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Qian CX, Zhao Y, Anindya K, Tenneti N, Desloge A, Atun R, Qin VM, Mulcahy P, Lee JT. Non-communicable disease risk factors and management among internal migrant in China: systematic review and meta-analysis. BMJ Glob Health 2021; 6:bmjgh-2020-003324. [PMID: 34593512 PMCID: PMC8487202 DOI: 10.1136/bmjgh-2020-003324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 06/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background In 2019, there are more than 290 million people who have ever migrated from rural to urban areas in China. These rural-to-urban internal migrants account for more than one-fifth of China’s population and is the largest internal migrant group globally. We present the first systematic review that examines whether internal migrants are more likely to exhibit non-communicable diseases (NCDs) risk factors and have worse NCD management outcomes than non-migrant counterparts in China. Methods A systematic review was conducted via medical, public health, and economic databases including Scopus, MEDLINE, JSTOR, WHO Library Database and World Bank e-Library from 2000 to 2020. Study quality was assessed using the National Institute of Health Quality Assessment tool. We conducted a narrative review and synthesised differences for all studies included, stratified by different types of outcomes. We also conducted random-effects meta-analysis where we had a minimum of two studies with 95% CIs reported. The study protocol has been registered with PROSPERO: CRD42019139407. Results For most NCD risk factors and care cascade management, comparisons between internal migrants and other populations were either statistically insignificant or inconclusive. While most studies found migrants have a higher prevalence of tobacco use than urban residents, these differences were not statistically significant in the meta-analysis. Although three out four studies suggested that migrants may have worse access to NCD treatment and both studies suggested migrants have lower blood pressure control rates than non-migrants, these findings were not statistically significant. Conclusion Findings from this systematic review demonstrate that there is currently insufficient evidence on migrant and non-migrant differences in NCD risk factors and management in China. Further research is expected to investigate access to healthcare among internal and its effect on both their NCD outcomes and long-term healthcare costs in China.
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Affiliation(s)
- Cynthia Xinyi Qian
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA .,The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yang Zhao
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Kanya Anindya
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Naveen Tenneti
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Allissa Desloge
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rifat Atun
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.,Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Vicky Mengqi Qin
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Patrick Mulcahy
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John Tayu Lee
- The Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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Xu H, Dupre ME, Østbye T, Vorderstrasse AA, Wu B. Residential Mobility and Cognitive Function Among Middle-Aged and Older Adults in China. Res Aging 2018; 41:3-30. [PMID: 29665751 DOI: 10.1177/0164027518770780] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To assess the association between rural and urban residential mobility and cognitive function among middle-aged and older adults in China. METHOD We used data from the World Health Organization Study on global AGEing and adult health that included adults age 50+ from China ( N = 12,410). We used multivariate linear regressions to examine how residential mobility and age at migration were associated with cognitive function. RESULTS Urban and urban-to-urban residents had the highest level of cognitive function, whereas rural and rural-to-rural residents had the poorest cognitive function. Persons who migrated to/within rural areas before age 20 had poorer cognitive function than those who migrated during later adulthood. Socioeconomic factors played a major role in accounting for the disparities in cognition; however, the association remained significant after inclusion of all covariates. DISCUSSION Residential mobility and age at migration have significant implications for cognitive function among middle-aged and older adults in China.
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Affiliation(s)
- Hanzhang Xu
- 1 School of Nursing, Duke University, Durham, NC, USA.,2 Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Matthew E Dupre
- 3 Department of Population Health Sciences, Duke University, Durham, NC, USA.,4 Department of Sociology, Duke University, Durham, NC, USA.,5 Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Truls Østbye
- 1 School of Nursing, Duke University, Durham, NC, USA.,2 Duke Global Health Institute, Duke University, Durham, NC, USA.,5 Duke Clinical Research Institute, Duke University, Durham, NC, USA.,6 Department of Community and Family Medicine, Duke University, Durham, NC, USA
| | | | - Bei Wu
- 7 New York University Rory Meyers College of Nursing, New York City, NY, USA
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