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Shen G, Tang J, Fang J, Huang J, Zheng Y, Wu L, Yang X, Chen YH, Chen L. Family and job microsystems as mediators between social integration and depression among rural-to-urban migrant workers in China: does having sons make a difference? Front Public Health 2024; 12:1406451. [PMID: 39011329 PMCID: PMC11247764 DOI: 10.3389/fpubh.2024.1406451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
Background Rural-to-urban migrant workers are a vulnerable group at risk of developing depression. Based on the social-ecological systems theory, this study investigates the impact of the lack of social integration on depression, considering the mediating roles of migrant workers' microsystems (family happiness and job burnout). Additionally, the study explores whether having sons influences these associations. Methods The sample of 4,618 rural-to-urban migrant workers was obtained from the 2018 wave of the China Labor Force Dynamics Survey (CLDS). All the measures in the survey exhibited good reliability, including the Center for Epidemiological Research Depression Scale (CES-D), family happiness, job burnout, and social integration. The data were primarily analyzed using a structural equation model. Results Social integration had a direct impact on depression among migrant workers. Additionally, it indirectly affected depression through the mediating roles of family happiness not job burnout. The moderating effect of having sons mainly occurred on the path from social integration to family happiness. Limitations The cross-sectional design impeded the ability to draw causal inferences. Conclusion This finding highlights the potential benefits of social integration and family happiness in promoting early prevention of depression among migrant workers. It indicates that the inclination toward having sons among migrant workers continues to impact their mental health.
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Affiliation(s)
- Guanghui Shen
- Wenzhou Seventh People's Hospital, Wenzhou, China
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jiayi Tang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Juan Fang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jiahui Huang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yawen Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Lishui Second People's Hospital, Lishui, China
| | - Liujun Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Xudong Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Ningbo, China
| | - Yu-Hsin Chen
- The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Li Chen
- The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Luo Q, Chen X, Zhao L, Hu Q, Du J, Shao S. Association between social capital and utilization of essential public health services among elderly migrants: a multilevel logistic study based on the 2017 China migrant dynamic survey (CMDS). BMC Public Health 2024; 24:1252. [PMID: 38741086 DOI: 10.1186/s12889-024-18726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 04/28/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND As the number of elderly migrants in China continues to grow, it is necessary to pay closer attention to their health and health services. Some studies have confirmed that social capital plays a significant role in the utilization of health services. Therefore, an in-depth exploration of the relationship between social capital and the utilization of essential public health services (EPHS) by elderly migrants will not only contribute to improving their overall health but also facilitate a more balanced development of public health service system in China. METHODS Based on the cross-sectional data from the 2017 China Migrants Dynamic Survey (CMDS), this study examined the impact of social capital on the utilization of EPHS among elderly migrants. We evaluated social capital at two distinct levels: the individual and the community, and considered two dimensions of social capital: structural social capital (SSC) and cognitive social capital (CSC). The study aimed to delve into the impact of these forms of social capital on the utilization of EPHS among elderly migrants, and whether the migration range moderates this impact by multilevel logistic regression analysis. RESULTS A total of 5,728 migrant elderly individuals were selected. The health records establishment rate and health education acceptance rate were approximately 33.0% and 58.6%, respectively. Social capital influenceed the utilization of EPHS among elderly migrants. Specifically, individual-level SSC and CSC have impacts on both the establishment of health records (OR = 1.598, 95%CI 1.366-1.869; OR = 1.705, 95%CI 1.433-2.028) and the acceptance of health education (OR = 1.345, 95%CI 1.154-1.567; OR = 2.297, 95%CI 1.906-2.768) among elderly migrants, while community-level SSC only affected the acceptance of health education (OR = 3.838, 95%CI 1.328-11.097). There were significant differences in individual-level SSC, health records, and health education among different migration range subgroups among elderly migrants. Migration range moderated the effect of social capital on the utilization of EPHS, crossing provinces could weaken the relationship between SSC and health education. CONCLUSIONS Social capital is associated with a higher utilization rate of EPHS among elderly migrants. It is necessary to encourage them to actively participate in social activities, strengthen public services and infrastructure construction in the area, and improve their sense of belonging and identity.
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Affiliation(s)
- Qi Luo
- School of General Practice and Continuing Education, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, China
| | - Xiaolei Chen
- School of General Practice and Continuing Education, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, China
| | - Linlin Zhao
- School of General Practice and Continuing Education, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, China
| | - Qinghua Hu
- School of General Practice and Continuing Education, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, China
| | - Juan Du
- School of General Practice and Continuing Education, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, China.
| | - Shuang Shao
- School of General Practice and Continuing Education, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing, 100069, China.
