Project description:To examine the interaction between social income inequality, social integration, and health status among internal migrants (IMs) who migrate between regions in China.We used the data from the 2014 Internal Migrant Dynamic Monitoring Survey in China, which sampled 15,999 IMs in eight cities in China. The Gini coefficient at the city level was calculated to measure social income inequality and was categorized into low (0.2 < Gini <= 0.3), medium (0.3 < Gini <= 0.4), high (0.4 < x < = 0.5), and very high (Gini >0.5). Health status was measured based upon self-reported health, subjective well-being, and perceptions of stress and mental health. Social integration was measured from four perspectives (acculturation and integration willingness, social insurance, economy, social communication). Linear mixed models were used to examine the interaction effects between health statuses, social integration, and the Gini coefficient.Factors of social integration, such as economic integration and acculturation and integration willingness, were significantly related to health. Social income inequality had a negative relationship with the health status of IMs. For example, IMs in one city, Qingdao, with a medium income inequality level (Gini = 0.329), had the best health statuses and better social integration. On the other hand, IMs in another city, Shenzhen, who had a large income inequality (Gini = 0.447) were worst in health statues and had worse social integration.Policies or programs targeting IMs should support integration willingness, promote a sense of belonging, and improve economic equality. In the meantime, social activities to facilitate employment and create social trust should also be promoted. At the societal level, structural and policy changes are necessary to promote income equity to promote IMs' general health status.
Project description:Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3-6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health measurements were improved with more years of residence. Moreover, our results show that two aspects of social integration, economic integration and self-identity, were significantly associated with health status. Subjective feeling of relative social status levels were more associated with health, which prompted the attention to social fairness and the creation of a fair and respectful culture. More interventions could be experimented, such as encouraging internal migrants to participate in community activities more actively, educating local registered residents to treat internal migrants more equally, and developing self-identity among internal migrants. Better social, economic, and cultural environment can benefit internal migrants' health statuses.
Project description:Social integration, a huge issue triggered by migration, leads to potential social fragmentation and confrontation. Focusing on the precise enhancement of "inner" subjective social integration is the ultimate urbanization solution to enhance people-centered well-being and promote full social integration. This article used data from the China Migrants Dynamic Survey 2017 (CMDS 2017) to reveal the spatial patterns and mechanisms of subjective social integration in Chinese cities. We make an innovative attempt to introduce multiscale geographically weighted regression (MGWR) to address the appropriateness of policy formulation by addressing the spatial variation in the factors. The results demonstrate that the influences on subjective social integration have a strong spatial heterogeneity in China, a vast and unevenly developed country. Expanding on the typical factors, household registration and political participation affect North China more than other regions; and housing and marriage have a greater impact in South China, especially in the Pearl River Delta and the Eastern Seaboard. Income, welfare, and healthcare are indiscriminately sweeping through most of China. Such a conclusion reminds the Chinese government that it needs to consider not only addressing some of the national constraints to subjective social integration but also imposing precise, site-specific changes for different regions.
Project description:The right to health is a fundamental human right for human beings to live in dignity. Everyone has the right to enjoy the fair and accessible highest standard of health by utilizing public health services. However, access to essential public health services also highly depends on the dialect culture. It is believed that the dialect culture also influences the efficiency of public health policies. To explore the phenomenon empirically, the current study utilized data sourced from geographical distribution information of Chinese dialects and the China Migrants Dynamic Survey for 2017. The study employed the Probit, IVprobit, and Eprobit models to estimate the impact of dialect culture on migrants' use of public health services. The findings revealed that the dialect culture significantly hinders the migrants' utilization of public health services. Further, by employing heterogeneity analysis, the findings revealed that the results are more pronounced in migrants, born after 1980, and are female with low educational background and also those migrants having local medical experiences and moving toward non-provincial cities. Finally to explore the mechanism of dialect culture influencing migrants' public health service, the study employed mediation analysis and KHB Method. The findings revealed that information transmission, health habits, social capital, and cultural identity are the potential pathways influencing the migrants' use of public health services. The findings conclude that rural-to-urban migrants' access to public health services is influenced by their cultural adaptation. Hence, the study proposes that the government should amend the policy inefficiency concerns caused by cultural differences and strengthen the regional cultural exchanges to build trust.
Project description:BackgroundAccessing 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.MethodsBased 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.ResultsHealth 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.ConclusionThe 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.
Project description:Entrepreneurship is an important means of economic development. Rural migrant workers returning home to start their own businesses can promote employment, alleviate poverty, and achieve rural development structural transformation of rural development. The entrepreneurial effect of rural return migrants is important for rural economic development. Using the data of the China Labor Force Dynamics Survey (CLDS thereafter) 2018 and China Household Finance Survey (CHFS thereafter) 2019, we analyze the entrepreneurial effects of return migrants upon their return to their hometowns. We construct a career choice model and build a mathematical model based on it to formulate the hypothesis. Then, we use the Probit regression model to test the hypothesis empirically. Results find that the rural return migrants can promote entrepreneurship among residents. Land circulation, human capital, and physical capital are stimulating factors in promoting the rural entrepreneurial activities of return migrants. We recommend that the government actively guide the rural return migrants to start businesses and provide security for entrepreneurial activities by upgrading various entrepreneurial elements.
