Migration, environmental hazards, and health outcomes in China

The Contribution of Environmental Science to Mental Health Research: A Scoping Review

Mental health is influenced by multiple complex and interacting genetic, psychological, social, and environmental factors. As such, developing state-of-the-art mental health knowledge requires collaboration across academic disciplines, including environmental science. To assess the current contribution of environmental science to this field, a scoping review of the literature on environmental influences on mental health (including conditions of cognitive development and decline) was conducted. The review protocol was developed in consultation with experts working across mental health and environmental science. The scoping review included 202 English-language papers, published between 2010 and 2020 (prior to the COVID-19 pandemic), on environmental themes that had not already been the subject of recent systematic reviews; 26 reviews on climate change, flooding, air pollution, and urban green space were additionally considered. Studies largely focused on populations in the USA, China, or Europe and involved limited environmental science input. Environmental science research methods are primarily focused on quantitative approaches utilising secondary datasets or field data. Mental health measurement was dominated by the use of self-report psychometric scales. Measures of environmental states or exposures were often lacking in specificity (e.g., limited to the presence or absence of an environmental state). Based on the scoping review findings and our synthesis of the recent reviews, a research agenda for environmental science's future contribution to mental health scholarship is set out. This includes recommendations to expand the geographical scope and broaden the representation of different environmental science areas, improve measurement of environmental exposure, prioritise experimental and longitudinal research designs, and giving greater consideration to variation between and within communities and the mediating pathways by which environment influences mental health. There is also considerable opportunity to increase interdisciplinarity within the field via the integration of conceptual models, the inclusion of mixed methods and qualitative approaches, as well as further consideration of the socio-political context and the environmental states that can help support good mental health. The findings were used to propose a conceptual model to parse contributions and connections between environmental science and mental health to inform future studies.

The Impact of Migration Experience on Rural Residents' Mental Health: Evidence from Rural China

Migration experience is considered to be an important factor affecting mental health. With the increasing number of rural-to-urban migrant workers returning to their hometowns, the impact of migration experience on rural residents is worthy of noting. Using the data from the 2018 China Labor Dynamics Survey, this paper took migration experience as the identification criteria for returning migrant workers and empirically examined the impact of migration experience on rural residents' mental health. Our results indicated that migration experience had a significant negative impact on the mental health of rural residents. That is, returning migrant workers had a worse mental health status than that of rural residents who never left their hometowns. Mechanism analysis showed that social support and social comparison played an intermediary role in the impact of migration experience on the mental health of rural residents. We also detected considerable heterogeneity in the effects of migration experience: the short-term returning migrant workers and the passive returning migrant workers are more likely to be negatively affected by the migration experience. Our results emphasized the mental health problem faced by returning migrant workers. The policy makers should strengthen psychological education and mental health consultation according to the intergenerational differences and individual characteristics of returning migrant workers.

Spatial Equity of PM2.5 Pollution Exposures in High-Density Metropolitan Areas Based on Remote Sensing, LBS and GIS Data: A Case Study in Wuhan, China

In-depth studies have been conducted on the risk of exposure to air pollution in urban residents, but most of them are static studies based on the population of residential units. Ignoring the real environmental dynamics during daily activity and mobility of individual residents makes it difficult to accurately estimate the level of air pollution exposure among residents and determine populations at higher risk of exposure. This paper uses the example of the Wuhan metropolitan area, high-precision air pollution, and population spatio-temporal dynamic distribution data, and applies geographically weighted regression models, bivariate LISA analysis, and Gini coefficients. The risk of air pollution exposure in elderly, low-age, and working-age communities in Wuhan was measured and the health equity within vulnerable groups such as the elderly and children was studied. We found that ignoring the spatio-temporal behavioral activities of residents underestimated the actual exposure hazard of PM_2.5 to residents. The risk of air pollution exposure was higher for the elderly than for other age groups. Within the aging group, a few elderly people had a higher risk of pollution exposure. The high exposure risk communities of the elderly were mainly located in the central and sub-center areas of the city, with a continuous distribution characteristic. No significant difference was found in the exposure risk of children compared to the other populations, but a few children were particularly exposed to pollution. Children's high-exposure communities were mainly located in suburban areas, with a discrete distribution. Compared with the traditional static PM_2.5 exposure assessment, the dynamic assessment method proposed in this paper considers the high mobility of the urban population and air pollution. Thus, it can accurately reveal the actual risk of air pollution and identify areas and populations at high risk of air pollution, which in turn provides a scientific basis for proposing planning policies to reduce urban PM_2.5 and improve urban spatial equity.

Heterogeneous Impact of Social Integration on the Health of Rural-to-Urban Migrants in China

BACKGROUND

While several studies have found that lower levels of social integration may lead to a deterioration in the health status of migrants, previous research on the nexus between social integration and health has generally ignored the potential endogeneity of social integration. This paper examines the heterogeneous impact of social integration on the health of rural-to-urban migrants in China by exploiting plausibly exogenous, long-term, geographic variation in dialectal diversity.