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Zhang C, Nie C, Su W, Balezentis T. Are digital technologies an effective inhibitor of depression among middle-aged and older adults? Micro-level evidence from a panel study. Soc Sci Med 2024; 348:116853. [PMID: 38598985 DOI: 10.1016/j.socscimed.2024.116853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/07/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
The increased number of middle-aged and older adults leads to depression in this stratum of the population as a topical social and public health issue. However, the new generation of information technologies has exerted a profound impact on the lives of middle-aged and older adults, and offers potential solutions for alleviating their depression. This study utilizes data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2018 and combines them with city-level traits. The results demonstrate that digital technology can reduce depression levels effectively in this group. Mechanism analysis reveals that digital technology could improve life satisfaction and subjective health status levels, which, in turn, reduces depression levels. Heterogeneity analysis shows that the positive effects of digital technology on depression were more pronounced among middle-aged and older adults with urban household registration compared to the rural population. Finally, recommendations are provided for reducing depression levels among middle-aged and older adults.
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Affiliation(s)
- Chonghui Zhang
- College of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, 310018, China.
| | - Chenying Nie
- College of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, 310018, China.
| | - Weihua Su
- College of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, 310018, China.
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4
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Zhao Q, Wu G, Wang H. Effect of health rights accessibility on the urban integration of minority rural migrants in China: a cross-sectional study. BMC Public Health 2024; 24:761. [PMID: 38468194 DOI: 10.1186/s12889-024-18294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/06/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Accessing health rights is an integral component of people's aspirations for a better life. Existing discussions and evaluations regarding the accessibility of health rights for minority rural migrants are insufficient. In comparison to objective health conditions, inequalities in health rights lead to chronic and long-term depletion of human capital among minority rural migrants. This study aimed to assess the overall impact, heterogeneity effects, and mechanisms of health rights accessibility on the urban integration of minority rural migrants. METHODS Based on the 2017 China Migrants Dynamic Survey Data (CMDS), this study employs OLS models, 2SLS models, conditional mixed process (CMP) methods, and omitted variable tests to estimate the impact of health rights accessibility on the urban integration of minority rural migrants. Additionally, from the perspectives of migration scope and illness experience, this study explored the heterogeneity in the relationship between health rights accessibility and urban integration. Finally, using the Karlson-Holm-Breen (KHB) model, this study dissects the mechanisms through which health rights accessibility influences the urban integration of minority rural migrants. RESULTS Health rights accessibility significantly enhances the urban integration of minority rural migrants. Moreover, compared to minority rural migrants who move across provinces and who have no history of illness, those who migrate within the same province and who have experienced illness are more sensitive to the positive impact of health rights accessibility. However, the enhancing effect of health rights accessibility does not significantly differ between the new and old generations of minority rural migrants. Furthermore, health rights accessibility can indirectly improve the urban integration of minority rural migrants by elevating health levels, improving health habits, and reinforcing health behaviors. Among these, the indirect effects mediated by health habits are more pronounced. CONCLUSION The research conclusions underscore the issue of health accessibility and urban integration among minority rural migrants, providing a reexamination and clarification of the policy effects of health rights in promoting the urban integration of minority rural migrants. Relevant policy design should commence with improving the health rights of minority rural migrants, enhancing their health integration capabilities, and effectively boosting their ability to integrate into urban life.
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Affiliation(s)
- Qingjun Zhao
- College of Economics and Management, Huzhou College, Huzhou, China
| | - Guosong Wu
- School of Economics and Management, Huzhou University, Huzhou, China.
- Institute of Sustainable Development, Huzhou University, Huzhou, China.
| | - Hanrui Wang
- College of Economics and Management, Nanjing Agricultural University, Nanjing, China
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Wang L, Chao J, Wu Y, Zhang N, Bao M. Social integration and utilization of national basic public health services among China's internal migrants with chronic diseases: A structural equation modelling approach. Heliyon 2024; 10:e25797. [PMID: 38352800 PMCID: PMC10862671 DOI: 10.1016/j.heliyon.2024.e25797] [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: 04/29/2023] [Revised: 01/28/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Abstract
Internal migrants with chronic diseases (IMCDs) are a specific subgroup of the internal migrants, but few studies have focused on health service utilization among this group. Social integration is an essential element in the maintenance of health and well-being in migrants. However, the measurement of social integration remains inconsistent. This study aimed to measure social integration more comprehensively and evaluate the association between social integration and National Basic Public Health Services (NBPHS) utilization among IMCDs in China, thereby providing theoretical support for health promotion among IMCDs. The data of this study were obtained from the China Migrants Dynamic Survey (CMDS) in 2017. A total of 9272 internal migrants who self-reported hypertension and/or type 2 diabetes were included in the analysis. Four factors were extracted through exploratory factor analysis to measure the social integration of IMCDs: psychological identity, community involvement, social security, and sociocultural adaptation. The results show the IMCDs underutilized NBPHS, with 26.80 % stating that they have not used any of the services in the NBPHS. We confirmed the positive association between social integration and NBPHS use among IMCDs. The social integration of IMCDs in developed regions was relatively worse than in developing regions, further exacerbating the underutilization of NBPHS in developed regions. Therefore, targeted government measures and supportive policies are necessary, especially in developed regions, to encourage IMCDs to participate in social organizations and community activities and stimulate their active participation in the NBPHS.
