001], had lower perceived social cohesion (OR = 1.46, 95% CI = 1.458, 1.463, p < 0.001), and poorer social adaptation (OR = 1.94, 95% CI = 1.932, 1.941, p < 0.001), are associated with higher odds of having clinically significant depressive symptoms. Social adaptation partially mediated the association between social cohesion and depressive symptoms by explaining 15.39% of its effect for urban-to-urban migrants and 18.97% for rural-to-urban migrants.

Conclusions

Findings from this study reveal mental health inequalities among internal migrants and demonstrate the importance of social adaption on the association between social cohesion and depressive symptoms. Social strategies and public policies are needed to build a more cohesive community that serves both local residents and internal migrants, especially rural-to-urban migrants.

Voting with Your Feet: The Impact of Urban Public Health Service Accessibility on the Permanent Migration Intentions of Rural Migrants in China

The accessibility of urban public health services is not only relevant to the health status of rural migrants but also plays an increasingly important role in their migration decisions. Most existing studies have focused on the effects of the level of public health service provision and parity on rural migrants' migration behavior, ignoring the role of public health service accessibility. This paper systematically examines the overall impact, heterogeneous impact and mechanism of action of public health service accessibility on rural migrants' intentions to migrate permanently based on data from the 2017 China Mobile Population Dynamics Monitoring Survey using probit, IVprobit, eprobit, omitted variable test model and KHB mediating effect model. It was found that: (1) public health service accessibility significantly increased rural migrants' intentions to migrate permanently, and the results remained robust after using instrumental variables to mitigate endogeneity problems and omitted variable tests. (2) Heterogeneity analysis shows that public health service accessibility has a greater effect on enhancing the intentions to migrate permanently among females and rural migrants born in 1980 and later. (3) Further mechanism testing revealed that public health service accessibility could indirectly increase rural migrants' intentions to migrate permanently by improving health habits, health status, identity, and social integration, with identity playing a greater indirect effect. The findings of this paper not only provide empirical evidence for the existence of Tiebout's "voting with your feet" mechanism in China but also contribute to the scientific understanding of the role of equalization of public health services in the process of population migration.

The impact of basic public health services on migrants' settlement intentions

An important task in the urbanization process of developing countries is to promote and support migrants’ settlement in cities. Based on the China Migrants Dynamic Survey of 2018, this paper analyzes how basic public health services (BPHSs) impact migrants’ settlement intentions. This study shows that establishing health records and access to health-related knowledge significantly and positively impact migrants’ intentions to settle permanently in inflow areas by increasing their health status and degree of social integration. Yet, this paper discusses how the trends are heterogeneous, finding that BPHSs more significantly impact the settlement intentions of female, less-educated and rural migrants. The findings of this paper provide new factual evidence that may support government policymaking to further improve migrants’ utilization of medical and health resources and their intention to settle down.

The Effect of Health Change on Long-Term Settlement Intentions of International Immigrants in New Destination Countries: Evidence from Yiwu City in China

Objective: Previous studies on settlement intentions have mainly focused on the explanations of social and economic rationality, culture, and institution, but insufficient attention had been paid to the relationship between health and settlement intentions. This study explored the relationship between changes in the health status of immigrants and their settlement intentions. Method: A cross-sectional survey was conducted both in 2018 and 2019. Foreigners who visited the Yiwu Municipal Exit−Entry Administration Office to extend their visas were invited to participate in the study. Quantitative data, such as the participants’ sociodemographic characteristics, job status, employment, immigration experience, key factors associated with the intention to settle down, medical insurance coverage, and changes in health status, were collected by questionnaire. Results: A change in health status significantly affected the intention to settle down: the more healthy that people became, the more likely they intended to settle down (β = 0.233; p < 0.001), and, simultaneously, changes in health status were also moderated by the length of stay in China (β = 0.320; p < 0.001) and medical insurance (β = 0.134; p < 0.001), which affected people’s willingness to settle down. Conclusions: Changes in health status, and not health status itself, affected immigrants’ willingness to settle down. In addition, social insurance, and the length of stay in the place receiving immigrants, affected immigrants’ willingness to settle down not only directly, but also indirectly by moderating the impact of the change in health status on the willingness to settle down.

