Rural Non-migrants Research Articles

The role of rural-urban migration on child survival in Kenya.

Migration in many developing countries is mostly motivated by the need to improve the well-being of individuals or household members. The aim of this study, therefore, was to establish the role of rural-urban migration on child survival in Kenya. Using a sample of 156,977 children pooled from six Demographic and Health Surveys conducted in Kenya between 1989 and 2014 we compared child survival for five sets of paired migration statuses using odds ratios. The results of the odds ratio for the composite analysis show that children born to rural non-migrants, rural-to-urban migrants and urban-to-rural migrants were 31 percent, 15 percent and 33 percent respectively more likely to die compared to those born to urban non-migrants. Children born to rural-to-urban migrants were 12 percent less likely to die compared to those born to rural non-migrant women while survival chances were similar for children born to urban-to-rural migrants and rural non-migrants. When odd ratios are decomposed by socioeconomic and health characteristics, the results suggest that most of the rural-to-urban migrants face adaptability challenges in urban region. From these results, we conclude that migration can affect child survival through the socioeconomic and environmental adaptability capability of the migrant households. Policies on child survival should therefore aim at bridging the socioeconomic gaps between migrant groups. Specifically, the progressive development policies at both national and devolved governance should aim at reducing the geographical socioeconomic disparities. Keywords: Migration, Child survival, Rural region, Urban region, Odds ratio

Rural–Urban Migration and Fertility Ideation in Senegal: Comparing Returned, Current, and Future Migrants to Dakar to Rural Nonmigrants

AbstractIn low‐ and middle‐income countries, significant differences in fertility beliefs between rural and urban areas arise from the differential timing and pace of fertility declines. Demographers have long hypothesized about the diffusion of these beliefs and behaviors from urban to rural areas, potentially via temporary rural–urban labor migration. In this paper, we investigate the association between temporary internal migration from rural Senegal to the capital city, Dakar, and differences in the fertility and contraceptive beliefs and preferences of migrants and nonmigrants. We test socialization, selection, and adaptation hypotheses by comparing the fertility ideation of current and returning migrants with that of nonmigrants and future migrants from their place of origin. Our results support selection effects, explaining half of the differences between nonmigrants and migrants. Once selection effects are removed, significant differences remain between nonmigrants and current or returning migrants. These differences are largely explained by two complementary measures of adaptation: years lived in Dakar and the number of ties to residents of that city. The results indicate that adaptation is as important, if not more so than selection in explaining differences between migrants and nonmigrants. This holds true even for returned migrants five years after their last migration spell. Of the two potential adaptation mechanisms explored, the time spent in Dakar generally explained adaptation better than ties to nonmigrants in Dakar. However, our complementary analyses do not rule out the importance of urban networks on fertility, as they contribute to migrant selection.

Internal migration and utilization of reproductive and maternity care among women in Pakistan: evidence from a recent National Survey.

During the last decades, migratory behavior has had a key role in population growth and redistribution in Pakistan. Migration has far-reaching socioeconomic implications for individuals and society at large that could influence the health integrity of Pakistani women. This study aimed to describe the migration patterns and drivers as well as their association with adequate access to reproductive and maternal care among married Pakistani women aged 15-49. The data from the 2017-18 Pakistan Demographic Health Survey (PDHS) was used to extract the information on the explanatory (sociodemographic and migration backgrounds) and outcome variables (unmet needs for family planning, adequate antenatal care, and delivery at health facilities). Bivariate and multivariate logistic regression analyses were employed to examine the relationship between these explanatory and outcome variables before and after adjustment for sociodemographic inequalities. In unadjusted models, the odds of having adequate ANC and delivery at health facilities were approximately 2 to 4 times higher in those living (urban non-migrant), moving to (urban to urban, rural to urban), or leaving the urban areas (rural to urban) as compared to rural non-migrants; likewise, the odds of the unmet needs for family planning was about 20-50% lower in the same migration streams compared to rural non-migrant. However, after adjustment for sociodemographic inequalities, most of these associations attenuated and only the association of urban to urban migration with unmet needs for family planning and the association of urban non-migrant with delivery at health facilities remained significant. Although the findings suggest that Internal migration flows, particularly those to urban areas (urban to urban and rural to urban), could be associated with better access to reproductive and maternity care among married Pakistani women aged 15-49 years; adjustment for sociodemographic inequalities, particularly education and wealth, nullified this association to a great extent. This has important implications for current policies and interventions in Pakistan and calls for policy reform and women's rights advocacy to enhance the literacy level of young Pakistani girls through well-tailored interventions, maintaining them at school.

