Abstract
Background: This study aimed to examine the association of internal migration experience with depressive symptoms among middle-aged and elderly Chinese, as well as explore possible mechanisms of the relationship. Methods: Participants were from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative sample of residents aged 45 years and older (n = 43,854). Survey data on depressive symptoms and internal migration experience were collected from biennial CHARLS surveys (CHARLS 2011/2013/2015) and a unique CHARLS life history survey in 2014, respectively. Multiple logistic regressions and the Karlson–Holm–Breen (KHB) method were employed in the statistical analyses. Results: The overall prevalence rate of depressive symptoms among middle-aged and older adults was 34.6%. Internal migration experience was associated with higher risks of depressive symptoms (OR = 1.07, 95% CI = 1.02–1.12, p < 0.01), especially among females (OR = 1.08, 95% CI = 1.01–1.14, p < 0.05), middle-aged adults (OR = 1.12, 95% CI = 1.06–1.19, p < 0.001), rural-to-urban migrants who had not obtained an urban hukou (OR = 1.13, 95% CI = 1.07–1.19, p < 0.001), and those who had low migration frequency and first migrated out at 35 years of age or older. Chronic disease (17.98%, p < 0.001), physical injury (7.04%, p < 0.001), medical expenditure (7.98%, p < 0.001), pension insurance (4.91%, p < 0.001), and parent–child interaction (4.45%, p < 0.01) were shown to mediate the association of internal migration experience with depressive symptoms. Conclusions: This study indicates that there is a significant association between internal migration experience and high risks of depression onset later in life. It is suggested to reduce institutional barriers for migrants and implement evidence-based interventions to improve migrants’ mental health.
Highlights
Introduction published maps and institutional affilWith the growing scope, complexity, and diversity of population movement, migration is becoming one of the determining global issues of the 21st century [1]
In terms of age differences, the results showed that internal migration experience significantly increased the risk of being depressed among the middle-aged participants (OR = 1.12, 95% CI = 1.06–1.19, p < 0.001) (Model 4); it had no significant effect on the depressive symptoms among older adults (Model 5)
When considering internal migration frequency, our analyses suggested that participants with low frequency of internal migration experience were more likely to suffer from depressive symptoms, while high migration frequency was not significantly associated with the presence of depressive symptoms
Summary
Introduction published maps and institutional affilWith the growing scope, complexity, and diversity of population movement, migration is becoming one of the determining global issues of the 21st century [1]. Migrating to urban areas is often beneficial to promote individual socioeconomic status in comparison with nonmigrants in the place of origin, city life is widely considered as stressful because “cities are polluted, unhealthy, tiring, overwhelming, confusing, alienating” [3]. Internal migration experience was associated with higher risks of depressive symptoms (OR = 1.07, 95% CI = 1.02–1.12, p < 0.01), especially among females (OR = 1.08, 95% CI = 1.01–1.14, p < 0.05), middle-aged adults (OR = 1.12, 95% CI = 1.06–1.19, p < 0.001), rural-to-urban migrants who had not obtained an urban hukou (OR = 1.13, 95% CI = 1.07–1.19, p < 0.001), and those who had low migration frequency and first migrated out at 35 years of age or older. It is suggested to reduce institutional barriers for migrants and implement evidence-based interventions to improve migrants’ mental health
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