Becoming Urban Citizens: A Three-Phase Perspective on the Social Integration of Rural-Urban Migrants in China

This article attempts to provide an integrated conceptual framework for understanding how rural–urban migrants in China integrate into urban society. We propose a three-phase conceptual framework in which the social integration of rural–urban migrants is categorized into circular migration, urban settlement, and urban integration. We argue that the three phases differ with respect to the aims of migration, the identity of migrants, the key dimensions of social integration, the role of government, and the hukou policy. While the transition from circular migration to urban settlement is an outcome of economic development and change in demographic structure, as reflected by the economic conditions of rural–urban migrants, welfare expansion also plays a critical role during this process. We further hypothesize that the transition from urban settlement to urban integration will be a result of the social interaction between rural–urban migrants and local urbanites, within which social capital and cultural factors are vital. Since most rural–urban migrants are currently at the phase of urban settlement, we suggest that the Chinese government should enlarge welfare provisions to support their settlement in cities. This study contributes to improving the understanding of how to facilitate social integration of internal migrants in developing countries.

Exploring the Effect of Health on Migrants' Social Integration in China

There are 376 million migrants, which account for more than 25% of the population in China according to the newest national demographic census, most of whom are from undeveloped areas to developed urban regions. Migrants’ social integration was one of the most important issues when the country aimed to build an inclusive society. As a form of human capital, the effect of migrants’ health status on social integration has rarely been explored until now, especially empirically. Previous studies have usually ignored health indicators when discussing the determinants of migrants’ social integration, and understanding the role of migrants’ physical health and mental health on their social integration is significant for efforts to ensure inclusive urbanization. For filling this research gap, the China Migrants Dynamic Survey dataset was used to uncover the role of migrants’ health status, including physical health and mental health, in their degree of social integration, and a further comparison of impact was conducted among rural–urban and urban–urban migrants. Through the empirical analysis, our results indicated the following. First, both better physical and mental health lead to higher social integration levels, and a one-point increase in physical and mental health improves the odds of good social integration by 33.27% and 5.98% for belonging and 66.05% and 6.35% for harmony, respectively. Second, health status is equally important for rural–urban and urban–urban migrants’ social integration, and the significant positive effect was consistent across groups, although some other impact factors may exhibit differences. Third, the effect of health status on social integration was moderated by social participation, which was more obvious for mental health than physical health. According to our findings, we discuss the measures to promote migrants’ health status and additional countermeasures to improve their social integration level.

The Impact of Health and Wealth on Settlement Intention of Migrants: The Moderating Effect of Social Welfare

Background: With the rapid urbanization, citizenization of migrants is becoming the development tendency in China. It is significant to analyze the determining factors of the settlement intention of migrants.

Methods: The data we used were taken from the China Migrants Dynamic Survey (CMDS) in 2017. Multilevel mixed-effects logistic regression was used to analyze the relationship between air pollution, economic advantages, and settlement intention between different migrants and the moderating effect of social welfare.

Results: At the individual level, being female, married, urban and other ethnic, having higher education, older, and health associated with likelihood of settlement intention of migrants. Higher health education, social integration, and, have a health record were positively associated with the likelihood of settlement intention. Higher educated, urban areas, and Han migrants were willing to reduce their pursuit of health for economic development.

Conclusion: Health education and more social organizational participation can reduce the negative effect of air pollution and increase the positive effect of economic advantages on settlement intention of migrants. But, in less economically advantaged areas, it has no obvious effect. In the choice of health and wealth, the settlement intention of migrants shows difference, and unfairness and social welfare, in particular health education, can narrow this difference.

City Size and Permanent Settlement Intention: Evidence from Rural-Urban Migrants in China

The location choice and livelihoods of rural-urban migrants are critical to the sustainable development of cities. By using data from the China Migrants Dynamic Survey (CMDS) in 2017, this paper extant the Rosen-Roback's model by adding factors of urban social network and air pollution to the function of the individual utility of migrants. Both the Probit Model and IV estimates imply evidence of an inverse U-shaped pattern of city size and migrants' permanent settlement in urban China. This view proves that Chinese migrants like to settle permanently in large cities, but not mega-cities, such as Beijing and Shanghai. The internal mechanism is explained by the agglomeration economies and the crowing effect brought by city size. In mega-cities, the attractiveness of the city caused by wage premium cannot offset the combined repulsive force caused by the high housing price, bad urban social network, air pollution, and health deterioration. It is worth noting that air pollution has a significant negative impact on the settlement intention of migrants, such as health conditions and precipitation. Besides, there is heterogeneity among high-skilled migrants and low-skilled migrants in different city sizes. Our findings enhance the understanding of "Escape from megacities" in China and have implications for the reform of the housing security system and the exploration of the urbanization path.