Male Fertility and Internal Migration in Rural and Urban Sub-Saharan Africa

Subnational differences in male fertility within sub-Saharan African countries have not been explored, nor the differences in male fertility according to migration status been sufficiently probed. We study divergences in rural and urban male fertility and investigate the relationship between male fertility and migration across 30 sub-Saharan African countries. We employ 67 Demographic and Health Surveys to estimate completed cohort fertility among men aged 50–64 according to migration status. Overall, we find that urban male fertility has declined faster than rural male fertility, widening the gap between the sectors. Rural-urban migrant men have lower fertility than their rural non-migrant counterparts. Men migrating within the rural sector have similarly high fertility as rural non-migrants, while urban–urban migrant men have even lower fertility than non-migrant urban men. Using country-fixed effects models, we find that among men with at least secondary education, differences in completed cohort fertility by migration status are widest. When we consider the timing of migration in relation to the timing of the birth of the last child, we observe that migrant men are a select group, having around two children less than non-migrant rural men. There is also evidence of adaptation to destination, though to a lesser extent. Furthermore, migration within the rural sector does not seem to be disruptive to fathering. These results indicate that rural-to-urban migration has the potential to delay rural fertility decline, and that urban male fertility is likely to decline further, especially as the proportion of urban-to-urban migration increases.

Generalized trust among rural-to-urban migrants in China: Role of relative deprivation and neighborhood context

China has experienced sizeable internal migration in the past several decades. This research examines the implications of internal migration on generalized trust in China. Using data from the 2014 China Labor-force Dynamics Survey (CLDS), a nationally representative survey, we compared the level of self-rated generalized trust in strangers among Chinese rural-to-urban migrants, rural nonmigrants, and urban nonmigrants. We further assessed the mediating effects of relative deprivation and neighborhood context in the relationship between migration status and generalized trust. The results show that migrants are less trusting than rural and urban nonmigrants after adjusting for relevant sociodemographic characteristics. The mediation analysis suggests that relative deprivation partially explains the difference in generalized trust between migrants and rural nonmigrants, and it greatly mediates the trust gap between migrants and urban nonmigrants. The neighborhood context largely explains the difference in generalized trust between migrants and rural nonmigrants. Moreover, urban nonmigrants are less trusting than migrants when taking neighborhood context into consideration, which indicates a suppression effect of neighborhood context on the relationship between migrant status and social trust in urban China. This study contributes to a deeper understanding of how social trust changes in the process of internal migration. Policy implications are discussed.

Urbanization and depressive symptoms among middle-aged and older adults in China.