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Affiliation(s)
- Leixia Wang
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Jianqian Chao
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Yanqian Wu
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Na Zhang
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
| | - Min Bao
- Health Management Research Center, School of Public Health, Southeast University, Nanjing, Jiangsu, 210096, China
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Gao T, Yan G, Zhang M, Leng B, Jiang F, Mi W. Effect of social integration on family doctor contracting services among migrant populations in China: a national cross-sectional survey. Fam Pract 2023; 40:538-545. [PMID: 37555256 DOI: 10.1093/fampra/cmad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The family doctor (FD) contracting system is a key reform in the development of the Chinese health system, and is considered an effective way to ensure equitable access to healthcare services. This study investigates the effects of social integration on FD contracting services among migrant populations. METHODS In total, 120,106 respondents from the 2018 China Migrants Dynamic Survey were included in this study. Two multivariate regression models were used to estimate the effect of social integration and other factors on FD contracting services among migrant populations. RESULTS This study found that only 14.0% of the migrant populations had a FD. Multiple dimensions of social integration and some covariates were shown to be positively associated with FD contracting services, including average monthly household income, local medical insurance (odds ratio [OR] = 1.34, 95% confidence interval [CI] = 1.29-1.39), employment status (OR = 0.86, 95% CI = 0.82-0.91), settlement intention (OR = 1.15, 95% CI = 1.09-1.22), received health education (OR = 4.88, 95% CI = 4.51-5.27), sex (OR = 1.16, 95% CI = 1.12-1.20), age (OR = 1.66, 95% CI = 1.51-1.82), marital status (OR = 1.38, 95% CI = 1.31-1.46), sickness within a year (OR = 0.84, 95% CI = 0.79-0.89), and flow range (OR = 1.12, 95% CI = 1.07-1.16). CONCLUSIONS All dimensions of social integration, including economic integration, social identity, and social involvement, are associated with FD contracting services among migrant populations. Policymakers should focus on improving the signing rates of migrant populations and implement more effective measures to enhance their social integration, such as settlement incentives and encouraging social participation.
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Affiliation(s)
- Tiantian Gao
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Genquan Yan
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Meiying Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Bing Leng
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fan Jiang
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Wei Mi
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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7
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Wang X, Liu J, Zhu J, Bai Y, Wang J. The association between social integration and utilization of primary health care among migrants in China: a nationwide cross-sectional study. Int J Equity Health 2023; 22:210. [PMID: 37814276 PMCID: PMC10561491 DOI: 10.1186/s12939-023-02018-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Migrants is a large population in China. To improve the health and wellbeing of migrants is a critical policy and social issue in China, and to enhance the utilization of primary health care by migrants is one of the most important approaches in promoting equity in health. However, there exists little research about the association between social integration and the utilization of primary health care. To address the research gap, this research aims at exploring the relation between social integration and the utilization of primary health care among migrants in China. METHODS Using the national data from China Migrants Dynamic Survey (CMDS) in 2017, 169,989 migrants were included in this study. Social integration was measured by social communication, acculturation and self-identity, with 8 indicators. The utilization of primary health care was measured by the receiving of health education on infectious diseases (ID) and noncommunicable diseases (NCD) as well as the first visit institution when migrants were sick. After the descriptive statistical analysis, binary logistic regression was employed to evaluate the association between social integration and the utilization of primary health care. RESULTS 65.99% of the migrants received health education on infectious diseases (ID), 40.11% of the migrants received health education on noncommunicable diseases (NCD) and 8.48% of the migrants chose to go to Community Health Center (CHC) seeking for health services. There was a positive effect of social organization participation, the influence of hometown customs, differences of hygiene habits between migrants and local people, integration willingness and evaluation of identity on the receiving of health education on ID and NCD, as well as a positive effect of civil activities engagement and differences of hygiene habits between migrants and local people on the utilization of CHC after getting sick. CONCLUSIONS Social integration was associated with the utilization of primary health care among migrants in China. Generally speaking, greater social integration was associated with higher possibility of receiving health education on ID and NCD. However, the effect of social integration on the utilization of CHC was more complex among different indicators. There should be more policy interventions to improve the social integration of migrant which help them to get familiar with the health resource available, as well as improve the capacity of CHC.
