Internal Migrants In China Research Articles

Social cohesion associated with health mediated by emotional experience and life satisfaction: Evidence from the internal migrants in China

Social cohesion is important for the physical health of migrants, but the mechanism is less discussed, and the mediating role of subjective well-being (SWB) is not clear. Based on the China Migrants Dynamic Survey in 2014 (N = 15,997), this study applied the structural equation model to analyze the mediating effect of SWB (consisting of emotional experience and life satisfaction) on social cohesion affecting physical health. The findings reveal that elevated social cohesion promoted the physical health and SWB of Chinese internal migrants, and SWB played an important mediating role in the relationship between social cohesion and physical health. Specifically, cohesion in local culture, social network, identity, and local acceptance were positively related to physical health, but hometown culture exclusion was negatively related to physical health. Both emotional experience and life satisfaction played a partial mediating role in all measures of social cohesion affecting physical health, except for life satisfaction in the process of network cohesion improving physical health. Furthermore, a heterogeneous mechanism between migrant workers and skilled or well-educated migrants was also observed. Social cohesion is a critical factor for the promotion of SWB and physical health in Chinese internal migrants, and targeted interventions should be taken to help different migrants integrate into their new life.

Prevalence of Depressive Symptoms and Associated Factors among Internal Migrants with Tuberculosis: A Cross-Sectional Study in China.

There are hundreds of millions of internal migrants in China, and tuberculosis (TB) is an important health threat to them. However, the mental health problems of internal migrants with TB in China have been ignored. The present study aimed to determine the prevalence of depressive symptoms and its associated risk factors among internal migrants with TB in China. A cross-sectional survey was conducted between June 2018 and March 2019 in Shenzhen, southern China. Data were collected from 1,057 internal migrants with TB using a structured questionnaire. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Multinomial logistic regression analysis was used to identify risk factors for depressive symptoms. Of the 1,057 participants included in this study, 53.8% had depressive symptoms. Of these, 38.9% had mild, whereas 14.9% had moderate-to-severe depressive symptoms. Multinomial logistic regression analysis suggested that higher likelihoods of depressive symptoms were associated with female gender, lower education, family dysfunction, poor doctor-patient communication, and TB-related stigma. This study shows that the prevalence of depressive symptoms among internal migrants with TB is high in China. Targeting interventions and treatment of depressive symptoms among internal migrants with TB are needed.

Using structural equation modeling to examine pathways between perceived residential green space and mental health among internal migrants in China

BackgroundEmerging evidence suggests that exposure to residential green space is beneficial for people's mental health along multiple pathways. It remains unknown, however, whether the complex pathways found for the general population also apply to internal migrants in China. AimTo examine the mediators of green space–mental health associations among migrants in the metropolis of Shenzhen, China. MethodsWe conducted a cross-sectional survey among 591 migrants aged between 18 and 68 years in January–April 2017 in Shenzhen, a city facing a considerable inflow of rural-urban migration. Migrants' mental health was assessed using the 12-item General Health Questionnaire. Data on migrant's green space perception, migration characteristics, environmental disturbances, social cohesion, physical health, etc. were obtained through a questionnaire. Structural equation modeling was used to analyze the mechanisms underlying the green space–mental health association. ResultsNo direct effect of perceived green space on migrants' mental health was found. We did find, however, that perceived green space is significantly and indirectly related to mental health through reducing perceived environmental disturbance and enhancing social cohesion. Migrants' residential mobility presented a significant potential risk to migrants’ physical health and might influence their mental health indirectly. A similar but only weakly significant health-threatening effect was found for migration frequency. Male and female respondents showed different patterns regarding their physical and mental health status. Migrants with higher personal incomes seemed to face a lower mental health risk. ConclusionsOur findings suggest distinctive pathways through which residential green space could affect the mental health of internal migrants in China. Further studies in rapidly urbanizing areas are advised to evaluate green space–mental health relationships for specific population groups/subgroups with distinctive socioeconomic backgrounds.