METHODS

Drawing on nationally representative data from the 2017 China Migrants Dynamic Survey (n = 117,446), we first regressed self-reported health on social integration using ordinary least squares estimation and then used an ordered probit model as a robustness check. Additionally, to rule out the potential endogeneity of social integration, we relied mainly on an instrumental variable approach and used dialectal diversity as a source of exogenous variation for social integration.

RESULTS

We found that social integration has a significant positive impact on rural-to-urban migrants' health. We also detected considerable heterogeneity in the effects of social integration across gender, generation, and wage levels: the health status of women, more recent generation migrants, and migrants with wages in the middle of wage distribution are more likely to be affected by social integration.

CONCLUSIONS

We confirmed the beneficial impact of social integration on migrants' health, which has some important policy implications. Successful migration policies should take the fundamental issue of migrants' social integration into account.

Do public employment services affect the self-rated health of migrant workers in China?

Migrant workers greatly contributing to China’s industrialization and urbanization are confronted with increasing health risks. This study empirically investigates the effects of public employment services on the self-rated health of migrant workers in Shanghai China, by using data from the National Bureau of Statistics from 2015 to 2020. The estimation results under the Ordered Probit model illustrate that public employment services significantly improve the self-rated health of migrant workers, and vocational training, job development and other related services show an apparently positive correlation with the self-rated health. The marginal effect analysis reveals that public employment services obviously reduce the probability of health satisfaction as “average”, “relatively satisfied” and “relatively dissatisfied”, which translate into a significant increase in the probability of “very satisfied”. The mechanism analysis verifies that public employment services enhance the self-rated health by increasing the proportion of medical insurance and injury insurance of migrant workers. The results are still reliable by adopting the methods of subsample regression, Propensity Score Matching and variable substitution to conduct robustness checks. This study further enriches the literature on public employment services and the health status of migrant workers, and provides policy implications on improving the health status of migrant workers and the public employment service system of China under the impact of the COVID-19 pandemic.

Spatial Inequalities and Influencing Factors of Self-Rated Health and Perceived Environmental Hazards in a Metropolis: A Case Study of Zhengzhou City, China

Research on environmental pollution and public health has aroused increasing concern from international scholars; particularly, environmental hazards are among the important issues in China, focusing public attention on significant health risks. However, there are few studies concentrated on how perceived environmental hazards are characterized by spatial variation and on the impact of these risks on residents' health. Based on a large-scale survey of Zhengzhou City in 2020, we investigated how the self-rated health of residents and the environmental hazards perceived by them were spatially inequal at a fine (subdistrict) scale in Zhengzhou City, China, and examined the relationship among self-rated health, environmental hazards, and geographical context. The Getis-Ord Gi* method was applied to explore the spatially dependent contextual (neighborhood) effect on environmental health inequality, and the ordered multivariate logistic regression method was used to examine the correlative factors with environmental hazards, geographical context, and health inequality. The results reveal that self-rated health and environmental hazards were disproportionately distributed across the whole city and that these distributions showed certain spatial cluster characteristics. The hot spot clusters of self-rated health had favorable environmental quality where the hot spot clusters of environmental hazards were located and vice versa. In addition, health inequality was evident and was related to gender, income level, educational attainment, and housing area of residents, and the inequalities of environmental hazards existed with respect to income and housing area. Meanwhile, environmental risk inequalities associated with the social vulnerability of residents (the poor and those with low educational attainment) were obvious, with those residents experiencing a disproportionately high exposure to environmental hazards and reporting bad health conditions. The role of the geographical context (subdistrict location feature) also helps to explain the spatial distribution of health and environmental inequalities. Residents with better exposure to green coverage generally reported higher levels of self-rated health condition. In addition, the geographical location of the subdistrict also had a significant impact on the difference in residents' self-rated health status. The purpose of this study is to provide reference for policy makers to optimize the spatial pattern of urban public services and improve public health and environmental quality at a fine scale.

Spatio-Temporal Variation-Induced Group Disparity of Intra-Urban NO2 Exposure

Previous studies on exposure disparity have focused more on spatial variation but ignored the temporal variation of air pollution; thus, it is necessary to explore group disparity in terms of spatio-temporal variation to assist policy-making regarding public health. This study employed the dynamic land use regression (LUR) model and mobile phone signal data to illustrate the variation features of group disparity in Shanghai. The results showed that NO₂ exposure followed a bimodal, diurnal variation pattern and remained at a high level on weekdays but decreased on weekends. The most critical at-risk areas were within the central city in areas with a high population density. Moreover, women and the elderly proved to be more exposed to NO₂ pollution in Shanghai. Furthermore, the results of this study showed that it is vital to focus on land-use planning, transportation improvement programs, and population agglomeration to attenuate exposure inequality.

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.