Urbanization plays an important role in individuals' health. However, it is difficult to isolate healthy migrant effect between urbanization and health. This study examined the effects of urbanization on depressive symptoms and its possible pathways among Chinese middle-aged and older adults independent of the influence of health-selective migration. Using the baseline survey of the China Health and Retirement Longitudinal Study, this study compared the depressive symptoms among three groups (urbanized rural residents, rural non-migrants and urban non-migrants). The 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) short form was used to measure depressive symptoms. Logistic regression models and Structural Equation Model (SEM) were applied to examine the association between urbanization and depressive symptoms and the corresponding potential mechanisms. Our final sample contained 11,156 respondents with an average age of 58.91 (SD = 9.48), with 5,142 males (46.09%) and 6,014 females (53.91%). Compared with urbanized rural residents, rural residents were more likely to have depressive symptoms (OR = 1.19, 95% CI = 1.07, 1.32), and urban residents were associated with a decreased risk of depressive symptoms (OR = 0.81, 95% CI: 0.70, 0.94). A large proportion of the association between urbanization and depressive symptoms were mainly mediated by social participation, income and living conditions. Planned urbanization had an independent impact on decreased depressive symptoms. Improvements in social participation, income and living conditions are the main drivers behind this relationship. Additionally, urbanization compensates for the negative impact of depressive symptoms from disadvantaged early life conditions, but it cannot eliminate the gap between urbanized rural people and urban non-migrants.

GENDER DIFFERENCES IN RURAL-URBAN MIGRATION AND ITS IMPACT ON MENTAL HEALTH IN LATER LIFE

Abstract Although rural-to-urban migration has been well researched, how gender shapes processes and outcomes, including later life health outcomes, has not been thoroughly investigated. Guided by a life course perspective, this study explores gender differences in rural-urban migration patterns and its association with mental health in later life among Chinese older adults. Exploiting rich life history data from the China Health and Retirement Longitudinal Study, we employ sequence analysis to identify the typical migration trajectories of Chinese older adults. Moderated mediation analysis is then used to examine gender-specific health pathways linking migration trajectories and later-life mental health. The results indicate that: men and women follow different migration trajectories across the life course. Men are more likely to migrate between rural and urban areas, and to migrate multiple times. Rural migrants who settled in urban regions have better mental health in later life than return migrants or rural non-migrants; the gender gap in mental health is marginally smaller among early urban settlers than rural non-migrants. Household income and Hukou conversion mediate the relationship between migration trajectories and later-life mental health among older people of rural origin. Household income in later life has stronger mediation effects for migrant men than for migrant women. The study suggests that a life course perspective and awareness of gender dynamics should be incorporated in policymaking to reduce the rural-urban divide and gender-based inequality in mental health.

Gender differences in rural-urban migration and its impact on depression in later life.

Although rural-to-urban migration has been well researched, how gender shapes processes and outcomes, including later-life health outcomes, has not been thoroughly investigated. Guided by a life course perspective, this study explores gender differences in rural-urban migration patterns and its association with depression in later life among Chinese older adults. Exploiting rich life history data from the China Health and Retirement Longitudinal Study, we employ sequence analysis to identify the typical migration trajectories of Chinese older adults. Moderated mediation analysis is then used to examine gender-specific health pathways linking migration trajectories and later-life depression. The results indicate that: rural migrants who settled in urban regions have lower level of depression in later life than 'return migrants' who moved back to rural areas or those who were rural non-migrants; the gender gap in depression is marginally smaller among early urban settlers than rural non-migrants; and household income in later life has stronger mediation effects for migrant men than for migrant women. The study therefore highlights the importance of considering the role of gender when designing policies aiming to improve the health and wellbeing of migrants in later life.

Urbanization and Cognitive Function Among Middle-Aged and Old Adults in China.

Our study examined the effect of urbanization on cognitive function and its possible pathways among Chinese middle-aged and older adults independent of the influence of health-selective migration. Using data from the China Health and Retirement Longitudinal Study, we compared cognitive function among three groups (urbanized-rural residents, rural nonmigrants, and urban nonmigrants). Logistic regression and structural equation models were applied to explore the impact of urbanization on cognitive function and the potential mechanisms. Compared with the urbanized-rural group, urban nonmigrants had better cognitive function, with a significant coefficient of 1.56 (95% CI: 1.22, 1.89) for global cognition scores and 0.37 (95% CI: 0.22, 0.53) for episodic memory scores. The rural nonmigrants had the worst cognitive function (β = -0.79, 95% CI: -1.04, -0.55) and lower scores of mental intactness (β = -0.65, 95% CI: -0.84, -0.57) and episodic memory (β = -0.14, 95% CI: -0.26, -0.03). The association between urbanization and cognitive function was mainly mediated by income and living conditions among middle-aged and older adults. Rural people who experienced planned urbanization in China had higher cognitive scores than rural non-migrants. Urbanization could thus have a beneficial and cumulative effect on cognitive function. Improvements in living conditions and changes in income are the main drivers behind the relationship. However, urbanization could compensate for the negative impact on cognitive function from disadvantaged early-life conditions, but it cannot completely eliminate the gap between urbanized-rural people and urban nonmigrants.