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Affiliation(s)
- Xueyao Wang
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872 China
- School of Public Administration and Policy, Renmin University of China, Beijing, 100872 China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, 100080 China
- Institute for Global Health and Development, Peking University, Beijing, 100871 China
- Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Beijing, 100083 China
| | - Jingmin Zhu
- Department of Epidemiology and Public Health, University College London, London, WC1E 7HB UK
| | - Yang Bai
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872 China
- School of Public Administration and Policy, Renmin University of China, Beijing, 100872 China
| | - Jun Wang
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872 China
- Beijing Famous Cultural Artist Studio--Health Beijing Governance Theory Creation Studio, Beijing, 100872 China
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8
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Jiang J. Relationship between social cohesion and basic public health services utilisation among Chinese internal migrants: a perspective of socioeconomic status differentiation. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2023; 32:179-197. [PMID: 36183410 DOI: 10.1080/14461242.2022.2112410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 08/04/2022] [Indexed: 05/18/2023]
Abstract
Social cohesion and socioeconomic status (SES) have been widely considered important factors influencing health services utilisation, but little is known about the association between social cohesion and health services utilisation across different SES groups. Based on a nationally representative survey, this study explores the influence of social cohesion on basic public health services utilisation in Chinese internal migrants at different SES levels. It is observed that objective and subjective cohesion forms have different effects on health record establishment and health education receipt. The positive effect of objective cohesion on health services utilisation is significantly larger than that of subjective cohesion, but two cohesion forms show similar effect sizes on health services utilisation among poor-SES migrants. With the promotion of SES, the effect size of objective cohesion gradually increases while that of subjective cohesion declines, showing a distribution of 'scissors gap'. For basic public health services utilisation, migrants not only have the agency to receive but are constrained by their SES. For migrants with poor SES, strong structural constraints hinder the utilisation of basic public health services.
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Affiliation(s)
- Junfeng Jiang
- School of Sociology, Central China Normal University, Wuhan, People's Republic of China
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9
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Zhou D, Cheng L, Wu H. The Impact of Public Health Education on Migrant Workers' Medical Service Utilization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15879. [PMID: 36497951 PMCID: PMC9737452 DOI: 10.3390/ijerph192315879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Based on the dynamic monitoring survey data of China's migrant population (CMDS) in 2017, this study analyzes the impact of public health education on migrant workers' medical service utilization. The study found that public health education can significantly promote the utilization of migrant workers' medical services and has a greater effect on the older generation groups, those who received secondary and higher education, and those working in first-tier cities. By distinguishing different types of public health education, it is found that smoking control education has the most obvious effect. Further differentiating disease types, the study found that the promotion effect of receiving occupational disease education is the highest, while the effect of receiving STD/AIDS education is relatively low. The mechanism test indicates that public health education has significantly improved migrant workers' utilization of medical services by influencing their health literacy, social network, and psychological integration.
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10
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Zhao Q, Song M, Wang H. Voting with Your Feet: The Impact of Urban Public Health Service Accessibility on the Permanent Migration Intentions of Rural Migrants in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14624. [PMID: 36429343 PMCID: PMC9691094 DOI: 10.3390/ijerph192214624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Qingjun Zhao
- College of Economics and Management, Nanjing Agricultural University, Nanjing 210095, China
| | - Meijing Song
- College of Finance and Economics, Hainan Vocational University of Science and Technology, Haikou 571126, China
| | - Hanrui Wang
- College of Economics and Management, Nanjing Agricultural University, Nanjing 210095, China
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11
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Jia H. The impact of basic public health services on migrants' settlement intentions. PLoS One 2022; 17:e0276188. [PMID: 36251698 PMCID: PMC9576043 DOI: 10.1371/journal.pone.0276188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022] Open
Abstract
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.
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Affiliation(s)
- Haowen Jia
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
- * E-mail:
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12
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Zhou Z, Jiang Y, Wu H, Jiang F, Yu Z. The Age of Mobility: Can Equalization of Public Health Services Alleviate the Poverty of Migrant Workers? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013342. [PMID: 36293922 PMCID: PMC9603761 DOI: 10.3390/ijerph192013342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 05/26/2023]
Abstract
Migrants workers are important participants in and contributors to economic and social construction, but they still face the reality of being marginalized. Based on data from the China Migrants Dynamic Survey in 2018, this paper systematically investigated the impact of public health services on the multidimensional poverty of migrant workers. The research found that, first, the current mean of the multidimensional poverty deprivation value of migrant workers is 0.1806, which is one dimension of poverty that exists on average. In addition, migrant workers do not have high access to public health services. The proportions of migrant workers who have not established residents' health files and who have not received public health education are 74.22% and 29.92%, respectively. Second, public health services can significantly alleviate the multidimensional poverty of migrant workers. After mitigating the potential endogeneity problem by the IV-2SLS method and conducting robustness tests by the PSM method, the conclusion is still robust. Further research found that the impact of public health services on the multidimensional poverty alleviation of migrant workers is heterogeneous. The improvement of public health services has the greatest effect on the multidimensional poverty alleviation of the new generation of migrant female workers in the western region. The research in this paper helps to examine and clarify the policy significance of public health services for the multidimensional poverty alleviation of migrant workers and provides empirical evidence for the use of public health services to tackle the poverty problem.
