Neighborhood-health links: Differences between rural-to-urban migrants and natives in Shanghai

Abstract

1. IntroductionAn abundant literature has documented the important role that neighborhood context plays in a variety of individual outcomes ranging from life chances and life trajectories to lifestyles and health outcomes, regardless of individual background (e.g., Bjornstrom and Kuhl 2014; Choi 2009; Ellis and Almgren 2009; Kawachi and Berkman 2003; Kim et al. 2011; Kimbro 2009; Li and Wu 2010; Logan, Alba, and Zhang 2002; Telles and Ortiz 2008; Wen, Hawkley, and Cacioppo 2006; Wen and Wang 2009). Evidence further suggests that perception of neighborhood environments is a crucial link between objective neighborhood conditions and health, and that perceived neighborhood contexts may even have stronger impacts on individual outcomes than objective neighborhood environments (Polling et al. 2014; Weden, Carpiano, and Robert 2008; Wen, Hawkley, and Cacioppo 2006). These neighborhood perceptions may vary across subgroups defined by socio-demographic background (Kamphius et al. 2010; O'Brien et al. 2014), such as immigrant status. Immigrants are often blamed for a rise in crime, violence, or social illness, which in turn affects the perceptions that both local residents and immigrants have about their neighborhood environments, especially in immigrant concentrated areas (Chiricos, McEntire, and Gertz 2001; Semyonov, Gorodzeisky, and Glikma 2012).So far most evidence on these issues is based on studies conducted in Western societies, which may not be applicable to other social, economic, and cultural settings. In China, research on the link between neighborhood environments/contexts and health has recently emerged, focusing on rural-to-urban migrants (hereafter migrant workers) in big cities and reporting significant associations between neighborhood contexts and health outcomes (e.g., Chen and Chen 2015; Palmer, Perkins, and Xu 2011; Wen et al. 2010). However, little work has been done to evaluate how the associations between neighborhood perceptions and health may differ between migrant workers and local residents. The large-scale rural-to-urban migration that has swept across all major Chinese cities is considered the largest population movement in human history in terms of migrant population size (China National Bureau of Statistics (NBSC) 2012). Migrant workers may be differently influenced by contextual exposures than urban natives, which could likely have far-reaching implications for urban health promotion. China's unique social setting has undergone rapid urbanization and industrialization since the reform and opening era in the late 1970s. Shanghai is the largest and one of the fastest growing cities in China, with migrant workers comprising 45% of the total de facto population of Shanghai in the 2010 census (NBSC 2012). Therefore, Shanghai offers a good sample for studying these issues.2. Literature reviewIt has long been recognized that neighborhood environments function as contextual regulators that shape individual behaviors, lives, and opportunities (e.g., Everson-Rose et al. 2011). Neighborhood contextual factors can be roughly categorized into physical (built/natural) environments and social environments (Diez Roux 2001; Hyman 2004; Macintyre, Ellaway, and Cummins 2002; Schulz et al. 2005). Examples of neighborhood physical environments are neighborhood amenities (e.g., infrastructures or facilities such as hospitals, schools, parks, libraries, and churches) and air quality. Examples of neighborhood social environments are social cohesion, solidarity, and safety (e.g., trust, helpfulness, friendliness, good relationships between neighbors, low crime rate) (Forst et al. 2010; Sallis et al. 2006).Neighborhood environments can be measured either objectively or subjectively. Objective measurements are usually obtained from census, administrative, archive, or GIS data, or from investigators' independent observations (Diez Roux and Mair 2010; Elo et al. 2009). Subjective measures are mainly collected in survey questionnaires by asking participants to report their own perceptions about their neighborhood environments (Diez Roux 2001). …