Project description:OBJECTIVES:There is a tendency to pursue higher-level hospitalisation services in China, especially for internal migrants. This study aims to investigate the choices of hospitalisation services among internal migrants, and evaluate the association between social health insurance and hospitalisation choices. METHODS:Data were from a 2014 nationally representative cross-sectional sample of internal migrants aged 15-59 years in China. Descriptive analyses were used to perform the distribution of healthcare facility levels for hospitalisation services, and multinomial logistic regression was applied to examine the association between social health insurance and hospitalisation choices. RESULTS:Of the 6121 inpatient care users, only 11.50% chose the primary healthcare facilities for hospitalisation services, 44.91% chose the secondary hospitals and 43.59% preferred the tertiary hospitals. The choices presented large regional variations across the country. Compared with the uninsured, social health insurance had no statistically significant effect on patient choices of healthcare facility levels among internal migrants in China, whereas socioeconomic status was positively associated with the choices. CONCLUSIONS:Social health insurance had little influence on the hospital choice among the internal migrants. Thus, social health insurance should be consolidated and portable to enhance the proper incentive of health insurance on healthcare seeking behaviours.
Project description:BackgroundAchieving universal health insurance coverage has become a fundamental policy for improving the accessibility and equity of healthcare services. China's Urban-Rural Resident Basic Medical Insurance (URRBMI) is a crucial component of the social security system, aimed at promoting social equity and enhancing public welfare. However, the effectiveness of this policy in improving rural residents' social fairness perceptions (SFP) remains to be tested.ObjectiveTo examine the impact of the urban-rural resident basic medical insurance (URRBMI) on rural residents' social fairness perception (SFP) in China.Methods and samplesThe study utilizes city-level and national micro-survey (CGSS) datasets, applying a time-varying difference-in-difference (DID) approach to analyze the equity effects of URRBMI. Excluding urban samples, the final dataset consists of 20,800 rural respondents from 2010, 2011, 2013, and 2015, covering 89 cities.ResultsKey findings reveal that URRBMI has a significant negative effect on SFP. The impact varies depending on the integration model and intensifies over time. Additionally, the negative effect shows heterogeneity based on income, age, health, and region.ConclusionThis study highlights the complexities and impacts of integrating China's urban and rural healthcare systems. It provides a detailed understanding of the role of URRBMI in rural China, emphasizing the need for targeted approaches to improve rural residents' perceptions of social fairness. The research offers specific policy recommendations, such as establishing differentiated contribution standards, implementing welfare policies favoring rural residents, and adopting varied reimbursement rates for different diseases.
Project description:BackgroundThe new-generation migrants born in 1980 and later are large and vulnerable internal migrants in China. Migration paths and social integration are important factors to explain for their mental health. However, they faced difficulties in social integration varying from migration paths. We aimed to explore the mediating role of social integration between migration paths and the mental health of new-generation migrants.MethodsThe migration paths included urban-to-urban, urban-to-rural, rural-to-urban and rural-to-rural. Mental health was assessed by the Kessler Screening Scale for Psychological Distress (K6) and the Perceived Stress Scales (PSS-4). Social integration was measured by economic integration, life integration, maintenance of the local culture, acceptance of the host culture and psychological integration. Multiple linear regressions with bootstrapping were used to examine the mediating effect.ResultsA total of 9,830 new-generation migrants were included in this study. The mean age was 26.92 (SD = 4.47) years and the proportion of rural-to-urban migrants was 63.7%. Compared with the new generation of rural-to-rural migrants, rural-to-urban migrants had higher psychological distress (β = 0.305, 95% CI: 0.152-0.458) and perceived stress (β = 0.328, 95% CI: 0.199-0.456). The bootstrapping test found that two dimensions ("life integration" and "acceptance of the host culture") of social integration as a mediator weakened the negative effect of the rural-to-urban migration path on the mental health of new-generation migrants.ConclusionRural-to-urban migrants had poorer mental health, and the association was mediated by their poorer social integration. The migration policies developed to enhance social integration could effectively improve the mental health of new-generation migrants.
Project description:OBJECTIVES:Essential public health service use among the migrants is the key obstacle of the equalisation of public health service in China. This study aims to investigate the status of the establishment of health records, and explore the effect of social integration on the establishment of health records among elderly migrants in China. DESIGN AND SETTING:This is a cross-sectional study of data from the 2015 National Internal Migrants Dynamic Monitoring Survey in China. PARTICIPANTS AND METHODS:Respondents who not clear about whether they had established health records and who lived in the inflow area for less than 6 months were excluded. A total of 3158 migrants aged over 60 years were included in this study. Univariate logistic regression and multivariate logistic regression were employed to explore the association between social integration and establishment of health records. RESULTS:Approximately 41.6% of elderly migrants established health records in their inflow communities. Those elderly migrants from higher-income households were less likely to establish health records (p<0.001; OR=0.64; 0.51-0.80). Elderly migrants with local medical insurance (p<0.001; OR=2.03; 1.60-2.57), long-term settlement intention (p<0.001; OR=1.37; 1.15-1.63), and had more than three local friends (p<0.001; OR=1.54; 1.27-1.86) were more likely to establish health records. CONCLUSIONS:This study demonstrates a relationship between social integration and establishment of the health records among elderly migrants in China. Improving the social integration of elderly migrants might be helpful to enhance the equalisation of essential public health services.