Migration trajectories and their relationship to mental health among internal migrants in urban China: A sequence alignment approach

AbstractAlthough migration trajectories over people's life courses seem to be associated with mental health outcomes, previous studies have considered migration at only one point in time when correlating migration with mental health. However, people can migrate multiple times during their life courses. The decision to migrate can be triggered by several life course development events, such as education, entry to the labour market, marriage, or retirement. The present study addressed this research gap by focusing on the trajectories of migration and their relationship to mental health among internal migrants in China. Data were collected from a cross‐sectional survey (N = 534) in Shenzhen, China, in 2017. People's migration trajectories were aligned into migration groups using sequence alignment method. Binary logistic regression models were estimated to assess the associations between each migration trajectory group and the prevalence of mental health problems, controlling for sociodemographics and self‐reported physical health. The results show that migration trajectories—namely, the sequence of multiple migrations between migrants' places of origin and their final destinations—are significantly related to mental health outcomes. Our findings suggest that treating migration as a one‐time transition could be problematic because many migrants undertake multiple migration trips.

Short-term acceptability of the Woman\u2019s Condom and influencing factors among internal migrants in China

BackgroundThe Woman’s Condom, a newly designed condom for women, has obtained market approval in China, but it remains relatively unfamiliar to the migrant population. The aim of this study is to evaluate the short-term acceptability of the Woman’s Condom and influencing factors among internal migrants.MethodsA longitudinal study was conducted among 1800 migrants in Beijing, Chongqing, and Shanghai in China between August 2013 and August 2014.Three-level model was implemented with the Statistical Analysis System software (v.9.4 SAS Institute) to analyze within-individual changes, between-individuals effects, and between-group effects.ResultsThree-level model analysis revealed statistically higher short-term acceptability of the Woman’s Condom among subjects who lived in Shanghai (β = 6.50, t = 2.76, p < 0.01), unmarried and not in a cohabiting relationship (β = 3.05, t = 2.76, p < 0.01) than those who lived in Beijing, married and in a cohabiting relationship. Female (β = − 1.69, t = − 7.55, p < 0.01) and lower educational attainment (β = − 2.30, t = − 1.94, p = 0.05) were negatively related, while occupations of education, health, and civil staff (β = 1.50, t = 2.92, p < 0.01) were positively related to acceptability. It was predicted that migrants’ acceptability of the Woman’s Condom would significantly increase over time (β = 1.09, t = 5.54, p < 0.01).ConclusionsThe findings indicate that the Woman’s Condom enjoyed relatively high short-term acceptability among migrants in China. In order to popularize the Women’s Condoms in migrants, more publicity, consultation and training in open and prosperous areas should be strengthened.

Citywide Transmission of Multidrug-resistant Tuberculosis Under China's Rapid Urbanization: A Retrospective Population-based Genomic Spatial Epidemiological Study.

Population movement could extend multidrug-resistant tuberculosis (MDR-TB) transmission and complicate its global prevalence. We sought to identify the high-risk populations and geographic sites of MDR-TB transmission in Shenzhen, the most common destination for internal migrants in China. We performed a population-based, retrospective study in patients diagnosed with MDR-TB in Shenzhen during 2013-2017. By defining genomic clusters with a threshold of 12-single-nucleotide polymorphism distance based on whole-genome sequencing of their clinical strains, the clustering rate was calculated to evaluate the level of recent transmission. Risk factors were identified by multivariable logistic regression. To further delineate the epidemiological links, we invited the genomic-clustered patients to an in-depth social network investigation. In total, 105 (25.2%) of the 417 enrolled patients with MDR-TB were grouped into 40 genome clusters, suggesting recent transmission of MDR strains. The adjusted risk for student to have a clustered strain was 4.05 (95% confidence interval, 1.06-17.0) times greater than other patients. The majority (70%, 28/40) of the genomic clusters involved patients who lived in different districts, with residences separated by an average of 8.76 kilometers. Other than household members, confirmed epidemiological links were also identified among classmates and workplace colleagues. These findings demonstrate that local transmission of MDR-TB is a serious problem in Shenzhen. While most transmission occurred between people who lived distant from each other, there was clear evidence that transmission occurred in schools and workplaces, which should be included as targeted sites for active case finding.The average residential distance between genomic-clustered cases was more than 8 kilometers, while schools and workplaces, identified as sites of transmission in this study, deserve increased vigilance for targeted case finding of multidrug-resistant tuberculosis.