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Affiliation(s)
- Ziming Zhou
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Yumeng Jiang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China
| | - Haitao Wu
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
| | - Fan Jiang
- Institute of Agricultural Economics and Technology, Hubei Academy of Agricultural Science, Wuhan 430073, China
| | - Zhiming Yu
- School of Business Administration, Zhongnan University of Economics and Law, Wuhan 430073, China
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Lu H, Kandilov IT, Nie P. Heterogeneous Impact of Social Integration on the Health of Rural-to-Urban Migrants in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9999. [PMID: 36011631 PMCID: PMC9407958 DOI: 10.3390/ijerph19169999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Haiyang Lu
- Institute of Western China Economic Research, Southwestern University of Finance and Economics, Chengdu 610074, China
| | - Ivan T. Kandilov
- Department of Agricultural and Resource Economics, North Carolina State University, Raleigh, NC 27695, USA
| | - Peng Nie
- School of Economics and Finance, Xi’an Jiaotong University, Xi’an 710061, China
- Institute for Health Care & Public Management, University of Hohenheim, 70599 Stuttgart, Germany
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14
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Zeng W, Wang C, Chen H, Tong B, Li D, Zou Z, Liu P, Yao Y, Shang S. Health status and public health education for internal older migrants in China: Evidence from a nationally representative survey. Front Public Health 2022; 10:937361. [PMID: 35937236 PMCID: PMC9353578 DOI: 10.3389/fpubh.2022.937361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background Self-rated health has been widely used as a useful screening tool to subjectively evaluate individuals' health status. Under the context of the rapid growth of aging, there was a dramatic rapid expansion in internal older migrants in China. Serious concerns on the issues of health status continue to attract quite a lot of attention over the past decades. Public health education is one of the most important health care services and methods to improve individuals' health status. However, most previous studies focus on the utilization of public health services such as visiting to doctors, physical examination, and hospitalization. There was limited evidence on the self-rated health and public health education of older migrants. Objectives The study aimed to evaluate self-rated health and the associated determinants in older migrants, as well as to gain a deeper insight into the current status of public health education received by older migrants. Methods We derived the data from the National Migrants Population Health and Family Planning Dynamic Monitor Survey 2018, a cross-sectional study, for secondary analysis. Internal migrants aged 60 years old or over were included in the study. Self-rated health was the dependent variable, while sociodemographic characteristics were the independent variable. The univariate and multivariate analyses were performed by Stata 15.1. Results A total of 5,589 older migrants were included in the study. Eighty-two percentage of older migrants reported healthy self-rated health. There was a significant association between age, gender, minzu, education level, monthly income, public health education, and self-rated health (P < 0.5). However, the proportion of older migrants that received specific public health education was <50%. The most common approach to receiving public health education was through the leaflet, while <20% of older migrants received public health education through public consultation and one-to-one education. Conclusions It was necessary to promote the publicity of public health education in older migrants through easy access and diverse approaches in order to effectively spread health-related knowledge to older migrants to satisfy their health needs and maintain their health.