Acculturation, urban identity, and psychological well-being of rural-urban migrants in China

Acculturation and identity are two significant determinants of the psychological well-being of migrants, but how they interactively affect psychological well-being is still underexplored. This study proposes an interactional perspective that links acculturation and urban identity to the psychological well-being of rural-urban migrants in China. Using data from the 2014 National Migrant Population Dynamic Monitoring Survey, the results of multilevel modeling indicate that both acculturation and urban identity significantly affect the psychological well-being of rural-urban migrants. Migrants who adopt the integration and assimilation strategy show better psychological well-being than those who adopt the separation and marginalization strategy. Rural-urban migrants who have a stronger sense of urban identity show better psychological well-being than those with a weaker sense of urban identity. Meanwhile, urban identity and acculturation also interactively affect the psychological well-being of rural-urban migrants. In particular, urban identity alleviates the negative pressure generated in the process of acculturation for those who adopt the acculturation strategy of separation. In addition, the effect of acculturation and urban identity on the psychological well-being of rural-urban migrants varies by migration distance. The research contributes to the literature by demonstrating that cultural identity and place identity interactively affect the psychological well-being of internal migrants.

How does air pollution affect urban settlement of the floating population in China? New evidence from a push-pull migration analysis

Background

Severe air pollution in China threatens human health, and its negative impact decreases the urban settlement intentions of migrants in destination cities. We establish a comprehensive framework based on the push-pull migration model to investigate this phenomenon.

Methods

We employ a logistic model to analyze air pollution’s impact on the settlement intentions of the floating population based on the CMDS 2017 in China, combining the city-level socioeconomic variables with the individual-level variables.

Results

Our results show that the annual average concentration of PM2.5 increases by 1 unit and that the probability of migrants’ settlement intentions will decrease by 8.7%. Using a heterogeneity analysis, we find that the following migrant groups are more sensitive to air pollution: males, people over 30 years old, less educated people, and migrants with nonagricultural hukou. With every 1 unit increase in PM2.5, each group’s settlement intentions decrease by 13.2, 16.7, 16.9, and 12.6%, respectively.

Conclusions

Our results are consistent with existing studies. This study discovers that both external environment and internal factors influence migrants’ settlement intentions. Specifically, the differences in population sizes, economic development levels, public services, infrastructure conditions, and environmental regulations between cities play a significant role in migration decisions. We also confirm heterogeneous sensitivities to air pollution of different migrant subgroups in terms of individual characteristics, family factors, migration features, social and economic attributes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11711-x.

The Association of Residence Permits on Utilization of Health Care Services by Migrant Workers in China

Due to the limitations in the verifiability of individual identity, migrant workers have encountered some obstacles in access to public health care services. Residence permits issued by the Chinese government are a solution to address the health care access inequality faced by migrant workers. In principle, migrant workers with residence permits have similar rights as urban locals. However, the validity of residence permits is still controversial. This study aimed to examine the impact of residence permits on public health care services. Data were taken from the China Migrants Dynamic Survey (CMDS). Our results showed that the utilization of health care services of migrant workers with residence permits was significantly better than others. However, although statistically significant, the substantive significance is modest. In addition, megacities had significant negative moderating effects between residence permits and health care services utilization. Our research results emphasized that reforms of the household registration system, taking the residence permit system as a breakthrough, cannot wholly address the health care access inequality in China. For developing countries with uneven regional development, the health care access inequality faced by migrant workers is a structural issue.

Escaping from pollution: Air pollution and the settlement intentions of floating migrants in Chinese cities

Understanding the mechanisms underlying floating migrants’ settlement intentions is vital for guiding evidence-based policies for China’s urbanisation and regional economic development. While prior studies have identified various determinants of migrants’ settlement decisions, little attention has been paid to the effects of environmental pollution on these decisions. To fill this gap, this study utilises a unique data set combining individual-level data from a national survey and city-level data obtained from various sources to investigate the effects of air pollution on floating migrants’ settlement intentions in China. Using a novel instrumental variable, our regression results show significantly negative impacts of air pollution on both migrants’ permanent settlement intention and their expected length of settlement. Additionally, these impacts are stronger for the skilled migrants compared to the less skilled ones. These findings imply that environmental pollution should be seriously considered when promoting urbanisation in China and beyond.