Comorbid Depressive and Anxiety Symptoms and Their Correlates Among 93,078 Multiethnic Adults in Southwest China

Background: Depressive symptoms and anxiety symptoms commonly coexist and severely increases the disease burden worldwide. Little is known about the patterns and correlates of comorbid depressive and anxiety symptoms among the multiethnic populations of China.

Methods: This population-based study investigated the comprehensive associations of comorbid depressive and anxiety symptoms with lifestyles, stressful life events, chronic diseases, and physical and mental well-being among 93,078 participants (37,193 men, 55,885 women) aged 30–79 years across seven ethnic groups in Southwest China. Multivariable logistic regression models were used to estimate associations.

Results: Overall, 2.9% (2.1% in men and 3.5% in women) participants had comorbid depressive and anxiety symptoms; there was considerable heterogeneity among multiethnic populations. Participants with chronic diseases were more likely to have comorbidity than those without them; people with rheumatic heart disease reported the highest risk, with an odds ratio (OR) of 6.25 and 95% confidence interval (CI) of 4.06–9.62. Having experienced 3 or more stressful life events (OR, 8.43, 95% CI: 7.27–9.77), very poor self-rated health status (OR, 33.60, 95%CI: 25.16–44.87), and very unsatisfied life (OR, 33.30, 95% CI: 23.73–46.74) had strong positive associations with comorbid depressive symptoms and anxiety symptoms, with a dose-response relationship (P < 0.05). High frequency of physical activity had negative associations. All the associations were stronger than depressive symptoms alone or anxiety symptoms alone.

Conclusions: Our findings emphasize the need to focus on the vulnerable ethnic groups with comorbid depressive and anxiety symptoms, ultimate for help early prevention and improvement of health equity in the underdevelopment and high urbanization areas.

Association of High-Speed Rail and Tuberculosis Transmission in Newly Integrated Regions: Quasi-Experimental Evidence from China

Objectives: The spread of tuberculosis (TB) is related to changes in the social network among the population and people’s social interactions. High-speed railway (HSR) fundamentally changed the integrated market across cities in China. This paper aims to examine the impact of HSR on TB transmission in newly integrated areas.

Methods: By exploiting the opening and operation of the first HSR in Sichuan province as a quasi-natural experiment, we have collected and used the economic, social, and demographic data of 183 counties in Sichuan province from 2013 to 2016.

Results: The new HSR line is associated with a 4.790 increase in newly diagnosed smear-positive TB cases per 100,000 people among newly integrated areas. On average, an additional increase of 34.178 newly diagnosed smear-positive TB cases occur every year in counties (or districts) covered by the new HSR.

Conclusion: HSR development has significantly contributed to the transmission of TB. The public health system in China needs to pay more attention to the influences of new, mass public transportation.

Do Neighborhoods with Highly Diverse Built Environment Exhibit Different Socio-Economic Profiles as Well? Evidence from Shanghai

The link between the built environment and residential segregation has long been of interest to the discussion for sustainable and socially resilient cities. However, direct assessments on how extensively diverse built environments affect the social landscapes of cities at the neighborhood level are rare. Here, we investigate whether neighborhoods with a diverse built environment also exhibit different socio-economic profiles. Through a geodemographic approach, we scrutinize the socio-economic composition of Shanghai’s neighborhoods. We statistically compare the top 10% (very high values) to the bottom 10% (very low values) of the following built environment variables: density, land use mix, land use balance, and greenness. We show that high-density areas have three times the percentage of divorced residents than low-density areas. Neighborhoods with a high level of greenness have median values of 30% more residents aged between 25–44 years old and five times the percentage of houses between 60 to 119 m2 than low-greenness areas. In high land-use mix areas, the share of people that live on a pension is 30% more than the low land-use mix areas. The findings of this study can be used to improve the designs of modern, sustainable cities at the neighborhood level, significantly improving quality of life.

Is Compact Urban Form Good for Air Quality? A Case Study from China Based on Hourly Smartphone Data

In previous studies, planners have debated extensively whether compact development can improve air quality in urban areas. Most of them estimated pollution exposure with stationary census data that linked exposures solely to residential locations, therefore overlooking residents’ space–time inhalation of air pollutants. In this study, we conducted an air pollution exposure assessment by scrutinizing one-hour resolution population distribution maps derived from hourly smartphone data and air pollutant concentrations derived from inverse distance weighted interpolation. We selected Wuhan as the study area and used Pearson correlation analysis to explore the effect of compactness on population-weighted concentrations. The results showed that even if a compact urban form helps to reduce pollution concentrations by decreasing vehicle traveling miles and tailpipe emissions, higher levels of building density and floor area ratios may increase population-weighted exposure. With regard to downtown areas with high population density, compact development may locate more people in areas with excessive air pollution. In all, reducing density in urban public centers and developing a polycentric urban structure may aid in the improvement of air quality in cities with compact urban forms.