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Affiliation(s)
- Wen Zeng
- Nursing School of Peking University Health Science Center, Beijing, China
- Guizhou Provincial People's Hospital, Guiyang, China
| | - Cui Wang
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Hongbo Chen
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Beibei Tong
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Dan Li
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Ziqiu Zou
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Peiyuan Liu
- Nursing School of Peking University Health Science Center, Beijing, China
| | - Yuanrong Yao
- Guizhou Provincial People's Hospital, Guiyang, China
- Yuanrong Yao
| | - Shaomei Shang
- Nursing School of Peking University Health Science Center, Beijing, China
- *Correspondence: Shaomei Shang
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15
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Zhou J, Zhu L, Zhang J. Social Integration and Health Among Young Migrants in China: Mediated by Social Mentality and Moderated by Gender. Front Psychol 2022; 13:863443. [PMID: 35548528 PMCID: PMC9082418 DOI: 10.3389/fpsyg.2022.863443] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/04/2022] [Indexed: 01/02/2023] Open
Abstract
Population mobility has been one of the most basic social characteristics of China’s reform and opening up for more than 40 years. As the main labor force in Chinese cities, young migrants have made major contributions toward China’s economic miracle as the country has experienced rapid industrialization and urbanization. However, frequent mobility has caused an imbalanced social mentality in young migrants and often leads to issues with social integration, which has made this group more vulnerable with respect to their health. This study used the 2013 and 2015 Chinese General Social Survey (CGSS) data of 1,007 young migrants to investigate social mentality mediating the linkage between social integration and health among young migrants. Additionally, to probe the moderating role of gender, multi-group structural equation modeling was applied to test if the pathways in the mediation model differed between young male and female migrants in a significant way. The results suggested that after controlling for the influence of age, marital status, education, and personal annual income, social integration positively impacted the health of young migrants in a significant way; social mentality mediated the action of social integration on this group’s health; and with respect to gender difference, on the three paths of social integration affecting health, social integration affecting social mentality, and social mentality affecting health, young male migrants were more affected than young female migrants. The findings of this study could help improve gender-specific policies on the health of the floating population and offer important theoretical reference and practical suggestions for future research.
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Affiliation(s)
- Jingjing Zhou
- School of Sociology and Population Studies, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Li Zhu
- Department of Sociology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Junwei Zhang
- College of Philosophy, Law and Political Science, Shanghai Normal University, Shanghai, China
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16
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How Different Is the Annual Physical Examination of Older Migrants than That of Older Nonmigrants? A Coarsened Exact Matching Study from China. Healthcare (Basel) 2022; 10:healthcare10050815. [PMID: 35627952 PMCID: PMC9141086 DOI: 10.3390/healthcare10050815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/09/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023] Open
Abstract
It has become a top priority to ensure equal rights for older migrants in China. This study aims to explore how different the annual physical examination of older migrants is compared to that of older nonmigrants in China by using a coarsened exact matching method, and to explore the factors affecting annual physical examination among older migrants in China. Data were drawn from the China Migrants Dynamic Survey 2015 and China Health and Retirement Longitudinal Survey 2015. The coarsened exact matching method was used to analyse the difference in the annual physical examination of older migrants and nonmigrants. A logistic regression was used to analyse the factors affecting annual physical examination among older migrants. The annual physical examination of older migrants was 35.6%, which was significantly lower than that of older nonmigrants after matching (Odds ratios = 0.91, p < 0.05). It was affected by education, employment, hukou, household economic status, health, health insurance, main source of income, type of migration, range of migration, years of migration, having health records in local community and number of local friends among older migrants in China. Older migrants adopted negative strategies in annual physical examination compared to older nonmigrants. Active strategies should be made to improve the equity of annual physical examination for older migrants in China.
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17
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Public Health Service and Migration Destinations among the Labor of Xinjiang Uygur Autonomous Region of China. SUSTAINABILITY 2022. [DOI: 10.3390/su14084718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The relationship between public investment and population migration is a classic topic in developing regions. With social and economic development, the role of public health services is paid high attention. However, empirical studies on the relationship between public health services and labor migration are rare, especially for populations from minority areas. This study investigated the correlation between public health services and migration destinations and its heterogeneity among laborers from Xinjiang. Data of the annual Xinjiang Statistical Yearbook and the CMDS are used, and multinomial logit regressions are adopted. The results show that public health services in a county have a significant and negative correlation with the probability of migration with a long range among laborers from Xinjiang. This correlation is inclusive of gender, age, human capital, hukou, marital status, home region, and economic status. It implies that the improvement of public health services in Xinjiang can attract laborers to live and work there, which could contribute to the revitalization of Xinjiang and reduce the development gap between Xinjiang and other provinces.
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18
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Family Support and Social Support Associated with National Essential Public Health Services Utilization among Older Migrants in China: A Gender Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031610. [PMID: 35162632 PMCID: PMC8835676 DOI: 10.3390/ijerph19031610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
China provides National Essential Public Health Services (NEPHS) free of charge to all citizens to ensure access to essential health services. The present study aimed to explore the associations between different sources of support and NEPHS service utilization among older migrants in China with a gender perspective. We used a national cross-sectional dataset derived from the 2015 China Migrants Dynamic Survey. Participants were included if they were aged ≥60 years and without household registration at the residence. Among 1989 participants, 35.2% enrolled in a free physical examination in the past year: 34.6% for males and 35.9% for females. Among male participants, having more local friends (OR = 1.47, 95% CI: 1.09, 1.99) and having insurance at the residence (OR = 1.75, 95% CI: 1.03, 2.96) were associated with enrolment in a free physical examination after controlling for age, education, and self-reported health status. Two additional factors, marital status and family structure, were found for female participants to be associated with enrolment in a free physical examination. NEPHS service utilization was far from satisfactory among older migrants in China, and both family support and social support played a role in it. There are common and unique factors associated with NEPHS service utilization in terms of gender.
