Housing Conditions, Neighborhood Physical Environment, and Secondhand Smoke Exposure at Home: Evidence from Chinese Rural-to-Urban Migrant Workers

Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021

PURPOSE OF REVIEW

The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods.

RECENT FINDINGS

We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.

Secondhand smoking exposure and quality of life among pregnant and postnatal women: a network approach

OBJECTIVE

This study examined the prevalence of exposure to secondhand smoke, its correlates and its association with quality of life (QOL) among pregnant and postnatal Chinese women.

DESIGN

This was a multicentre, cross-sectional study.

SETTING

Participants were consecutively recruited from eight tertiary hospitals located in eight municipalities or provinces in China.

PARTICIPANTS

A total of 1140 women were invited to join this study and 992 (87.02%) completed all measures.

PRIMARY AND SECONDARY OUTCOME

Measures women's secondhand smoking behaviour (frequency and location of exposure to secondhand smoking), and their QOL measured by the WHO Quality of Life Questionnaire.

RESULTS

A total of 211 women (21.3%, 95% CI 18.7% to 23.8%) had been exposed to secondhand smoking. Exposure to secondhand smoking was most common in public areas (56.4%), and residential homes (20.5%), while workplaces had the lowest rate of exposure (13.7%). Women with physical comorbidities were more likely to report secondhand smoking exposure, while older women, women living in urban areas, those with college or higher education level, and women in their second trimester were less likely to report exposure to secondhand smoking. Network analysis revealed that there were six significant links between secondhand smoke and QOL items. The strongest negative edge was the connection between secondhand smoke and QOL9 ('physical environment health', edge weight=-0.060), while the strongest positive edge was the connection between secondhand smoke and QOL3 ('pain and discomfort', edge weight=0.037).

CONCLUSION

The prevalence of exposure to secondhand smoking is becoming lower among pregnant and postnatal women in China compared with findings reported in previous studies. Legal legislation should be maintained and promptly enforced to establish smoke-free environments in both public and private urban/rural areas for protection of pregnant and postnatal women, especially those who are physically vulnerable and less educated.

[Social Determinants Affecting Changes in Mental Health of Rural-Urban Migrant Population in Chengdu: An Oaxaca-Blinder Decomposition Analysis]

Objective

To investigate the social determinants that influenced the changes in the mental health of the rural-urban migrant population in Chengdu.

Methods

Using data from two cross-sectional surveys, one conducted in 2009 and another, in 2018, of the rural-urban migrant population in Chengdu, we analyzed the social determinants of mental health affecting the rural-urban migrant population in Chengdu by multiple linear regression, and analyzed the contribution of changes in social determinants to the disparity in mental health over a decade using the Oaxaca-Blinder decomposition analysis.

Results

This study included 3091 cases of rural-urban migrants in Chengdu, with 965 (31.22%) covered in the survey year of 2009 and 2126 (68.78%) covered in 2018. Multiple linear regression models were established with mental component summary (MCS) as the dependent variable, the social determinants of health as the independent variables, and gender, age, and survey year as covariates. The findings showed that being married ( β=2.33, P<0.001), drinking 1-2 times per week ( β=-1.42, P<0.05), illness within four weeks ( β=-2.57, P<0.001), and hospitalization in the past year ( β=-1.82, P<0.05), wage arrears ( β=-1.67, P<0.05), job satisfaction ( β=1.25, P<0.001), monthly housing costs (housing costs below monthly income: β=-1.55, P=0.001; housing costs above monthly income: β=-4.59, P=0.001) and housing condition ( β=0.23, P<0.05) had significant impact on the MCS of the rural-urban migrant population. The results of the Oaxaca-Blinder decomposition method showed that the MCS disparity between the two surveys was -4.7660 points. With 2018 as the base year, the explainable parts accounted for 15.80%. Being married, decrease in the prevalence of illnesses within four weeks, and increased job satisfaction formed positive contribution to the improvement of the mental health, and increase in the proportion of monthly housing expenses formed negative contribution.

Conclusion

Between 2009 and 2018, the mental health of the rural-urban migrant population in Chengdu showed improvement, and changes in marital status, illness within four weeks, job satisfaction, and monthly housing costs contributed to improvements in mental health during the period. Future intervention measures to promote the mental health of the floating population can be developed with the perspective of improving the social determinants of health in mind.

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.