Establishment and associated factors of health records among young Chinese migrants

BACKGROUND

Most Chinese migrants have been faced with obstacles to getting access to local public health services. Young migrants among internal migrants make a major contribution to the economy. However, the establishment of their health records has been ignored. This research was aimed at exploring the status and associated factors of the establishment of health records among young Chinese migrants.

METHODS

Data were obtained from the 2017 China Migrants Dynamic Survey (CMDS). Chi-square test and binary logistic regression were performed to investigate the associated factors of the establishment of health records among young Chinese migrants.

RESULTS

Approximately 30.2% of young migrants had their health records established in inflow communities. Urban residence, medical insurance (insured), and lower average monthly household income were attributed to the establishment of more health records. Young migrants who were in northeast China and across provinces and immigrated for working or engaging in trade were less likely to have health records established. Young migrants who participated in social activities and public affairs activities and took type of people in touch as natives in the inflow area showed a higher possibility of establishing health records. Meanwhile, receiving health education and hearing about national basic public health services (BPHSs) were beneficial for establishing the health records of more young migrants.

CONCLUSION

This study showed that the health records of young migrants had a relatively low establishment rate. Sociodemographic and migration characteristics, health status, public health services, and social integration factors were all related to the health record establishment of young Chinese migrants.

An analysis of mother stress before and during COVID-19 pandemic: The case of China

In this study, the authors aimed to examine relations between mothers' stress (PSI-SF) and their children during the COVID-19 pandemic confinement in mainland China (N  = 274; mean age = 32.95, SD = 5.59). Our analyses revealed mothers identified more stress problems during the confinement than before including Difficult Child, Parental Distress, and Parent-Child Dysfunctional Interaction, which predicted requests for clinical or parents support services. Mothers living in rural areas reported less stress. Single mothers and those in small households displayed a higher level of stress. Our research results may assist policymakers, professionals, and researchers to design support needed to promote families' psychological well-being.

Relationship between Long-Term Residential Green Exposure and Individuals' Mental Health: Moderated by Income Differences and Residential Location in Urban China

Environmental health effects during urbanization have attracted much attention. However, knowledge is lacking on the relationship between long-term cumulative residential environment and health effects on individuals during rapid transformations in urban physical and social space. Taking Guangzhou, China, as a case example, this study analyzed the relationship between long-term exposure to green environments and residents’ mental health under urban spatial restructuring. Based on a household survey in 2016, 820 residents who have lived in Guangzhou for more than 15 years were used as the sample. High-resolution remote sensing images were used to assess the long-term green exposure of residents. The results indicate that long-term green exposure in residential areas had a negative correlation with residents’ mental health (p < 0.05), and the correlation was strongest for the cumulative green environment in the last five years. However, this significant effect was moderated by income and residential location. Green exposure had a positive relationship with mental health for low income groups, and a negative relationship for middle and high income groups. In addition, residents living farther away from the city center were likely to have fewer green environmental health benefits. Residential relocation in a rapidly urbanizing and transforming China has led to the continuous differentiation of residential green environments among different income groups, which has also caused different mental health effects from green exposure. It provides empirical evidence and theoretical support for policymakers to improve the urban environment and reduce environmental health disparities by considering social differences and residential location.

Health-related quality of life in Chinese rural-to-urban migrants: Investigating the roles of working conditions and job satisfaction

The existing research aims to explore the relationships between working conditions, job satisfaction and health-related quality of life (HRQL) of Chinese rural-to-urban migrants. Both probability and nonprobability sampling methods were done in four randomly chosen jurisdictions of Nanjing (N = 712). Results reveal that the working environment has the strongest and positive correlation with job satisfaction. In addition, job satisfaction is negatively correlated with the number of working days per week, and affects the physical and psychological health status of Chinese rural-to-urban migrants. This study highlights the importance to improve working conditions for migrants and their HRQL and recommends government policies to provide services to Chinese migrants and protect their human rights, as well as promote awareness of their working conditions and HRQL.

Experiences of discrimination and self-reported health in Chinese migrants: a structural equation model

Background

Many migrants suffer from discrimination and poor health in China. We sought to examine the associations between experiences of discrimination and self-reported health among internal migrants in China, as well as the mediators of social integration and perceived stress.

Methods

The data was obtained from a specific survey of migrants, as a part of the National Health and Family Planning Dynamic Monitoring for Migrants conducted in 2014. A total of 15,999 migrants aged 15 to 59 years were recruited by a stratified, multistage clustered sampling procedure in eight Chinese cities. Structural Equation Modeling (SEM) was conducted.

Results

The results indicated that experiences of discrimination were associated with worse self-reported health (β = − 0.32, P < 0.001), less social integration (β = − 0.25, P < 0.001), as well as higher perceived stress (β = 0.21, P < 0.01). Both objectively measured socioeconomic status (β = 0.21, P < 0.001) and subjective social status (β = 0.21, P < 0.01) had significantly positive correlations with self-reported health.

Conclusions

The discrimination, social exclusion and perceived stress experienced by migrants have significant implications on their health.

