Psychological distress of rural-to-urban migrants in two Chinese cities: Shenzhen and Shanghai

Revisiting the impact of public spaces on the mental health of rural migrants in Wuhan: an integrated multi-source data analysis

Current research on public spaces and mental health often focuses on the independent relationship of one or more social mediators, neglecting the nuanced implications and serial mechanisms inherent in the progressive social process. Using Wuhan city, China, as a study case with multi-source data, this research applies Multilevel Generalized Structural Equation Modeling and deep learning techniques to explore the differential effects of public spaces with varying degrees of publicness (i.e., typical, semi-, and privately owned) on rural migrants' mental health. Crucially, this study scrutinizes both explicit (social interaction) and implicit (perceived integration) social mechanisms to revisit the relationships. The findings reveal that not all public spaces equally influence mental health, with typical and privately owned public spaces conferring profound benefits. Notably, public spaces impact mental health chiefly through perceived integration instead of through direct social interaction. Social interaction improves mental health primarily by enhancing perceived integration, suggesting that meaningful connections beyond superficial encounters are critical. In particular, we observed significant social effects in typical and privately owned public spaces but limited social functionality in semi-public spaces. This evidence contributes to the knowledge required to create supportive social environments within public spaces, integral to nurturing inclusive urban development.

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.

Influenza vaccination uptake and its determinants during the 2019-2020 and early 2020-2021 flu seasons among migrants in Shanghai, China: a cross-sectional survey

Influenza vaccination coverage has generally been low in mainland China. However, few studies have attempted to measure influenza vaccination coverage among internal migrants in China who are at an increased risk of influenza infections. This study assessed influenza vaccination coverage and the factors associated with vaccination uptake among internal migrants in Shanghai, China. We conducted a cross-sectional online survey among a sample of migrants residing in Shanghai during November 1–20, 2020, to investigate vaccination uptake during the 2019–20 and early 2020–21 flu seasons (September to November 2020). Multivariable logistic regression was used to examine the factors associated with influenza vaccination uptake for the two flu seasons. About a quarter, 26.3%, and 24.4% of respondents reported receiving an influenza vaccination during the 2019–20 and early 2020–2021 flu seasons, respectively. Respondents who were divorced or widowed, had more household members (2 or ≥ 3), and considered themselves in good health were more likely to receive an influenza vaccine, regardless of the season. Respondents who perceived that they were highly susceptible to influenza and COVID-19 and those who reported ever consulting a medical professional about COVID-19 were more likely to have received a flu vaccination in the early 2020–21 flu season. The uptake of influenza vaccination among internal migrants in Shanghai was suboptimal. We found a range of factors linked to influenza vaccination uptake, pointing to the need for more in-depth evaluations on the underlying reasons driving the vaccination uptake among vulnerable populations in China, especially during the COVID-19 pandemic.

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.

Confidence, Acceptance and Willingness to Pay for the COVID-19 Vaccine among Migrants in Shanghai, China: A Cross-Sectional Study

Understanding the public’s attitude towards COVID-19 vaccination and their acceptance could help facilitate the COVID-19 rollout. This study aimed to assess the acceptance and willingness to pay (WTP) for the COVID-19 vaccine among migrants in Shanghai, China. A cross-sectional study was conducted among 2126 migrants in Shanghai for the period 1–20 November 2020. Convenience sampling was used to recruit respondents in workplaces with large numbers of migrant workers. Multivariable (ordered) logistic regressions were used to examine factors associated with acceptance and WTP of the COVID-19 vaccine. Most (89.1%) migrants would accept COVID-19 vaccination. Over 90.0% perceived the COVID-19 vaccine as important, while only 75.0% and 77.7% perceived vaccines safe and effective. Socio-demographic factors were not significantly associated with vaccine acceptance, but confidence in the importance (OR 8.71, 95% CI 5.89–12.89), safety (OR 1.80, 95% CI 1.24–2.61) and effectiveness (OR 2.66, 95% CI 1.83–3.87) of COVID-19 vaccine was significantly positively associated with vaccine acceptance. The top reasons for vaccine hesitancy were lack of vaccine information and confidence. The proportion of those definitely willing to get the COVID-19 vaccine was 20% lower if paid by themselves than free vaccination. Migrants were willing to pay a median amount of USD 46 for the COVID-19 vaccine. Results show that a high acceptance of the COVID-19 vaccine was universal among migrants in Shanghai. Concerns about vaccine safety, effectiveness and high costs of the COVID-19 vaccine may hinder their uptake. Effective health communication to build confidence in the COVID-19 vaccine and subsidies toward the costs of these vaccines are needed to improve uptake.

Gender disparities in depressive and anxiety symptoms among internal migrant workers in Shenzhen: a cross-sectional study

OBJECTIVES

To investigate the gender disparities in the prevalence and severity of depressive and anxiety symptoms and associated factors among internal migrant workers in Shenzhen.

DESIGN

Cross-sectional study.

SETTING

Labour intensive factories in Shenzhen, Guangdong, China.

PARTICIPANTS

We recruited 3200 internal migrant workers who aged over 18 years old and above and did not register in Shenzhen's household registration system. There were 3095 participants eligible for this study.