Toward Job or Amenity?: Evaluating the Locational Choice of Internal Migrants in China

This study provides new evidence on the debate of job opportunities versus urban amenities in determining the locational choice of migrants. We employ a conditional logit model to generate credible estimates, using two large representative data sets on China’s internal migrants. Our findings confirm that both job opportunities and amenities play consistent and salient roles in the geographical choice of internal migrants, while highly skilled migrants tend to attach more importance to urban amenities. Additionally, China’s household registration system seems to play an undeniable role: migrants are increasingly shunning cities providing better quality public services that are still largely inaccessible to temporary migrants in China.

Cross-District Transmission of Multidrug-Resistant Tuberculosis in Shenzhen, a Newly Developed Metropolis of China with Massive Young Migrant Workers

Background: Population movement could extend multidrug-resistant tuberculosis (MDR-TB) transmission and complicate its global prevalence. We sought to identify the high-risk populations and geographic sites of MDR-TB transmission in Shenzhen, the most common destination for internal migrants in China. Methods: We performed a population-based, retrospective study of patients who were diagnosed with MDR-TB in Shenzhen during 2013-2017. By defining genomic clusters with a threshold of 12 SNP distance based on whole-genome sequencing their clinical strains, the clustering rate was calculated to evaluate the level of recent transmission. Risk factors for MDR-TB transmission were identified by multivariable logistic regression. To further delineate the epidemiological links, we invited the genomic-clustered patients to an in-depth social network investigation. Results: In total, 105 (25·2%) of the 417 enrolled MDR-TB patients were grouped into 40 genome clusters, suggesting recent transmission of MDR strains. The adjusted risk for students to have a clustered strain was 4·05 (95% confidential intervals [CI], 1·06-17·0) times greater than other patients. The majority (70%, 28/40) of the genomic clusters involved patients who lived in different districts, with residences separated by an average of 8·76 kilometers. Other than household members, confirmed epidemiological links were also identified among classmates and workplace colleagues. Interpretation: These findings demonstrate that local transmission of MDR-TB is a serious problem in Shenzhen city. While most transmission occurred between people who lived distant from each other, there was clear evidence that transmission occurred in schools and workplaces, which should be included as targeted sites for active case finding. Funding: Sanming Project of Shenzhen (SZSM201611030); and National Science and Technology Major Project of China (2017ZX10201302 & 2018ZX10715012-005) Declaration of Interest: We declare that we have no conflicts of interest. Ethical Approval: The study protocol was approved by the Ethical Review Board of Shenzhen CCDC (No. 20180310).

Characteristics of and Risk Factors Associated with Self-Reported Sexual Repression among Internal Migrants in China: A Large-Scale Cross-Sectional Study

Objective: This large-scale cross-sectional study aims to identify the characteristics of and risk factors associated with sexual repression among internal migrants in China. Methods: Between August 2013 and August 2015, a total of 8,669 internal migrants from four major cities in China (Beijing, Shanghai, Chengdu, and Chongqing) voluntarily participated in our study. They were interviewed, and the data on their demographic information, occupation, and sexual activities were collected. The Chi-square test and multiple logistic regressions were conducted to identify significant associations. A stepwise method was adopted for the selection of variables. Results: There were 3,597 (41.49%) males and 5,072 (58.51%) females in total. A higher percentage of males reported that they felt sexual repression compared to females (14.43% vs. 9.21%). After adjusting for other covariates, the consequence was showed that male migrants working for more than 5 days were more likely to report sexual repression (odds ratio [OR] = 1.40, P Conclusions: Sexual repression was significantly associated with a few demographic, occupational, and sexual risk factors. Meaningful differences have been identified between male and female migrants. More effective intervention programs such as safeguard measures and welfare policies should be designed and implemented for a majority of female migrants and for those with agricultural household registration status.