COVID-19 Interconnectedness: Health Inequity, the Climate Crisis, and Collective Trauma

The COVID-19 pandemic brings to the forefront the complex interconnected dilemmas of globalization, health equity, economic security, environmental justice, and collective trauma, severely impacting the marginalized and people of color in the United States. This lack of access to and the quality of healthcare, affordable housing, and lack of financial resources also continue to have a more significant impact on documented and undocumented immigrants. This paper aims at examining these critical issues and developing a framework for family therapists to address these challenges by focusing on four interrelated dimensions: cultural values, social determinants of health, collective trauma, and the ethical and moral responsibility of family therapists. Given the fact that family therapists may unwittingly function as the best ally of an economic and political system that perpetuates institutionalized racism and class discrimination, we need to utilize a set of principles, values, and practices that are not just palliative or after the fact but bring forth into the psychotherapeutic and policy work a politics of care. Therefore, a strong call to promote and advocate for the broader continuum of health and critical thinking preparing professionals to meet the challenges of health equity, as well as economic and environmental justice, is needed. The issues discussed in this paper are specific to the United States despite their relevance to family therapy as a field. We are mindful not to generalize the United States' reality to the rest of the world, recognizing that issues discussed in this paper could potentially contribute to international discourse.

Resilience, mental health and urban migrants: a narrative review

Purpose

The purpose of this paper is to provide a narrative review of the literature on mental health resilience and other positive mental health capacities of urban and internal migrants.

Design/methodology/approach

The methodology for this narrative review included a search of articles published up to 2017. The abstracts were screened and relevant articles studied and discussed. Literature on the particular mental health challenges of urban migrants in India was also studied. References found in the literature relating to neurourbanism were also followed up to explore broader historical and conceptual contexts.

Findings

Several key sources and resources for mental health resilience were identified – including familial and community networks and individual hope or optimism. Nevertheless, much of the literature tends to focus at the level of the individual person, even though ecological systems theory would suggest that mental health resilience is better understood as multi-layered, i.e. relevant to, and impacted by, communities and broader societal and environmental contexts.

Originality/value

This paper provides insight into an aspect of migrant mental health that has tended to be overlooked hitherto: the mental health resilience and positive mental health capacities of urban migrants. This is particularly relevant where professional “expert” mental health provision for internal migrant communities is absent or unaffordable. Previous work has tended to focus predominantly on mental health risk factors, despite growing awareness that focusing on risk factors along can lead to an over-reliance on top-down expert-led interventions and overlook positive capacities for mental health that are sometimes possessed by individuals and their communities.

Health Disparities: A Perspective on Internal Migration and Health Behavior in Sudan

Background:

Natural hazards, poor socio-economic conditions, low literacy levels, and long-standing conflicts affect traditional gold miners in Sudan and contribute to multiple health vulnerabilities. An extensive survey reveals differential health risk among internal migrant miners leading to short-, medium-, and long-term health consequences and disparities. The need to identify determinants of health behavior and limited prior research on internal migrants involved in traditional gold mining in Sudan motivated this research.

Objective:

To investigate potential health disparities between internal migrant workers participating in traditional gold mining and their local counterparts.

Methods:

Questionnaires on socio-demographic and health status in the Abideya area in the River Nile state of Sudan were administered to 211 miners. Composite score variables were devised based on existing literature and data for assessment of underlying risk determinants for the miners’ vulnerability (migrants and non-migrants). Six new composite variables were constructed and subjected to analysis by immigration status.

Findings:

There are disparities in drivers of health behavior related to the immigration status of traditional gold miners. Access to water, sanitation, and hygiene services are common determinants for the health behavior of both internal migrant miners (p < 0.001) and their local counterparts (p < 0.001). However, knowledge (p < 0.05) and perception (p < 0.05) are additional critical determinants for the health behavior of local miners, while education (secondary, p < 0.01) is an additional modifier for the immigrants’ health behavior.

Conclusions:

The outcomes of this field-based research suggest increased awareness and risk perceptions among migrants could improve health-related behaviors. The study advocates for policymaking and implementation of health programs at all levels to reduce health disparities between migrants and non-migrants, improving the health status of the entire community.

Relationship of economic development, family income and health status in China: The moderating role of environmental pollution perception

Based on the matched data set of the 2013 Chinese General Social Survey and the gross domestic product per capita data extracted from China Statistical Yearbook 2013, this study used hierarchical regression analysis and structural equation models to examine whether environmental pollution perception would moderate the association between economic development and health status. Results revealed that economic development had a mediating effect via family income on health status. A moderated actor effect showed higher level of pollution perception weakens the relationship between family income and health status. Our findings suggested that appropriate environmental regulations should be implemented to sustain healthy economic growth in China.

