The Association between Social Integration and Utilization of Essential Public Health Services among Internal Migrants in China: A Multilevel Logistic Analysis

Zhu

et al. 2021

Int J Equity Health

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.

Section: Marital Statusmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sociodemographic disparities in the establishment of health records among 0.5 million migrants from 2014 to 2017 in China: a nationwide cross-sectional study

Zhu

et al. 2021

Int J Equity Health

“…Other factors with minor importance also were documented in the early research. Early studies reported that market-oriented financing reforms of public health services ( 35 ), clear and detailed protocols ( 36 ), structural social capital ( 37 ), household registration ( 38 ), satisfaction with the attitude of primary health care workers ( 39 ), and social integration ( 40 ) were responsible for an increased utilization of local public health services among domestic migrants in China.…”

Section: Discussionmentioning

confidence: 99%

Associations Between Geodemographic Factors and Access to Public Health Services Among Chinese Floating Population

Guan

2020

Front. Public Health

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.

“…The data we used were taken from the China Migrants Dynamic Survey (CMDS) in 2017, conducted in all the provinces by the National Health and Family Planning Commission of People's Republic of China. CMDS focused on internal migrants, who were above 15 years old and have been living in destination cities for at least 1 month but without their household registration (Hukou) (excluding students, soldiers, and households where one of the spouses has the local hukou) ( 27 ). A three multiple-stage and Probability-Proportional-to-Size sample methods were used to size the samples.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Health and Wealth on Settlement Intention of Migrants: The Moderating Effect of Social Welfare

Zheng

Xue

et al. 2021

Front. Public Health

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.