Prenatal care among rural to urban migrant women in China

BackgroundThere is a very large population of internal migrants in China, and the majority of migrant women are of childbearing age. Little is known about their utilization of prenatal care and factors that influence this. We examined this using data from a large national survey of migrants.Methods5372 married rural to urban migrant women aged 20–34 who were included in the 2014 National Dynamic Monitoring Survey on Migrants and who delivered a baby within the previous two years were studied. We examined demographic and migration experience predictors of prenatal care in the first trimester and of adequate prenatal visits.Results12.6% of migrant women reported no examination in the first trimester and 27.6% had less than 5 prenatal visits during their latest pregnancy. Multivariate analysis indicated that demographic predictors of delayed and inadequate care included lower educational level, lower income and not having childbearing insurance. Migrating before pregnancy, longer time since migration, having migrated a greater distance, and not returning to their home town for delivery were correlated with better prenatal care.ConclusionsMany internal migrant women in China do not receive adequate prenatal care. While internal migration before pregnancy seems to promote adequate prenatal care, it also creates barriers to receiving care. Strategies to improve prenatal care utilization include expanding access to childbearing insurance and timely education for women before and after they migrate.

Hukou Locality and Intermarriages in Two Chinese Cities: Shanghai and Shenzhen

China’s household registration system (hukou) has created an institutional boundary for the social integration of migrants, but few studies have explored if hukou barriers vary by city. We investigate the value of hukou locality in Shanghai and Shenzhen by comparing their patterns of intermarriage between locals and migrants. We hypothesize that levels of intermarriage reflect the rigidity of the hukou barrier—the likelihood of intermarriage is lower and tradeoffs for local hukou are higher if one city has more stringent hukou policies than the other. Using data from the 2005 mini-census, we find support for our hypothesis. Shanghai, in which internal migrants in China find it most difficult to secure local hukou, exhibits lower levels of intermarriage and lower levels of hukou locality–education exchange between locals and migrants compared to Shenzhen. The findings suggest that the decentralization of China’s hukou system and subsequent varying hukou policies have made hukou locality an increasingly salient factor in shaping migrants’ integration and social inequaltiy.

The prevalence of smoking, second-hand smoke exposure, and knowledge of the health hazards of smoking among internal migrants in 12 provinces in China: a cross-sectional analysis

BackgroundPrevious studies have provided inconsistent findings on smoking among migrants, and very limited data exist on their second-hand smoke exposure. This study aims to investigate internal migrants’ smoking prevalence, second-hand smoke exposure among non-smokers, and knowledge of the health hazards of smoking in 12 major migrant provinces in China in 2013.MethodsData from the 2013 Migrant Dynamics Monitoring Survey in China published by the National Commission of Health and Family Planning was used in this study. Descriptive analysis, Chi-square analysis, and sex-stratified multivariate logistic regression analysis were used to explore the determinants of current smoking and second-hand smoke exposure.ResultsAmong 7200 migrants, 34.1% (55% male, 4% female) were current smokers. For males, factors associated with current smoking were education year (aOR = 0.95, 95% CI: 0.93–0.98), duration of stay (aOR = 1.01, 95% CI: 1.00–1.03) and occupation (aOR = 1.25, 95% CI: 1.03–1.53). For females, household registration status (aOR = 1.70, 95% CI: 1.04–2.80) was the most important factor associated with current smoking. Sixty five percent of non-smokers were exposed to second-hand smoke. Factors associated with exposure to second-hand smoke were duration of stay (aOR = 1.01, 95% CI: 1.00–1.02), divorced/widowed marital status (aOR = 0.48, 95% CI: 0.25–0.91), occupation (aOR = 1.29, 95% CI: 1.05–1.58) and the nature of employer (aOR = 0.77, 95% CI: 0.60–0.97). About 95% of participants were aware that lung cancer is one of the hazards of smoking. Non-current smokers had a better knowledge of fertility reduction and accelerated aging as hazards of smoking than current smokers (p < 0.01). Knowledge of the impact of smoking on cardiovascular diseases was relatively low compared with knowledge of other smoking-related hazards (26.1–44.3%).ConclusionsCurrent smoking and exposure to second-hand smoke among internal migrants in China is high. Socio-demographic characteristics and migration status were strongly associated with current smoking and second-hand smoke exposure. We recommend specifically targeted tobacco control interventions to help to address these risk factors, such as focusing on divorced/widowed women.