Using street view data and machine learning to assess how perception of neighborhood safety influences urban residents' mental health

Previous studies have shown that perceptions of neighborhood safety are associated with various mental health outcomes. However, scant attention has been paid to the mediating pathways by which perception of neighborhood safety affects mental health. In addition, most previous studies have evaluated perception of neighborhood safety with questionnaires or field audits, both of which are labor-intensive and time-consuming. This study is the first attempt to measure perception of neighborhood safety using street view data and a machine learning approach. Four potential mediating pathways linking perception of neighborhood safety to mental health were explored for 1029 participants from 35 neighborhoods of Guangzhou, China. The results of multilevel regression models confirm that perception of neighborhood safety is positively associated with mental health. More importantly, physical activity, social cohesion, stress and life satisfaction mediate this relationship. The results of a moderation analysis suggest that the beneficial effects of physical activity and social cohesion on mental health are strengthened by a perception of neighborhood safety. Our findings suggest the need to increase residents' perception of neighborhood safety to maintain mental health in urban areas of China.

The influence of urban planning factors on PM2.5 pollution exposure and implications: A case study in China based on remote sensing, LBS, and GIS data

In recent years, haze pollution has become a serious environmental problem affecting cities in China. Reducing PM_2.5 concentrations through urban planning is a promising method that has been a focus of recent multidisciplinary research. Most existing studies only analyze the relationship between urban planning factors and PM_2.5 concentration, and it is difficult to accurately reflect residents' actual air pollution exposure without considering their space-time behaviors. This study uses satellite remote sensing and location service data to measure PM_2.5 pollution exposure in Wuhan metropolitan area and explores the effects of urban spatial structure, land use, spatial form, transportation, and green space on pollution exposure. The results show that spatial structure, building density, road density, and green space coverage have a significant impact on PM_2.5 pollution exposure. In addition, this study proposes corresponding implications for urban planning to improve public respiratory health.

Exploring the relationship between migrants' purchasing of commercial medical insurance and urbanisation in China

Background

Over the past 40 years, the Chinese government has diligently promoted the market-oriented reform of the health insurance system. However, as it is affected by the urban-rural dual structure, most rural-to-urban migrants are excluded from local public health services and medical insurance schemes in the cities in which they live. Buying local commercial medical insurance (CMI) is an important way for migrants to obtain local medical services. Therefore, this study’s purposes were to explore the city factors that affect migrants’ purchase of CMI and to investigate the relationship between urbanisation and migrants’ purchase of CMI.

Methods

This study used the 2013 National Floating Population (Migrants) Dynamic Monitoring Survey data, which covered 31 provinces, municipalities, and autonomous regions in China. The respondents were migrants (15–59 years; n = 164,752) who lived in the inflow areas for more than a month without obtaining a local household registration record. We used city factors, neighbourhood factors, and individual factors that affect residents’ purchase of CMI to construct a theoretical framework and examined the effect of urbanisation on migrants’ choice of CMI using multilevel logistic regression.

Results

The proportion of migrants who had local or hometown CMI was 5.70%; most migrants had no CMI (94.30%). Of these, 4.42% had CMI in the city in which they live (i.e. local CMI) and 1.64% had CMI in their hometown (i.e. hometown CMI). Migrants living in first-tier and third-tier cities were less likely to have CMI than those in second-tier cities (odds ratio [OR] = 0.454, 95% confidence interval [CI]: 0.395–0.521; OR = 0.588, 95% CI: 0.464–0.746). Furthermore, the regression results revealed a U-shaped relationship between the odds of migrants having CMI and the urbanisation rate of the prefecture-level cities. The findings also indicated that with higher socioeconomic status, there was a greater probability of purchasing CMI.

Conclusions

The improvement of urbanisation has a positive effect on migrants’ purchase of CMI. However, China’s medical insurance market is still underdeveloped. It is necessary for the Chinese government to increase migrants’ participation rate in CMI to cover soaring medical expenses.

The relationship between urbanization and depression in China: the mediating role of neighborhood social capital

BACKGROUND

Previous studies in developed countries have found that living in rapidly urbanizing areas is associated with higher risk of mental illness and that social capital had a protective effect on individual mental health. However, the literature is missing empirical studies of the relationship between urbanization, neighborhood social capital and mental health in rapidly urbanizing countries. To bridge this knowledge gap, this study investigated the effects of urbanization on depressive symptoms in China, with an emphasis on the mediating role of neighborhood social capital in the relationship between urbanization and individual-level depressive symptoms.

METHODS

Nationally representative survey data from the 2016 wave of China's Labor-force Dynamics Survey were used. A sample of 20,861 individuals was obtained from 401 neighborhoods in 158 prefecture-level divisions of 29 provinces. Depressive symptoms were measured using CES-D scores. Neighborhood social capital was assessed by three individual-level variables aggregated to the neighborhood level: perceptions of neighborly trust, the extent of neighborly reciprocity, and membership to neighborhood social groups. Multilevel linear regression and mediation analyses were used to estimate the statistical relationships.