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19
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Zheng X, Xue Y, Yin Y, Dong F, Chang J, Zhang C. The Impact of Health and Wealth on Settlement Intention of Migrants: The Moderating Effect of Social Welfare. Front Public Health 2022; 9:741812. [PMID: 35004570 PMCID: PMC8733198 DOI: 10.3389/fpubh.2021.741812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Xiao Zheng
- School of Public Health, Southern Medical University, Guangzhou, China.,School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Public Health, Southern Medical University, Guangzhou, China.,School of Health Management, Southern Medical University, Guangzhou, China
| | - Yu Yin
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Fang Dong
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jinghui Chang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Chichen Zhang
- School of Health Management, Southern Medical University, Guangzhou, China.,Department of Health Management, Nafang Hospital, Guangzhou, China.,Institute of Health Management, Southern Medical University, Guangzhou, China
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20
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Wulandari RD, Laksono AD, Prasetyo YB, Nandini N. Socioeconomic Disparities in Hospital Utilization Among Female Workers in Indonesia: A Cross-Sectional Study. J Prim Care Community Health 2022; 13:21501319211072679. [PMID: 35068256 PMCID: PMC8793371 DOI: 10.1177/21501319211072679] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The study aims to analyze the relationship between socioeconomic and hospital utilization among female workers in Indonesia. METHODS The study analyzed secondary data from the 2018 Indonesian Basic Health Survey. The study gathered 161 186 female workers through stratification and multistage random sampling. As control factors, the study looked at age, marital status, education, occupation, and health insurance, in addition to the categories of socioeconomic and hospital utilization. The study used binary logistic regression to evaluate the data in the final step. RESULTS The result shows female workers with poorer wealth status are 1.142 times more likely than the most impoverished female workers to utilize the hospital (AOR 1.142; 95% CI 1.135-1.148). Female workers with median wealth status are 1.509 times more likely than the poorest female workers to take advantage of the hospital (AOR 1.509; 95% CI 1.501-1.517). Female workers with wealthier wealth status are 1.808 times more likely than the poorest female workers to use the hospital (AOR 1.808; 95% CI 1.799-1.817). The wealthiest female workers are 2.399 times more likely than the poorest female workers to utilize the hospital (2.399; 95% CI 2.387-2.411). CONCLUSION The study concluded a relationship between socioeconomic status and hospital utilization among female workers in Indonesia. The better the socioeconomic, the better the hospital utilization.
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Affiliation(s)
- Ratna Dwi Wulandari
- Universitas Airlangga, Surabaya, Indonesia
- The Airlangga Centre for Health Policy, Surabaya, Indonesia
| | - Agung Dwi Laksono
- The Airlangga Centre for Health Policy, Surabaya, Indonesia
- The National Agency for Research and Innovation of The Republic of Indonesia, Jakarta, Indonesia
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21
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Wang J, Zhu J, Wang X, Che Y, Bai Y, Liu J. Sociodemographic disparities in the establishment of health records among 0.5 million migrants from 2014 to 2017 in China: a nationwide cross-sectional study. Int J Equity Health 2021; 20:250. [PMID: 34856984 PMCID: PMC8638552 DOI: 10.1186/s12939-021-01584-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Migrants account for a large part of China's population. Many policies and inventions have been taken to improve access to public health services and the health of migrants. China's Basic Public Health Services(BPHS) are a series of public health services in this policy domain, which aims at promoting the access of public health sevices and improve health equity of residents. The establishment of health records is the fundamental service of BPHS. However, there is little known about the establishment of health records among migrants in China, which hinders the more efficient provision of health services for migrants, and health equity is difficult to achieve. Based on the research gap, this study aims at showing the sociodemographic disparities in the establishment rate of health records, and identifying priorities and recommendations for promoting health equity of migrants in China. METHODS This study used national data from China Migrants Dynamic Survey (CMDS) from 2014 to 2017 to evaluate the sociodemographic disparities in the establishment rate of health records and utilization of relevant public health services. The study included 539,926 respondents. Following the descriptive statistics of migrants, we showed the establishment rate of health records by sociodemographic characteristics and migrating related characteristics. Multivariate analysis was conducted to explore the associations between sociodemographic charicteristics, migrating related charicteristics and the establishment of health records. RESULTS The establishment rate of health records among migrants in the sampled years were 22.99, 38.44, 27.29% respectively, and 29.18% in general, and there existed heterogeneity in the establishment rate of health records by sociodemographic charicteristics and migrating related charicteristics. Female migrants who were older, from middle age, married or living with partner, with higher educational attainment, with urban household registration, migrated for longer time, migrated for the reason of studying or family issues, migrated in province were more likely to establish health records. CONCLUSION There existed sociodemographic disparities in the establishment rate of health records and inequalities in the utilization of health records services among migrants in China. Migrating related characteristics also had impact on the establishment status. Policies should take both supply side and demand side of health services to improve the health equity of migrants, which means that relative departments should continue to invest in primary healthcare centers to improve their ability to provide services as well as migrants' health literacy.
