City Size and Permanent Settlement Intention: Evidence from Rural-Urban Migrants in China

Does the population size of a city matter to its older adults' self-rated health? Results of China data analysis

Clarifying the association between city population size and older adults' health is vital in understanding the health disparity across different cities in China. Using a nationally representative dataset, this study employed Multilevel Mixed-effects Probit regression models and Sorting Analysis to elucidate this association, taking into account the sorting decisions made by older adults. The main results of the study include: (1) The association between city population size and the self-rated health of older adults shifts from a positive linear to an inverted U-shaped relationship once individual socioeconomic status is controlled for; the socioeconomic development of cities, intertwined with the growth of their populations, plays a pivotal role in yielding health benefits. (2) There is a sorting effect in older adults' residential decisions; compared to cities with over 5 million residents, unobserved factors result in smaller cities hosting more less-healthy older adults, which may cause overestimation of health benefits in cities with greater population size. (3) The evolving socioeconomic and human-made environment resulting from urban population growth introduces health risks for migratory older adults but yields benefits for those with local resident status who are male, aged over 70, and have lower living standards and socioeconomic status. And (4) The sorting effects are more pronounced among older adults with greater resources supporting their mobility or those without permanent local resident status. Thus, policymakers should adapt planning and development strategies to consider the intricate relationship between city population size and the health of older adults.

Effect of weekend versus weekday admission on the mortality of acute ischemic stroke patients in China: an analysis of data from the Chinese acute ischemic stroke treatment outcome registry

Background

Due to disparities in medical resources in rural and urban areas as well as in different geographic regions in China, the effect of weekend versus weekday admission on the outcomes of acute ischemic stroke (AIS) patients is unknown. Our aim was to investigate whether the outcomes of AIS patients differ according to the day of admission in China.

Methods

The data were extracted from the Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR), a multicenter prospective study database of patients diagnosed with AIS. The chi-square test (χ²) and logistic regression were used to assess mortality for weekday and weekend admissions among AIS patients stratified by rural or urban status and geographic region (including the eastern, northeastern, central, and western regions).

Results

In total, 9,256 patients were included in this study. Of these patients, 57.2% were classified as urban, and 42.8% were classified as rural. A total of 6,760 (73%) patients were admitted on weekdays, and 2,496 (27%) were admitted on weekends. There was no significant difference in the mortality rate among patients admitted on weekends compared with those admitted on weekdays in urban (7.5% versus 7.4%) or rural areas (8.8% versus 8.1%; p > 0.05). The mortality rate was the highest among patients admitted on weekends and weekdays (11.6% versus 10.3%) in the northeastern area, without statistical significance before and after adjusting for the patients' background characteristics (p > 0.05). In addition, regression analysis revealed that the mortality of patients admitted on weekdays was more likely to be influenced by regional subgroup, hospital level and intravenous thrombolysis than that of patients admitted on weekends.

Conclusion

The weekend effect was not observed in the mortality of patients with AIS regardless of rural-urban status or geographic region in China.

The interaction effects between exposure to ambient PM2.5 and economic development on the settlement intention for floating population in China

Limited studies examined the interaction effects between exposure to ambient PM_2.5 and economic development on the settlement intention of floating population. We used binary logistic model to examine the association of PM_2.5, per capita GDP (PGDP), PM_2.5 [Formula: see text] PGDP on the settlement intention. Additive interaction term of PM_2.5 and PGDP level was used to investigate their interactive effects. Overall, each one grade increment in annual average PM_2.5 was associated with decreased probability of settlement intention (OR = 0.847, 95%CI: 0.811-0.885). The interaction effect between PM_2.5 and PGDP on settlement intention was significant (OR = 1.168, 95%CI: 1.142-1.194). The stratified analysis showed PM_2.5 exhibits lower settlement intention in the aged 55 years or above, engaged in low-skilled works, and living in the western China. This study indicates that PM_2.5-exposed will decrease the settlement intention of floating population. High economic development level can weaken the relationship between PM_2.5 and settlement intention. Policymakers should balance the socio-economic development and environmental health and focus on vulnerable population.

Intercity mobility pattern and settlement intention: evidence from China

Floating population is an important group in the emerging urbanization process. This group promotes long-term settlement, which is a significant driving force increasing the urbanization level of countries. This study analyzed the changes in population mobility between Chinese cities and the willingness of the floating population to settle down. The analyses were based on data obtained from the China Migrants Dynamic Survey (CMDS) in 2017, and the China Seventh Census 2020. Spatial econometric models were constructed for in-depth research. The result showed that: ① the floating population migrated mainly from the central region to the surrounding cities, and their long-term settlement intention presented a spatial pattern of "high in the east, low in the west, and local concentration." ②the long-term settlement intention significantly negatively affected the urban floating population. City economic level, public service capacity, and environmental quality significantly positively or negatively influence the number of the floating population. For promoting more floating population to become urban residents, management of the group should be strengthened, construction level of the urban economy, society, and ecology improved, and the willingness of the group to settle for an extended time encouraged.

Voting with Your Feet: The Impact of Urban Public Health Service Accessibility on the Permanent Migration Intentions of Rural Migrants in China

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.

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.