RESULTS

The multilevel linear regression analyses found negative relationships between urbanization rate and CES-D score. The mediation analysis found that neighborhood-level social capital was an inconsistent mediator in the relationship between urbanization rate and CES-D score. Interaction terms between urbanization rate and two measures of neighborhood-level social capital were statistically significant, indicating that the protective effects of neighborly reciprocity and membership to neighborhood social groups on CES-D scores (negative relationships) were stronger in the relatively more urbanized areas.

CONCLUSION

Urbanization supports mental health in the Chinese context, although it might undermine residents' mental health by reducing neighborhood social capital. The protective effect of neighborhood-level reciprocity and social group membership on mental health increased with urbanization.

Perceived Environmental Pollution and Its Impact on Health in China, Japan, and South Korea

Objectives

Environmental pollution is a significant global issue. Both objective (scientifically measured) environmental pollution and perceived levels of pollution are important predictors of self-reported health. The purpose of this study was to compare the associations between perceived environmental pollution and health in China, Japan, and South Korea.

Methods

Data were obtained from the East Asian Social Survey and the Cross-National Survey Data Sets: Health and Society in East Asia, 2010 (n=7938; China, n=3866; Japan, n=2496; South Korea, n=1576).

Results

South Koreans perceived environmental pollution to be the most severe, while Japanese participants perceived environmental pollution to be the least severe. Although the Japanese did not perceive environmental pollution to be very severe, their self-rated physical health was significantly related to perceived environmental pollution, while the analogous relationships were not significant for the Chinese or Korean participants. Better mental health was related to lower levels of perceived air pollution in China, as well as lower levels of perceived all types of pollution in Japan and lower levels of perceived noise pollution in South Korea.

Conclusions

Physical and mental health and individual socio-demographic characteristics were associated with levels of perceived environmental pollution, but with different patterns among these three countries.

Differences in the health-age profile across rural and urban sectors: a study on migrants and non-migrants in China

OBJECTIVES

The objective of this study is to examine age-health differentials between migrants and non-migrants in the context of migration in China.

STUDY DESIGN

We use nationally representative data from the China Labor-force Dynamics Survey to analyze the relationship between age and health across different migration status groups.

METHODS

We used a comprehensive measure of perceived health from factor analysis and structural equation models to take multiple dimensions of subjective health into consideration.

RESULTS

We found a difference in the association between age and health (net of controls) at age 46 years and above but not for younger age groups. That is, there is a health disadvantage between those who had ever migrated and urban non-migrants in older adulthood but not for young adulthood. However, the age-health profile of rural ever-migrants is not different from that of rural non-migrants.

CONCLUSIONS

These results highlight the effect of migration on health at different ages, which reflects the toll that migration takes on health over time. Our results imply that researchers should take into consideration life stages when examining the migration-health nexus. We also argue that there are potential influences related to China's longstanding division between rural and urban sectors.

Competing Forces of Socioeconomic Development and Environmental Degradation on Health and Happiness for Different Income Groups in China

China's rapid socioeconomic growth in recent years and the simultaneous increase in many forms of pollution are generating contradictory pictures of residents' well-being. This paper applies multilevel analysis to the 2013 China General Social Survey data on social development and health to understand this twofold phenomenon. Multilevel models are developed to investigate the impact of socioeconomic development and environmental degradation on self-reported health (SRH) and self-reported happiness (SRHP), differentiating among lower, middle, and higher income groups. The results of the logit multilevel analysis demonstrate that income, jobs, and education increased the likelihood of rating SRH and SRHP positively for the lower and middle groups but had little or no effect on the higher income group. Having basic health insurance had an insignificant effect on health but increased the likelihood of happiness among the lower income group. Provincial-level pollutants were associated with a higher likelihood of good health for all income groups, and community-level industrial pollutants increased the likelihood of good health for the lower and middle income groups. Measures of community-level pollution were robust predictors of the likelihood of unhappiness among the lower and middle income groups. Environmental hazards had a mediating effect on the relationship between socioeconomic development and health, and socioeconomic development strengthened the association between environmental hazards and happiness. These outcomes indicate that the complex interconnections among socioeconomic development and environmental degradation have differential effects on well-being among different income groups in China.

The effect of socioeconomic status and social inclusion on the mental health of Chinese migrants: A comparison between interprovincial and intra-provincial migrants

This article sought to explore the impacts of socioeconomic status and social inclusion on intra-provincial and interprovincial migrants' mental health by constructing the Bayesian structural equation model. A total of 14,584 migrants aged 15-59 years living in eight cities of China were selected. It was found that the impacts of socioeconomic status and social inclusion on mental health were converse for these two groups. And the manifest variables coefficients of socioeconomic status and social inclusion were also converse. Therefore, governments should make some policies to further improve the mental health of migrants, including strengthening the community cohesion, social atmosphere, and governmental support.

The social income inequality, social integration and health status of internal migrants in China

Background

To examine the interaction between social income inequality, social integration, and health status among internal migrants (IMs) who migrate between regions in China.

