Abstract
BackgroundRural migrants usually suffer from major disease risks, but little attention had been paid toward the relationship between self-employment behavior and health status of rural migrants in China. Present study aims to explore the causal effect of self-employment behavior on rural migrants’ sub-health status and chronic disease. Two research questions are addressed: does self-employment status affect the sub-health status and chronic disease of rural migrants? What is potential mechanism that links self-employment behavior and health status among rural migrants in China?MethodsThe dataset from the 2017 National Migrants Population Dynamic Monitoring Survey (NMPDMS-2017) was used to explore the causal effect. Logit regression was performed for the baseline estimation, and linear probability model with instrument variable estimation (IV-LPM) was applied to correct the endogeneity of self-employment. Additionally, logit regression was conducted to explore the transmission channel.ResultsSelf-employed migrants were more susceptible to sub-health status and chronic disease, even when correcting for endogeneity. Moreover, self-employed migrants were less likely to enroll in social health insurance than their wage-employed counterparts in urban destinations.ConclusionSelf-employed migrants were more likely to suffer from sub-health status and chronic disease; thus, their self-employment behavior exerted a harmful effect on rural migrants’ health. Social health insurance may serve as a transmission channel linking self-employment and rural migrants’ health status. That is, self-employed migrants were less prone to participate in an urban health insurance program, a situation which leaded to insufficient health service to maintain health.
Highlights
Rural migrants usually suffer from major disease risks, but little attention had been paid toward the relationship between self-employment behavior and health status of rural migrants in China
Industry factor had a similar result, such that rural migrants working in construction and service industries were less likely to suffer from sub-health status than their counterparts working in other industries (construction industry: β = − 0.0690, 95% CI: − 0.1404, 0.0024; service industry: β = − 0.0616, 95% CI: − 0.1285, Table 2 Descriptive statistics of study participants according to employment status. (NMPDMS-2017)
After closely examining the estimates from linear probability model (LPM) and IV-LPM models, we found that results of the former were smaller in sub-health status model (0.47% compared with 2.4%) and chronic disease model (1.99% compared with 2.77%), which were in accord with the reserve causality story
Summary
Rural migrants usually suffer from major disease risks, but little attention had been paid toward the relationship between self-employment behavior and health status of rural migrants in China. Present study aims to explore the causal effect of self-employment behavior on rural migrants’ sub-health status and chronic disease. Rural migrants often work in the secondary urban labor market, which involves lower income, unstable jobs, longer work hours, and the lack of occupational health protection [3, 4]. Such situation affects the socio-economic status of rural migrants in urban destinations, but may produce negative effects on rural migrants’ health [4, 5]. Previous studies have revealed that rural migrants usually suffer from major disease risks, especially occupational diseases, chronic illnesses, and sexually transmitted diseases [6, 7].
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