Abstract
In recent years, China has made great efforts to resolve the health inequality caused by household registration restrictions, and the unequal allotment of health services faced by migrant workers has been effectively alleviated. However, inequality in health services may exist not only between migrant workers and local citizens but also among migrant workers. Thus, the unbalanced utilization of health services among migrant workers deserves attention. Using data from the 2017 China Migrants Dynamic Survey (CMDS), we examined the relationship between socioeconomic status (SES) and healthcare-seeking behavior through multivariate regression analysis. Then, from the perspective of SES, this study divided migrant workers into different groups to explore the characteristics of healthcare-seeking behavior in different groups. The results showed that SES had a significant relationship with healthcare-seeking behavior. Those with high SES were more likely to use high-quality health services. By subdividing the category of migrant workers, we found that the utilization of health services among migrant workers was unbalanced. Education and income had significant gradients in multiple measures of healthcare-seeking behavior, while occupation had no significant difference in the behavior. Migrant workers with higher income and education were more likely to use high-quality health services. Especially for migrant workers who had high incomes (above 15,000 CNY) or whose educational backgrounds were graduate level or above, their utilization of health resources was significantly higher than that of other groups. When designing particular policies to improve the healthcare-seeking behavior of different SES migrant workers, we should pay attention to the low-education groups and low-income groups. Policymakers can reduce the current health inequality of migrant workers by strengthening health education and increasing medical subsidies to achieve health equality among migrant workers and between migrant workers and local citizens.
Highlights
Migrant workers are the labor force that does not change their household registration but works as temporary residents in non-household locations [1]
In Model 1, taking primary school and below as the reference, the educational background of each level was negatively related to the treatment attitude, whereas no significant correlation was found for doctor consultation
Migrant workers in the middle-income and relatively high-income categories had no significant relationships with treatment attitude and doctor consultation
Summary
Migrant workers are the labor force that does not change their household registration but works as temporary residents in non-household locations [1]. In 2018, China had 288.36 million migrant workers, accounting for 20.7% of the total population [2]. Migrant workers have made significant contributions to urban development, they have a difficult time receiving good urban socioeconomic welfare due to the restrictions of the household registration system [3,4,5]. This difficulty is no exception in the field of health services [6, 7]. Migrant workers live at the “edge of the city” and lack necessary health protection, which affects the city’s public health. Based on protecting the fundamental human rights of migrant workers and urban public health services, the Chinese government has formulated a series of policies, including the popularization of basic social insurance, to improve the availability and convenience of health services for migrant workers [8, 9]
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