Effect of Rural-Urban Migration on Age at Marriage Among Adolescent Girls in Bangladesh.

ObjectivesBangladesh reports one of the highest rates of child marriage (CM) (59%) in the world and the highest rate within South Asia. Age at marriage of girls is a critical human rights and developmental issue in Bangladesh. Migration has been documented to be positively associated with age at marriage. Bangladesh experiences one of the highest rates of rural to urban migration in the world. An increase in rural-urban migration of adolescent girls has been observed over the last few decades in Bangladesh with the expansion of employment opportunities particularly in the ready-made garment industry (RMG). This analysis explores the effect of migration on age at marriage and CM among adolescent girls living in urban slums of Dhaka.MethodsThe sample was selected from icddr,b's Urban Health and Demographic Surveillance System (UHDSS) and comprises of never-married adolescent girls aged 15–19, who migrated in from rural Bangladesh to slums in and around Dhaka during 2015–2019. These in-migrants were matched with their rural counterparts from icddr,b's Matlab HDSS (MHDSS), using one to one nearest neighbor matching with caliper 0.1 using propensity score matching (PSM) method. The sample derived included a total of 2,700 never-married adolescent girls from Dhaka and Matlab. The association between migration and age at first marriage was estimated using a linear regression model and the effect of migration on CM was explored using logistic regression analyses.ResultsThe in-migrants perfectly matched with their rural peers in terms of age, household wealth and religion. However, their income earning status was hugely different. Urban migrants had significantly higher age at marriage than the rural non-migrants for both 15–19 (Coefficient, 1.77; 95% CI, 1.07–2.46) and 20–24 years age group (Coefficient, 2.87; 95% CI, 2.18–3.55). The migrant girls aged 20–24 years were 71% (aOR, 0.29; 95% CI, 0.12–0.69) less likely to get married before CM age bar in Bangladesh compared to their rural counterparts.ConclusionMigration has a positive effect on delaying marriage and reducing CM among adolescent girls. Findings from this study suggest that CM can be reduced by creating educational and economic opportunities for females.

Migration and sexual partnerships among unmarried young men in Thailand: a longitudinal approach.

Migrants typically report more sexual behavior than non-migrants. In existing work, the potentially confounding effects of selection loom large. Our objective is to discern whether migrants actually do engage in more sexual activity than their non-migrating counterparts, once selection is accounted for. We used three waves of data from a longitudinal panel study in Thailand. Panel members were rural unmarried men, some of whom subsequently migrated to urban areas and were re-interviewed there. Migrants were compared to their non-migrant counterparts and to a separate sample of long-term urban dwellers. There were no differences between eventual migrants and non-migrant counterparts in sexual partnerships before migration. Migration increased sexual partnerships with stable partners and strangers, compared with rural non-migrants. Unmarried men who moved to urban areas had increased sexual partnerships with stable partners and strangers. Without proper means of protection, this pattern of behavior puts these men and their sexual partners at elevated risk of unwanted pregnancy and sexually transmitted infections (STIs). Public health programs should target unmarried male migrants for pregnancy control and STI prevention.