Methods

We used the data from the 2014 Internal Migrant Dynamic Monitoring Survey in China, which sampled 15,999 IMs in eight cities in China. The Gini coefficient at the city level was calculated to measure social income inequality and was categorized into low (0.2 < Gini <= 0.3), medium (0.3 < Gini <= 0.4), high (0.4 < x < = 0.5), and very high (Gini >0.5). Health status was measured based upon self-reported health, subjective well-being, and perceptions of stress and mental health. Social integration was measured from four perspectives (acculturation and integration willingness, social insurance, economy, social communication). Linear mixed models were used to examine the interaction effects between health statuses, social integration, and the Gini coefficient.

Results

Factors of social integration, such as economic integration and acculturation and integration willingness, were significantly related to health. Social income inequality had a negative relationship with the health status of IMs. For example, IMs in one city, Qingdao, with a medium income inequality level (Gini = 0.329), had the best health statuses and better social integration. On the other hand, IMs in another city, Shenzhen, who had a large income inequality (Gini = 0.447) were worst in health statues and had worse social integration.

Conclusion

Policies or programs targeting IMs should support integration willingness, promote a sense of belonging, and improve economic equality. In the meantime, social activities to facilitate employment and create social trust should also be promoted. At the societal level, structural and policy changes are necessary to promote income equity to promote IMs’ general health status.

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

Previous studies have not paid enough attention to the effect of health on urban-settlement intention of rural-urban migrants in China. Using survey data from the Rural Urban Migration in China project, this article examines how self-rated physical and mental health influence rural-urban migrants' intention to settle down in cities. First, the results show that both self-rated physical and mental health are significant factors influencing the migrants' intention to permanently move to cities. Second, the effect of physical health on rural-urban migrants' intentions to permanently reside in cities can be moderated by their length of urban residence. Third, the impact of health on rural-urban migrants' urban-settlement intention shows no generational differences. According to the research findings, this paper discusses how urban-settlement intention of rural-urban migrants based on health selection might impair urbanization, exacerbate health disparity between the rural and urban areas, and aggravate the burden on healthcare system in rural areas of China in the long run.

Community Restructuring and Depressive Symptoms of Rural Mature and Elderly Adults: A Multilevel Analysis Based on a National Dataset in China

Community restructuring is an important predictor for residents' mental health. However, few studies have investigated how it affects the depressive symptoms of rural ageing population. Using cross-sectional data from China Health and Retirement Longitudinal Study (CHARLS), this study examined how community restructuring was associated with depressive symptoms of Chinese rural mature and older adults and what community-level factors mediated the association. We found that people in restructuring communities reported .75 unit lower depression score (p < .01); community restructuring is associated with more infrastructure, recreational amenities, and grassroots organization (p < .001) in the community; and the availability of infrastructure (p < .01) and grassroots organization (p < .05) had significant indirect effect on the association between community restructuring and depressive symptoms. World countries' urbanization policy shall not only focus on community physical environment, but also on the development of grassroots organizations that involve and connect local people.

Urbanization and Mental Health in China: Linking the 2010 Population Census with a Cross-Sectional Survey

Along with the rapid urbanization in China, the state of mental health also receives growing attention. Empirical measures, however, have not been developed to assess the impact of urbanization on mental health and the dramatic spatial variations. Innovatively linking the 2010 Chinese Population Census with a 2011 national survey of urban residents, we first assess the impact of urbanization on depressive symptoms measured by the Center of Epidemiological Studies Depression Scale (CES-D) of 1288 survey respondents. We then retrieve county-level characteristics from the 2010 Chinese Population Census that match the individual characteristics in the survey, so as to create a profile of the “average person” for each of the 2869 counties or city districts, and predict a county-specific CES-D score. We use this county-specific CES-D score to compute the CES-D score for the urban population at the prefectural level, and to demonstrate the dramatic spatial variations in urbanization and mental health across China: highly populated cities along the eastern coast such as Shenyang and Shanghai show high CES-D scores, as do cities in western China with high population density and a high proportion of educated ethnic minorities.

Role of casual contacts in the recent transmission of tuberculosis in settings with high disease burden

Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. It is expected that combining multiple molecular methods will further help in focusing contact investigations. We performed a population-based molecular epidemiological study in six sites in China between 1 June 2009 and 31 December 2010. A genotyping method combining 7-loci MIRU-VNTR and IS6110-based RFLP was employed to determine predictors of recent transmission. A second interview was performed with the clustered patients to identify potential epidemiological links. The molecular clustering analysis revealed that 187 isolates (15.3%) were clustered by sharing identical VNTR-IS6110 combined patterns, with an estimated recent transmission index being 8.9%. None of these patients reported having contacts with other members within the same cluster. Nineteen of 121 reported having a history of contact with a TB case within 2 years before the current TB diagnosis. Additionally, geographical correlation was established for 19 cases in nine clusters, while only one possible epidemiological link was established in secondary interview. The results underscore the role of casual contact or reactivation of latent TB as a driving factor maintaining the current endemicity in rural China, with high disease burdens of tuberculosis.