Influence Factors of Sexual Activity for Internal Migrants in China.

BackgroundSexual frequency is associated with the quality of life. China’s internal migrants that are sexually active are more likely to participate in sexual behavior. However, less work has been undertaken to assess the sexual frequency and its predictors in migrants.AimThis study seeks to explore which factors were related to sexual frequency in migrants and how the association varies with different levels of sexual frequency.MethodsA total of 10,834 men and 4,928 women aged 20–49 years from 5 cities in China were enrolled by multi-stage sampling during August 2013–August 2015.OutcomesSexual frequency among migrants was determined by asking: How many times have you had sexual intercourse with a man/woman in the past 30 days?ResultsIn this study, sexual frequency with an average age of 38.28 years was 5.06 (95% CI 5.01–5.11) time per month. Negative binomial showed that male gender, younger age, earlier age of sexual debut, masturbation, more knowledge of sexual and reproductive health, longer time together with a spouse, and higher school education and incomes were predictors of increased sexual frequency in migrants. Communicating with sexual partners frequently had the largest effect on sexual frequency compared with occasional communicating (β = 0.2419, incidence rate ratio = 1.27, 95% CI 1.23–1.31). In the quantile regression, months of cohabitation (β = 0.0999, 95% CI 0.08–0.12), frequent sexual communication (β = 0.4534, 95% CI 0.39–0.52), and masturbation (β = 0.2168, 95% CI 0.14–0.30) were positively related to lower levels of sexual frequency. Interestingly, migrants who had low and high sexual frequency would be affected in opposite directions by the knowledge of sexual and reproductive health.Clinical TranslationClinicians can more understand the relationship between sexual frequency and its factors that can as the symptom basis of sexually-related diseases.ConclusionsThe present findings indicate that specific demographic, socioeconomic, and epidemiological characteristics influenced sexual frequency among migrants. Sexual communication as the largest effect predictor to sexual frequency should be paid more attention to, to improve sexual activity of migrants.Zhang J, Wu J, Li Y, et al. Influence factors of sexual activity for internal migrants in China. J Sex Med 2018;6:97–107.

3.10-P25Comparison of hospital service use by male and female internal migrants in China: evidence from a nationally representative cross-sectional survey

3.10-P25Comparison of hospital service use by male and female internal migrants in China: evidence from a nationally representative cross-sectional survey

Rural–urban divide and identity conflicts of migrant Muslim students in Northwest China

A huge flow of internal migrants in China is an indicator of the significant changes in the geographical and cultural patterns brought by China’s recent economic growth. The Hui (10.6 million), as one of the largest ethnic minority groups in China, and the Dongxiang, with almost 100% of them holding the Islamic belief, are migrating from rural areas to urban centers in Northwest China. Analyzing the qualitative data from narrative stories, thematic photos, group discussions, semi-structured interviews, and field observations, this study interprets the cultural experience of rural Muslim migrant students in Chinese public schools and examines their complex and fluid rural–urban identities. This study further discusses the possibilities of including and integrating rural migrant students in cities.

Association between social health insurance and choice of hospitals among internal migrants in China: a national cross-sectional study

ObjectivesThere is a tendency to pursue higher-level hospitalisation services in China, especially for internal migrants. This study aims to investigate the choices of hospitalisation services among internal migrants, and evaluate...