Impact of Occupation and Family Burden on Psychological Adjustment in Returning Migrants

Background: Recently, increasing returning migrants in China accompany the massive rural-urban migration, but little information on mental health is available. Methods: A cross-sectional survey was conducted in 2,100 households from seven provinces to examine the effect of return migration on mental health and its association with entrepreneurial experience, occupation, and family burden compared with local rural non-migrants. The 12-item General Health Questionnaire (GHQ-12) was used to measure mental health status, and factor scores were extracted through factor analysis to gauge three sub-domains of loss of confidence, social dysfunction, and anxiety. A general linear regression model was used to analyze the data for the association. Results: Returning migrants were more likely to have elevated levels of anxiety compared with rural non-migrants when adjusting for social and demographic variables. Entrepreneurial experiences reduced loss of confidence and social dysfunction but increased anxiety; started but not currently running a business, and having older adults at home to care seemed growing concern in returning migrants but not in the rural non-migrants. Conclusion: Our study supports the salmon bias effect, but that occupation, entrepreneurship, and family burden may have non-negligible impacts on the anxiety in returning migrants. The findings may have implications for promoting social integration for returning migrants.

Filial Considerations in Mate Selection: Urban and Rural Guangdong in the Post-Mao Era

This article examines the transformation of filial piety by probing disagreements between parents and children over marriage decisions. Based on field observations and in-depth interviews in Guangdong, this research shows that children’s responses to disagreements vary by gender, generation, and rural or urban background. Collective family economies and intergenerational moral imperatives create a strong patriarchal basis for filial obedience for older respondents and rural non-migrants. Rural migrants’ responses are the most diverse given the option to live separately from their parents, although they feel obligated to please their parents, who are morally and culturally constrained by their rural community. The resurgence of parental power is conflated with strong reciprocal emotional bonding in young urbanites, contributing to painful and prolonged negotiations with parents. Sons are more constrained by parental authority than daughters, given the continued importance of patrilineality. This study therefore illustrates the resilience and the multifaceted transformation of filial piety in China.

Impact of internal female migration on unmet need for modern contraception in Zambia

BackgroundUnmet need for contraception, the proportion of women who want to limit or delay childbirth but use no form of contraception, is the core indicator to evaluate the effectiveness of family planning programs. Understanding how migration influences unmet need is important to identify to whom and how to target sexual and reproductive health programs. We assessed how migration status in rural and urban settings is associated with having an unmet need for family planning.MethodsData on sexually active, fecund, reproductive-aged (15–49 years) women from the 2013–14 Zambia Demographic and Health Survey were analysed through univariate and multivariate logistic regression models.ResultsUnmet need for modern contraceptive methods was significantly higher among rural to rural migrant women (OR 1.30, 95%CI 1.00–1.70 p < 0.05) and rural non-migrant women (OR 1.41, 95%CI 1.06–1.85 p < 0.01) compared to urban non-migrant women after controlling for age, marital status, parity, religion, education and wealth.ConclusionWomen residing in, and migrating between, rural areas were significantly more likely to have an unmet need for contraception. Our findings highlight the importance of understanding migration and migrant streams to strengthen family planning programs. In Zambia, a focus on rural-rural migrants, rural non-migrants and the poorest could improve the health of the entire population.

Nutrition transition, overweight and obesity among rural-to-urban migrant women in Kenya.

To assess the effect of rural-to-urban migration on nutrition transition and overweight/obesity risk among women in Kenya. Secondary analysis of data from nationally representative cross-sectional samples. Outcome variables were women's BMI and nutrition transition. Nutrition transition was based on fifteen different household food groups and was adjusted for socio-economic and demographic characteristics. Stepwise backward multiple ordinal regression analysis was applied. Kenya Demographic and Health Survey 2014. Rural non-migrant, rural-to-urban migrant and urban non-migrant women aged 15-49 years (n 6171). Crude data analysis showed rural-to-urban migration to be associated with overweight/obesity risk and nutrition transition. After adjustment for household wealth, no significant differences between rural non-migrants and rural-to-urban migrants for overweight/obesity risk and household consumption of several food groups characteristic of nutrition transition (animal-source, fats and sweets) were observed. Regardless of wealth, migrants were less likely to consume main staples and legumes, and more likely to consume fruits and vegetables. Identified predictive factors of overweight/obesity among migrant women were age, duration of residence in urban area, marital status and household wealth. Our analysis showed that nutrition transition and overweight/obesity risk among rural-to-urban migrants is apparent with increasing wealth in urban areas. Several predictive factors were identified characterising migrant women being at risk for overweight/obesity. Future research is needed which investigates in depth the association between rural-to-urban migration and wealth to address inequalities in diet and overweight/obesity in Kenya.

