Migration and Health—Freedom of Movement and Social Benefits for Chinese Migrant Workers

Aging in Place with Few Children and Social Services-- Understanding Structural and Cultural Lags in Rural China

This study uses mixed methodologies to reveal how structural and cultural changes are changing the connotations of home and aging in rural China. Based on surveys (n = 830) and 33 intensive interviews with older migrant workers, this study found that having rural public pensions, adult children living nearby, and owning land in their hometowns were associated with the respondents' desire for aging in place (AIP). Moreover, although the image of the rural home is idyllic, the reality is difficult. Aging migrant workers are gaining a strong sense of financial independence and their children's lack of parental care. The authors argue that having no social-care services, while adult children are rarely available for old-age care, is changing the connotations of AIP in rural China. These social and cultural transformations are making AIP more of a romantic ideal than a practical reality for migrant workers.

Health Crowding-Out Effect of Family Migration on First Cohort Migrant Workers: An Empirical Analysis

In the dynamic panorama of China's shifting social mobility, characterized by a transition from individual to family mobility, the migration of the first cohort of migrant workers and their families has taken center stage. However, the scholarly discourse on how family migration influences the health of migrant workers remains contentious. This study uses data from the China Migrants Dynamic Survey (CMDS) of 2017 to focus on the first cohort of migrant workers. Drawing on the theories of family stress and life course, the empirical analysis incorporated heterogeneity tests, total effects, robustness tests, mediation effects, and propensity score matching to explore the mechanisms underlying the impact of family migration on migrant workers' health. Data analysis reveals a substantial negative impact of family migration on the health status of the first cohort of migrant workers. Variations in health outcomes were identified across different family migration patterns. Further analysis indicates that the first cohort of migrant workers, when confronted with family livelihood pressures, tends to prioritize economic resources to support urban family life over their own health. This is because they are influenced by a family-centered culture. Our findings reveal a nuanced landscape. While family migration provides potentially enhances social support systems, it also imposes significant health trade-offs due to increased life stressors. These stressors include economic instability, increased responsibility for family care, and the psychological impacts of adapting to new urban environments. There are the health crowding-out effect of family migration on first cohort migrant workers.

Cumulative health disadvantages: an empirical study of the health and mobility of the first cohort of migrant workers in China

Background

The study aimed to understand the factors affecting the health and healthcare of the first cohort of migrant workers in China using the concept of the cumulative disadvantage framework.

Methods

Data from the China Migrants Dynamic Survey (2017) were used to analyze the process of cumulative disadvantage of health and healthcare among migrant workers. The study also analyzed the spatial lag problem between localized medical insurance policies and healthcare accessibility.

Results

The results revealed a significant negative association between the mobility of the first cohort of migrant workers and their health status. Long-term exposure to hazardous work had a greater negative impact on their health. Chinese migrant workers faced significant obstacles in accessing healthcare due to the lack of portability in health insurance.

Conclusion

The study emphasizes the urgent need for addressing the structural barriers hindering healthcare access and outcomes for migrant workers. It is crucial to promote a more equitable and sustainable healthcare system in China to ensure migrant workers' health and well-being.

Use of social health insurance for hospital care by internal migrants in China-Evidence from the 2018 China migrants dynamic survey

Background

China's welfare system including social health insurance has been closely linked to its unique household registration system, despite high population mobility over the past few decades. This study aimed to determine the pattern of health insurance usage from internal migrants in mainland China for hospital care.

Methods

Data were extracted from the 2018 China Migrants Dynamic Survey. The respondents who enrolled in a social health insurance program and reported illness or injury over the past year were eligible for this study (n = 15,302). Two groups of outcome indicators were calculated assessing the use (incidence and settlement location) of insurance funds for hospital care and the burden of hospital expenditure (total hospital expenditure, out-of-pocket payments, and share of insurance reimbursement), respectively. Logit regression and Heckman's sample selection models were established to determine the predictors of insurance fund usage and the burden of hospital expenditure, respectively.

Results

Most respondents enrolled in a social health insurance program outside of their residential location (70.72%). About 28.90% were admitted to a hospital over the past year. Of those hospitalized, 72.98% were admitted to a hospital at their migration destination, and 69.96% obtained reimbursement from health insurance, covering on average 47% of total hospital expenditure. Those who had a local insurance fund aligned with residency (AOR = 2.642, 95% CI = 2.108-3.310, p < 0.001) and enrolled in employment-based insurance (AOR = 1.761, 95% CI = 1.348-2.301, p < 0.001) were more likely to use insurance funds for hospital care, and paid less out-of-pocket (β = -0.183 for local funds, p = 0.017; β = -0.171 for employment-based insurance, p = 0.005) than others. A higher share of insurance reimbursement as a proportion of hospital expenditure was found in the employment-based insurance enrollees (β = 0.147, p < 0.001). Insurance claim settlement at the residential location was associated with lower total hospital expenditure (β = -0.126, p = 0.012) and out-of-pocket payments (β = -0.262, p < 0.001), and higher share of insurance reimbursement (β = 0.066, p < 0.001) for hospital expenditure.

Conclusion

Low levels of health insurance benefits for hospital care are evident for internal migrants in mainland China, which are associated with the funding arrangements linked to household registration and inequality across different funds.

Neglected Part of Education Sustainability: Social Work Intervention on the Quality of Extracurricular Life of Migrant Workers’ Children

The extracurricular life and education of migrant children are significant to the formation of personality and values, but it has been ignored for a long time. The aim of this study is to obtain evidence supporting the theoretical argument that social work intervention in extracurricular education can have a positive impact on migrant children’s learning ability, social adaptability, personality, and interest shaping. From the perspective of practice, including participatory observation and case study method, this paper analyzes the situation of 71 migrant children in order to improve their extracurricular life quality by social work intervention. In the short term, project members have generally developed good study habits. In the long term, the academic performance is generally excellent, which is beneficial to the development of school teaching tasks. The project has an obvious beneficial impact on the academic learning ability and mental health of migrant workers’ children, especially the ability of social adaptation and the shaping of personality interests. The project helps to strengthen the sustainability of migrant children’s education.