Behavioural risks acquired from internal migration: a nationwide cross-sectional survey

Abstract

BackgroundRapid urbanisation and economic development in China comes with a huge wave of internal migration. As of 2016, the amount of people who have moved out of their hometown have outnumbered 245 million. The number of people affected by the migration process increases as people stop migrating and return home. In this study, we investigated the effect of migration experience on health risk behaviours according to the migration phases framework. MethodsWe extracted data for participants from the 2014 wave of China Labor-force Dynamic Survey, a national representative survey covering 29 of 31 provinces of China with a multistage stratified sampling method. We explored the difference in behaviour prevalence between different phase groups (non-migrants, the floating migrants, the settled migrants, and the returned migrants) with standard rates and the propensity score matching method (PSM) to control the confounding from the so-called healthy migrant effect. Behaviours considered included smoking, alcohol drinking, and physical exercise. The survey was reviewed and approved by the ethics committee of the Centre for Social Survey, Sun Yat-sen University, Guangzhou, China. Written informed consent was obtained from all participants. FindingsOf all 23 594 participants included in this study, 17 307 were non-migrants, 2155 were floating, 1633 had settled in the destination, and 2499 had returned home. Similar results were obtained from the standardised rates and the PSM model. In the PSM model, smoking prevalence was 9·4% higher in returned migrants (p<0·0001), 5·8% higher in the floating migrants (p<0·0001) and 1·9% higher (p=0·1003) in the settled migrants than in the non-migrants (standardised rate 22·0%). The prevalence of frequent alcohol drinking was higher in the returned (4·0% higher, p=0·0003), the floating (5·9% higher, p<0·0001), and the settled (2·1% higher, p=0·0559) migrants than in non-migrants (standardised rate 15·7%). The prevalence of physical exercise was higher in the returned (0·6% higher, p=0·511), the floating (3·6% higher, p=0·0009), and the settled (9·7% higher, p<0·0001) migrants than in non-migrants (standardised rate 16·3%). InterpretationInternal migration increases several risk behaviours. The returned migrants were most susceptible to risk behaviours such as smoking and drinking while the settled were more likely to have healthier habits than the other migrants. Further health intervention should be tailored to target the migration process and returned migrants. FundingNone.