Illness representations and coping practices for self-managing hypertension among sub-Saharan Africans: A comparative study among Ghanaian migrants and non-migrant Ghanaians

ObjectiveHypertension (HTN) control is a major obstacle among sub-Saharan African populations partly due to poor self-management. We explored and compared how persons’ social and physical context shapes their illness representations regarding HTN and the coping strategies they develop and adapt to mitigate challenges in self-managing HTN. MethodsA cross sectional multisite qualitative study using semi-structured interviews among 55 Ghanaians with HTN living in The Netherlands and urban and rural Ghana. A thematic approach was used in data analysis. ResultsFamily HTN history, personal experiences with HTN and outcomes of using biomedical and traditional treatments shaped participants’ illness representations and coping strategies. Migrants and urban non-migrants modified medication schedules and integrated taking medication into daily routine activities to cope with experienced side effects of taking antihypertensive medication while rural non-migrants used traditional remedies and medicines to mitigate experienced medication side effects and/or in search for a cure for HTN. ConclusionContextual factors within participants’ social and physical environments shape their illness representations and coping strategies for HTN though interactive phrases. Practice implicationsHealth professionals should harness the relationships within peoples’ social and physical environments, encourage implementation of family-wide behavioural changes and involve family and communities in HTN treatment to enhance patients’ self-management of HTN.

Within-country migration and obesity dynamics: analysis of 94,783 women from the Peruvian demographic and health surveys

BackgroundRural-to-urban migration is associated with increased obesity, yet it remains unknown whether this association exist, and to what extent, with other types of internal migration.MethodsWe conducted a secondary analysis of the Peruvian Demographic and Health Surveys (2005 to 2012) on data collected from women aged 15–49 years. Participants were classified as rural stayers, urban stayers, rural-to-urban migrants, intra-rural migrants, intra-urban migrants, and urban-to-rural migrants. Marginal effects from a logit regression model were used to assess the probabilities of being and becoming obese given both the length of time in current place of residence and women’s migration status.ResultsAnalysis of cross-sectional survey data generated between 2005 and 2012. Data from 94,783 participants was analyzed. Intra-urban migrants and rural-to-urban migrants had the highest rates of obesity (21% in 2012). A steady increase in obesity is observed across all migration statuses. Relative to rural non-migrants, participants exposed to urban environments had greater odds, two- to three-fold higher, of obesity. The intra-rural migrant group also shows higher odds relative to rural stayers (42% higher obesity odds). The length of exposure to urban settings shows a steady effect over time.ConclusionBoth exposure to urban environments and migration are associated with higher odds of obesity. Expanding the characterization of within-country migration dynamics provides a better insight into the relationship between duration of exposure to urban settings and obesity.

Impacts of migration on health and well-being in later life in China: Evidence from the China Health and Retirement Longitudinal Study (CHARLS).