No health insurance and multiple insurance among internal migrants in China: a national cross-sectional study

BackgroundChina's system of social health insurance is fragmented into three separated insurance plans and is not transferrable across regions, which can leave some migrants without insurance or with multiple insurance. This study aimed to investigate the health insurance status among internal migrants, and its relationship with migration characteristics. MethodsWe used data from a national cross-sectional database from the 2014 and 2015 Migrant Dynamics Monitoring Survey in China for respondents aged 15 years or older. We applied multinomial logistic regressions to estimate the association between migration characteristics and health insurance status, adjusting for sociodemographic characteristics. Insurance status included being uninsured, having one insurance plan, and having multiple insurance. FindingsThe 2014 sample included 200 937 respondents and the 2015 sample included 201 294 respondents. In 2014, 163 906 (81·6%) migrants were covered by one insurance plan, and 7098 (3·5%) had multiple insurance, while 29 933 (14·9%) were uninsured. In 2015, the uninsured rate and the multiple insurance rate decreased to 7·3% (n=14 783) and 2·9% (n=5780), respectively. Using the 2014 sample, cross-city migration within a province significantly increased the probability of being uninsured by 53% (relative risk ratio 1·53, 95% CI 1·46–1·61) and having multiple insurance by 35% (95% CI 1·22–1·46) compared with intra-city migration, whereas cross-province migration increased the probability of being uninsured by 105% (95% CI 1·93–2·13) and having multiple insurances by 14% (95% CI 1·03–1·23). Living in the destination city for 5 years or longer significantly increased the likelihood of being uninsured by 4% (95% CI 1·01–1·08) and having multiple insurance by 30% (95% CI 1·21–1·37), compared to those staying for less than 1 year. The same patterns held in the 2015 sample except that no statistically significant relationship was detected between years lived in the destination city and having multiple insurance. InterpretationCross-province migration and living in the destination city for longer times were positively associated with no insurance and multiple insurance, causing inequality and inefficiency in the insurance system. Policies that integrate the three insurance plans across the country should be urgently promoted to achieve universal coverage. FundingNational Nature Science Foundation of China (grant no 71403007 and 71503059).

Social health insurance coverage and financial protection among rural-to-urban internal migrants in China: evidence from a nationally representative cross-sectional study

IntroductionMigrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We...

Public Health Services Utilization and Its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey.

There have been obstacles for internal migrants in China in accessing local public health services for some time. This study aimed to estimate the utilization of local public health services and its determinants among internal migrants. Data were from the 2014 and 2015 nationally representative cross-sectional survey of internal migrants in China. Multivariate logistic regressions were used to estimate the relationship between socioeconomic, migration, and demographic characteristics and public health services utilization. Our results showed that internal migrants in more developed eastern regions used less public health services. Those with higher socioeconomic status were more likely to use public health services. The years of living in the city of residence were positively associated with the utilization of public health services. Compared to migration within the city, migration across provinces significantly reduced the probability of using health records (OR = 0.88, 95% CI: 0.86–0.90), health education (OR = 0.97, 95% CI: 0.94–1.00), and health education on non–communicable diseases (OR = 0.92, 95% CI: 0.89–0.95) or through the Internet (OR = 0.96, 95% CI: 0.94–0.99). This study concludes that public health services coverage for internal migrants has seen great improvement due to government subsidies. Internal migrants with lower socioeconomic status and across provinces need to be targeted. More attention should be given to the local government in the developed eastern regions in order to narrow the regional gaps.

Network effects on labor contracts of internal migrants in China: a spatial autoregressive model

This paper studies the fact that 37% of the internal migrants in China do not sign a labor contract with their employers, as revealed in a nationwide survey. These contract-free jobs pay lower hourly wages, require longer weekly work hours, and provide less insurance or on-the-job training than regular jobs with contracts. We find that the co-villager networks play an important role in a migrant’s decision on whether to accept such insecure and irregular jobs. By employing a comprehensive nationwide survey in 2011 in the spatial autoregressive logit model, we show that the common behavior of not signing contracts in the co-villager network increases the probability that a migrant accepts a contract-free job. We provide three possible explanations on how networks influence migrants’ contract decisions: job referral mechanism, limited information on contract benefits, and the “mini-labor union” formed among co-villagers, which substitutes for a formal contract. In the subsample analysis, we also find that the effects are larger for migrants whose jobs were introduced by their co-villagers, male migrants, migrants with rural Hukou, short-term migrants, and less educated migrants. The heterogeneous effects for migrants of different employer types, industries, and home provinces provide policy implications.