Peigang Wang   Editor The Health Status of Internal Migrants in China The Health Status of Internal Migrants in China Peigang Wang Editor The Health Status of Internal Migrants in China 123 Editor PeigangWang Population andHealthResearch Center Schoolof HealthSciences WuhanUniversity Wuhan, China ISBN978-981-15-4414-9 ISBN978-981-15-4415-6 (eBook) https://doi.org/10.1007/978-981-15-4415-6 ©SpringerNatureSingaporePteLtd.2020 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpart of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission orinformationstorageandretrieval,electronicadaptation,computersoftware,orbysimilarordissimilar methodologynowknownorhereafterdeveloped. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoesnotimply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfrom therelevantprotectivelawsandregulationsandthereforefreeforgeneraluse. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authorsortheeditorsgiveawarranty,expressorimplied,withrespecttothematerialcontainedhereinor for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictionalclaimsinpublishedmapsandinstitutionalaffiliations. ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSingaporePteLtd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore Preface At present, China is in a critical period of socio-economic developmental trans- formation. The rapid progression of urbanization has absorbed a large number of rural laborers into cities, which contributes to the unprecedented population migration.“ChinaStatisticalYearbook2019”statesthatthesizeofChina’sinternal migrantsin2018was241millionpeople(NationalBureauofStatistics,2020).The large size of the internal migrants has made great contributions to China’s social and economic development, but it is not without an owing consequence to the health of migrants. The internal migrants are mainly engaged in labor-intensive work in the inflow areas, with low occupational status, high work intensity, and longworkinghours.Thepoorworkingenvironmentexposesworkerstohealthrisks suchas dust, noise, andtoxicsubstances,whichmay lead tooccupational diseases such as silicosis, chronic poisoning, and various types of work injuries (Li et al., 2018; Niu, 2013). Weak economic foundation makes it difficult for internal migrants to access high-quality health services or obtain a decent living setting whichaggravatestheirrisksfor common respiratoryandgastrointestinalinfectious diseases (Fan, 2019). Urbanization dynamics including work pressure and social isolation also task the mental health of internal migrants (Fan, 2019; Liu, 2018). In the era of large population movements, population mobility deserves utter attention. For example, the COVID-19 outbreak in China might have accelerated due to the large-scale population movement during the Spring Festival. The high mobilityoftheinternalmigrants,thedifficultyoftrackingandmanagement,andthe poorurbanlivingconditionscoupledwiththeweaklinksinpreventionandcontrol further precipitated the endemicity of the outbreak. At present, China’s large-scale migrationandurbanizationoftheinternalmigrantshavestrainedthemodernization of urban governance and the modernization of migrant population management services. Solving the health problem of the internal migrants is an integral part ofthegovernment’spromotionofmodernizationofsocialgovernance.In2014,the Chinese government launched a pilot project with the aim of equalizing and improving the quality and efficiency of basic public health services for migrants (Yueetal.,2014).TheOutlineof“HealthyChina2030”Planpromulgatedin2019 specifically emphasized the need to address the health issues of the internal v vi Preface migrantswhenitputsforwardthestrategicstatusofpeople’shealthasapriority.In addition, health interventions and policies such as medical treatment and reim- bursements have continuously been introduced and implemented in various set- tings, to reduce institutional barriers between the internal migrants and health services. Solving the health problems of the internal migrants does not only help achieve the goals of “Healthy China” and “Health for All”, but is also an inherent requirement for maintaining a healthy society and a stable economy. All the papers collected in this book are original studies, and they are analyzed using data from the China Migrants Dynamic Survey (2013–2018). As the survey does not provide data on “children and family planning services” in the national database,theteamfetchedrespectivecontentfromthe2013–2018HubeiProvincial Health and Health Committee database. The above data is an annual large-scale national sampling survey of migrants since 2009, covering 31 provinces (au- tonomous regions and municipalities). The influx of migrants in the Xinjiang ProductionandConstructionCorpsisrelativelyconcentrated,withasamplesizeof nearly 200,000 households per year. It covers basic information on the migrant population and family members including the scope and trend of migration, employment andsocialsecurity,income and expenditure, and residence, andbasic public health services, management of marital and family planning services, child mobility and education, psychological culture, etc. In addition, some years also include the special survey on social integration and mental health of the internal migrants, the special survey on health and family planning services in the outflow areas, and the special survey on medical and health services for the mobile elderly (http://www.chinaldrk.org.cn/wjw/#/home). This book comprehensively applies cutting-edge research design and analysis methods, integrates trend analysis and causal inference analysis, and considers the potential role of social determinants of health of migrants to provide empirical evidenceforscientificinterventions.Theuniqueadvantageoftheinternalmigrants in the study of the relationship between social factors and health is that it has undergoneahugechangeinthelivingenvironmentandthesocialrelationshipsthat havechangedwithit.Basedonthisandadynamicresearchapproach,itiseasierto observe significant changes in social factors and health outcomes, which helps to