Unprecedented internal migration to urban areas has happened in China over the last few decades. While, we know that migration has a bidirectional relationship with health, this relationship has only been studied to a limited extent in China. In particular, the exiting literature has neglected the effects of migration on health and well-being in later life, instead focusing on the relationship between these outcomes over the short term, and also have only focused on temporary rural-to-urban migrants with a rural hukou rather than the broader range of internal migration flows. The hukou system, also known as the Chinese household system, an institutional feature with the power to restrict population mobility and access to local welfare resources. Using an inter-disciplinary approach, drawing on literature from economics, epidemiology and sociology, this paper conceptualises and examines the association between different forms of internal migration and their relationship with later-life health and well-being in China. It then attempts to draw conclusions on likely mechanisms through which migration affects health and well-being, including taking account of the selective nature of migration. To do this, we use the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative and multi-disciplinary dataset that examines the circumstances of the Chinese population aged over 45 years old. The results show that there are strong associations between migration status and later life health and well-being in China, with migrants to or within urban areas report the greatest health. Even after controlling for the selective nature of migration and other post-migration factors, there is still an unexplained, positive and statistically significant association between temporary rural-to-urban migration and depression scores. In addition, there are no differences between rural-to-rural migrants and rural non-migrants across all models. In terms of relevant mechanisms, selection of migrants seems to be particularly important in explaining the health and mental health differences between non-migrants and migrants to or within urban areas. Current socioeconomic circumstances and post-migration adaptation also explain some health differences between migrant groups and non-migrants.

Migration Status and Smoking Behaviors in Later-Life in China-Evidence From the China Health and Retirement Longitudinal Study (CHARLS).

Background: China is the biggest consumer of tobacco in the world, with a high prevalence of smoking especially among men. Along with the rapid demographic change in China, the burden of diseases attributable to health behaviors, particularly smoking is steadily increasing. So, smoking has become a major risk factor for mortality in China. Smoking behaviors may be related to migration processes, as a result of both who migrates and post-migration experiences related to socioeconomic position, stress and acculturation. Existing studies that have examined smoking and migration in China have, however, only focused on temporary rural-to-urban migrants and focused on relatively younger migrants. This paper examines the association between smoking behaviors and a comprehensive assessment of migration status in later-life in China.Methods: Using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset, this paper studies smoking behaviors of rural-to-urban migrants, urban-to-urban migrants, rural return migrants, and urban return migrants. We compare them with corresponding non-migrant groups in both rural and urban locations in China. Using a model that controls for demographic factors, early-life circumstances, socioeconomic factors, and factors related to migration, we examine both the decision to start smoking and the decision to quit smoking. In addition, we also address pre-migration selection in our analyses.Results: The results show rural-to-urban migrants are no more likely to start smoking compared with rural non-migrants, but they are more likely to quit smoking. While urban-to-urban migrants are more likely to start smoking compared with urban non-migrants, this effect is explained by the factors we include in the full model. Urban-to-urban migrants are, however, less likely to quit smoking. Moreover, both rural return migrants and urban return migrants seem to be more likely to start smoking and less likely to quit smoking compared with non-migrant groups.Conclusion: There are strong associations between migration status and later-life smoking behaviors in China; these associations vary greatly according to different migration status and point to populations and factors that public health activities should focus on.

Differences in the health–age profile across rural and urban sectors: a study on migrants and non-migrants in China

ObjectivesThe objective of this study is to examine age–health differentials between migrants and non-migrants in the context of migration in China. Study designWe use nationally representative data from the China Labor-force Dynamics Survey to analyze the relationship between age and health across different migration status groups. MethodsWe used a comprehensive measure of perceived health from factor analysis and structural equation models to take multiple dimensions of subjective health into consideration. ResultsWe found a difference in the association between age and health (net of controls) at age 46 years and above but not for younger age groups. That is, there is a health disadvantage between those who had ever migrated and urban non-migrants in older adulthood but not for young adulthood. However, the age–health profile of rural ever-migrants is not different from that of rural non-migrants. ConclusionsThese results highlight the effect of migration on health at different ages, which reflects the toll that migration takes on health over time. Our results imply that researchers should take into consideration life stages when examining the migration–health nexus. We also argue that there are potential influences related to China's longstanding division between rural and urban sectors.