METHODS

Participants completed sociodemographic questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the UCLA Loneliness Scale, the Barratt Impulsiveness Scale, the Social Support Rating Scale, the Simplified Coping Style Questionnaire and Meaning in Life Questionnaire. We applied χ² test, analysis of variance, Wilcoxon rank test, Fisher's exact test and univariate and multivariate multilevel linear regression analysis.

RESULTS

The overall prevalence of depressive and anxiety symptoms was 27.85% and 19.26% among internal migrant workers. We reported gender disparities of depressive and anxiety symptoms among participants that the prevalence of depressive and anxiety symptoms was higher in women (30.57% vs 26.43% and 22.67% vs 17.47%), and the symptoms were more severe among women. Female migrant workers were more likely to be singled, have lower prevalence of smoking and drinking, receive less education and monthly income, have higher level of impulsiveness and social support and lower level of meaning in life. We found age, marriage, income, adaption to living in Shenzhen, being discriminated, drinking, loneliness, impulsiveness, social support, coping strategies and meaning of life were associated with the severity of depressive and anxiety symptoms among internal migrant workers in Shenzhen.

CONCLUSION

Gender inequality may be the institutional factor leading to disparities in depressive and anxiety symptoms among internal migrant workers. Interventions should be embedded with strategies improving gender equality.

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.

The Potential Psychological Mechanism of Subjective Well-Being in Migrant Workers: A Structural Equation Models Analysis

Objective: The aim of this study was to identify the potential psychological mechanism of well-being in migrants in Shanghai, China. Methods: A cross-sectional study was conducted in 2018. First, a literature review was conducted to understand the salutogenesis of migrants in China. Then, 2573 random participants were recruited from six workplaces and public places in six districts of Shanghai. The Chinese versions of the Patient Health Questionnaire-9 (PHQ-9), the Personal Wellbeing Index (PWI), and the Sense of Coherence (SOC) Scale were used to evaluate the depression, subjective well-being (SWB), and SOC of migrants. The t-test, ANOVA, and multiple linear regression and structural equation models (SEM) were used to analyze the correlations and paths among generalized resistant resources (GRRs), SOC, PHQ, and SWB. Results: The subjects were aged between 18 and 58 (mean, 28.17; SD, 6.99). SOC showed a positive correlation with SWB (r = 0.46, p < 0.001) and a negative correlation to PHQ (r = -0.53, p < 0.001). After controlling for the demographic characteristics, we found that PHQ, SOC (comprehensibility, manageability, meaningfulness), and GRRs (income ratio, marital status) contributed 33.3% of the variance in SWB, and their linear regression coefficients were: -0.32 (p < 0.001), 0.09 (p < 0.001), 0.09 (p < 0.001), 0.15 (p < 0.001), 0.06 (p < 0.05), and 0.16 (p < 0.05), respectively. These findings not only confirmed the direct association among SOC, PHQ and SWB, but also verified two underlying mechanisms regarding the mediating effect of SOC by using SEM: (1) GRRs (income ratio, marital status) are positively associated with a higher SOC, which further contributes to favorable SWB; and (2) PHQ is negatively associated with poor SWB indirectly via SOC. Conclusion: Migrant workers with low SOC and high PHQ are vulnerable to poor well-being levels. Meanwhile, GRRs (income ratio, marital status) may strengthen the SOC level, and can be regarded as the basis of intervention. Further investigation may be needed to focus on external psychological support factors.

Religion Affiliation and Depression Risk: Factory Workers Working in Hi-Tech Companies in Shanghai, China

This study examines factors contributing to depression among migrant factory workers in Shanghai. A survey was designed with mental health questions under a framework explaining: (1) social capital, (2) migratory stress, and (3) mental health consequences. With a return rate of 98.3%, 1966 individuals completed the survey. Only 11.1% of the respondents indicated having a religious affiliation. The findings are not surprising about the relationship between trust, economic condition, and depression. However, it is surprising to find that not having a religious affiliation is significantly connected to better mental health. The effect of religious beliefs should be examined as a trust factor to remove the barrier of perceiving religion as an added stressor.

Mental Health among Migrants in Shenzhen, China: Does it Matter Whether the Migrant Population is Identified by Hukou or Birthplace?

Massive rural–urban migration in China has drawn attention to the prevalence of mental health problems among migrants. Research on the mental health of Chinese migrants has a narrow focus on rural–urban migrants, emphasizing the institutional role of hukou in migrant mental health. We argue that the heterogeneity of migrants, including their place of origin and whether they are temporary or permanent migrants, should be taken into account when trying to understand the meaning of migration as an actual movement from one place to another. The data used for this study is from a cross-sectional survey (N = 855) conducted in Shenzhen to compare the differences in migrants’ mental health that arise when using the two definitions (e.g., hukou and birthplace). Binary logistic regression models were estimated to assess the associations between people’s mental health and migration, while controlling for settlement experiences, self-reported physical health, and sociodemographics. The results reveal inconsistent findings across both definitions: general migrants by birthplace were found to be unlikely to have mental problems compared to non-migrants, whereas temporary migrants were at higher risk of mental problems. The study provides important evidence that different migrant groups have different mental health outcomes. The choice of the definition used influences both migrant group selection and the actual linkage between migration and mental health.