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Affiliation(s)
- Jun Wang
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872 China
| | - Jingmin Zhu
- Department of Economics, University of Birmingham, B15 2TT, Birmingham, UK
| | - Xueyao Wang
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872 China
| | - Yue Che
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872 China
| | - Yang Bai
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, 100872 China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, 100080 China
- Institute for Global Health and Development, Peking University, Beijing, 100871 China
- Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Beijing, 100083 China
- School of Public Health, Peking University; Institute for Global Health and Development, Peking University, Beijing, 100191 China
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22
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Zhao J, Kong F, Li S. Association between social integration and medical returns among the migrant elderly following children to Jinan City China. BMC Public Health 2021; 21:1822. [PMID: 34627226 PMCID: PMC8501928 DOI: 10.1186/s12889-021-11901-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/27/2021] [Indexed: 11/22/2022] Open
Abstract
Background Studies had shown that social integration was related to the utilization of medical services. Few studies investigated the relationship between social integration and medical returns among the elderly. None research had ever clarified the effect of social integration on medical returns among the migrant elderly following children (MEFC) to new cities. This study aimed to explore the association between social integration and medical returns among the MEFC in Jinan, China. Method This cross-sectional study included 627 MEFC in Jinan China. Social integration was evaluated by economic integration, acculturation, and identification. Medical return was assessed by asking the subjects whether go back to hometown to use the medical services when ill. Chi-squared test and multivariable logistic regression were applied to analyze the association between social integration and medical returns of the MEFC. Results and discussion It was found that 20.3% of the MEFC had a medical return. As for social integration, those who had not joined local medical insurance (OR = 3.561, 95% CI 1.577–8.039, p = 0.002) and were unwilling to stay for a long time (OR = 2.600, 95% CI 1.620–4.174, p = 0.001) were more likely to have a medical return. Furthermore, our findings showed that the MEFC who were accompanied by one or more (OR = 1.568, 95% CI 1.027–2.392, p = 0.037) were more likely to have a medical return than those who migrated alone. Conclusion Negative relationship between social integration and medical returns was found among the MEFC, which means the better social integration of the MEFC would generally have fewer medical return, as well as the better refunding connections of the medical insurance between the current residence and hometown.
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Affiliation(s)
- Jinfeng Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.,NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
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23
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Guan M. Associations Between Geodemographic Factors and Access to Public Health Services Among Chinese Floating Population. Front Public Health 2020; 8:563180. [PMID: 33363076 PMCID: PMC7758272 DOI: 10.3389/fpubh.2020.563180] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/09/2020] [Indexed: 01/10/2023] Open
Abstract
Background: The floating population in urban China is facing multiple barriers to access to comprehensive, affordable, and culturally effective public health services. However, little is known about the role of geodemographic factors. This study aimed to assess the associations between geodemographic factors and access to public health services among the Chinese floating population. Methods: This study employed the data from the 2015 Migrant Dynamic Monitoring Survey data in China. Descriptive statistical analysis and principal component analysis were used to provide basic characteristics of the main variables. Multiple logistic models were used to analyze how province-level units, economic regions, and economic zones had significant associations with residential health records establishment, social medical insurance, and types and methods of health knowledge attainment in urban China. Using multiple indicator multiple cause models, the association between geodemographic factors and types and methods of health knowledge attainment was studied. Results: The results indicated that there was regional unbalance in the case of residential health records. Regional differences were significantly associated with social medical insurance. Provincial differences were significantly associated with health knowledge attainment. There were regional differences in the methods of health knowledge attainment. In the most provincial units, geodemographic factors had significant associations with types and methods of health knowledge attainment. Conclusions: This study confirmed empirical associations between geodemographic factors and access to public health services among Chinese floating population. The relevant suggestion was that provincial units with less-developed public health services should enhance their capabilities to equalize public health services.
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Affiliation(s)
- Ming Guan
- International Issues Center, Xuchang University, Xuchang, China.,Family Issues Center, Xuchang University, Xuchang, China.,School of Business, Xuchang University, Xuchang, China
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