Beyond the Intention: Individual-Level Determinants and Intergenerational Differences of Floating Populations' Actual Settlement Choices in Dongguan, China

The migration process and patterns of floating populations have received continuing attention from scholars and policymakers. In China, however, studies have been focused on the settlement intention of floating populations based on sampling surveys and yielded inconsistent findings. Drawing upon 18,178,167 authentic individual samples of floating populations in Dongguan city, this study contributes to the literature by examining the effect of individual characteristics on the actual resident actions of floating populations, and revealing both the heterogeneity and continuity of their urban residence among four generations (i.e., during the 1960s, 1970s, 1980s, and 1990s). The results show that the proportion of actual resident actions is lower than that reported by previous studies on settlement intentions, and that male, married, middle-aged, more educated, and long-residing members are more likely to choose to stay in Dongguan. Compared to their predecessors, the 1990 cohort reveals significant heterogeneities in their actual settlement choices. The study draws broad implications from the analysis, calling for the equalization of public welfare in Chinese cities and the encouragement of floating populations to sustain long-term residence in the destination cities.

On the Settlement of the Floating Population in the Pearl River Delta: Understanding the Factors of Permanent Settlement Intention versus Housing Purchase Actions

Previous investigations of the settlement intentions of China’s floating population have been undermined by an oversimplification of the concepts and measurements related to settlement intentions. More attention should be paid to influencing factors from the theoretical framework of “place utility” in new periods. Based on this framework, we use a multinormal logistic regression model to explore the impact of economic, human capital, and social factors on migration intentions and housing purchase actions of the floating population in the Pearl River Delta. The results revealed that the floating population’s purchasing ability is generally lower than its willingness to settle down, and this population experiences an incomplete citizenization problem. Among the economic and human capital factors, family economic factors have become an important basis for the housing purchase actions of the floating population and may even be more important than their own economic income and education level. After the State Council implemented the “Notice of Further Promoting the Reform of the Hukou System”, the decision of whether to pass restrictions of urban hukou (household registration) acquisition threshold has played an important role in the settlement decisions of the floating population. The government should formulate settlement policies according to the characteristics of the floating population.

Factors Influencing the Settlement Intentions of Chinese Migrants in Cities: An Analysis of Air Quality and Higher Income Opportunity as Predictors

With rapid urbanization, the air pollution issue is becoming an increasingly serious issue given that people are strongly swayed in their location choice to settle down in a growing urban area where most job opportunities have been created. This study investigated the influences of both air quality and income on the settlement intentions of Chinese migrants by using microlevel samples of the China Migrants Dynamic Survey (CMDS) data from 2017 and the annual average concentration of PM2.5 (particles with diameter ≤ 2.5 μm in the air) to measure a city’s air quality. The results showed that the settlement decisions of Chinese migrants involved a trade-off between income and air quality. Poorer air quality could significantly decrease the settlement intention, while a higher income could significantly increase the settlement intention of Chinese migrants. However, as the migrants’ income opportunity increased at a location, the negative influence of poorer air quality on the settlement intention at that location gradually declined. Specifically, when deciding whether to settle down in cities, the migrants with a non-agricultural “hukou” (household registration) tended to pay more attention to air quality than the migrants with an agricultural “hukou,” and migrants who moved farther away in geographic distance tended to pay more attention to income. It was concluded that the influences of air quality and income on the settlement intentions of the migrants were robust and consistent after using different estimation methods and considering the issue of endogeneity.

The Impact of Health Insurance on Healthcare Utilization by Migrant Workers in China

Health insurance is an essential instrument to ensure equal access to medical resources and promote the health of the general population. Robust evidence regarding whether migrant workers have benefited from available insurance schemes is limited. Drawing on survey data from the Rural Urban Migration in China (RUMiC) Project, this paper examines the effects of health insurance on migrant workers’ utilization of routine medical services, the medical burden, and the utilization of preventive medical services using a two-part model, the Heckman model, the Tobit model, and a probit model. Our findings indicate that, first, participating in medical insurance increases migrant workers’ probability of visiting a doctor. Unlike other medical insurance programs that positively affect migrant workers’ medical expenditure, the new rural cooperative medical system fails to play an effective role. Second, participation in any medical insurance program effectively reduces migrant workers’ medical burden and can improve the probability of preventive medical service utilization. Third, self-reported health and disease severity are pivotal to determining migrant workers’ medical expenditure. Fourth, high-income people have a good health status and a lower probability of becoming ill and can afford relatively higher medical expenses once they become ill. China’s medical insurance appears to mainly serve to reduce the financial burden for serious illnesses, reflecting important policy implications for policy-makers.