identifythecausalrelationshipbetweenthetwoandproposetargetedinterventions. In an academic sense, this project is at the forefront. It integrates relevant the- ories and methods, explores the potential causal mechanism in the relationship betweensocialfactorsandthehealthoftheinternalmigrantsbasedontheChinese cultural contexts, which enriches the logical framework of causality between the two. From a practical perspective, in the context of the rapid urbanization and the large size of the internal migrants, solving the health problems of the internal migrants isofagreat significance for maintaining thestable development ofurban andruralareas,achievingthe“HealthyChina2030”andthe“HealthforAll”goals. General Secretary, Xi Jinping, pointed out that it is necessary to strive to provide quality and comprehensive health services for people throughout their life-course (http://www.xinhuanet.com/health/zt/2016JK20/). Moreover, the Outline of “Healthy China 2030” Plan has repeatedly emphasized that a solution must be Preface vii sought for the health problems of the internal migrants. The current pandemic of COVID-19 also proves that the health problem related to population mobility is a concerning public health issue. Therefore, analyzing and researching the health problems of the internal migrants is not only relevant to the realization of the “Healthy China 2030” Goal, but also helps to promote the modernization of the capacityofthenationalgovernancesystemandmaintainahealthysocio-economic development of the country. Wuhan, China Peigang Wang References NationalBureauofStatistics:ChinaStatisticalYearbook2019,2020,ChinaStatisticsPress. Li, J., Wang, T., Sun, Z. (2018). From health advantage to health disadvantage “Epidemiology Paradox”inruralandurbanfloatingpopulation.PopulationResearch,42(6),46–60. Niu, J. (2013). The impact of population mobility on the health differences between urban and ruralresidentsinChina,ChineseSocialSciences,(2),46–63. Fan, X. (2019). The health status, problems and countermeasures of floating population, MacroeconomicManagement,(4),42–47. Liu, H. (2018). Actively responding to the mental health problems of the floating population, ChinaPopulationNews(3rded.),November26. Yue, J., Li, X. (2014). Migrants’ health consciousness and utilization of health services from a communityperspective:Astudybasedonthepearlriverdelta,JournalofPublicManagement, 11(4),125–135. http://www.chinaldrk.org.cn/wjw/#/home. http://www.xinhuanet.com/health/zt/2016JK20/. Contents 1 Migration, Migrants and Health in Flux. . . . . . . . . . . . . . . . . . . . . 1 Junfeng Jiang 2 Utilization of Basic Public Health Services Among Internal Migrants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Yanqun Liu and Yani Hu 3 Association Between Medical Insurance, Migration Direction and Health Seeking Behaviors of Internal Migrants . . . . . . . . . . . . 39 Jing Liang and Shuqin Wu 4 MinimumWageStandardandMigrants’SocialHealthInsurance Take-Up in China. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Shengfeng Lu and Sixia Chen 5 Identity Patterns and the Health of Internal Migrants . . . . . . . . . . 73 Tao Zhong and Junfeng Jiang 6 Economic Factors and Life Satisfaction in Internal Migrants: A Moderated Mediation Model of Perceived Stress and Social Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Peigang Wang, Yayun Xu, and Ling Zhang 7 Effects of Migration Experiences on the Health of Internal Migrants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Chaoping Pan 8 Marriage and Childbirth Situation of Internal Migrants at Different Birth Cohorts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Yuehui Wang, Hong Yan, and Jingjing Li 9 Age at Marriage and First Birth Interval Among Female Internal Migrants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Tiantian He ix x Contents 10 Individual- and Community-Level Determinants of Contraceptive Behaviors in Young Female Migrants . . . . . . . . . . . 149 Fang Tang 11 How Does the Education of Migrants Influence Their Accompanying Elderly Parents’ Health?. . . . . . . . . . . . . . . . . . . . . 163 Junfeng Jiang Chapter 1 Migration, Migrants and Health in Flux JunfengJiang Atthetimeofwritingthisbook,therearemorethan240millioninternalmigrants influxinChina,whichisalargenumberinanycountryorregion.Inthesettingof socialtransition,mostmigrantsmovefromruraltourbanareasandbecomemigrant workers or businessmen in China. Migrant workers are products of urbanization andindustrialization, andthey have made indelible contributions toChina’s social and economic development. Since most migrants become workers, they need to participateinlocallabormarkets,sohealthhumancapitalisnecessaryfortheinternal migrantsinChina.Numerousstudiesobservethat,asakindofhumancapital,health can largely contribute to socioeconomic development (Grossman, 1972). A better healthstatuscanhelpworkersimprovetheirmarketcompetitiveness,increasetheir timeavailable forwork,incomeandopportunities forpromotion,andreduce their probabilityofunemployment(Cheng,Jin,Gai,&Shi,2014;Ecob&Smith,1999; Zhang,2011). However,plentyofevidenceshowsthatmigrantsareusuallyexposedtoamounts ofhealthriskfactors,includingalowersocioeconomicstatus(SES)(lessincome,less education,lowoccupationalstatus),highworkintensityormorepressure,socialiso- lationanddiscrimination,adverseaccesstohealthrelatedresources,low-levelsocial integrationandadaption(Li,Wang,&Sun,2018;Niu,2013).Alltheseriskfactors arecloselyrelatedtoseriesofstructuralfactors,e.g.thehouseholdregistrationsys- tem(Wang&Fan,2012).Accordingtothe“healthymigranteffect”theory,although theselectionofmigrationresultsinabetterhealthstatusformigrantsattheinitial stageofmigration,thesehealthriskfactorswillceaselesslydamagemigrants’health and lead to a higher health loss rate than average (Chen, 2011; Lu & Qin, 2014; Tong & Piotrowski, 2012). With the deterioration of health condition, the social competitiveness of migrants weakens, forcing them to return to their hometown. B J.Jiang( ) SchoolofHealthSciences,WuhanUniversity,Wuhan,China e-mail:[email protected] ©SpringerNatureSingaporePteLtd.2020 1 P.Wang(ed.),TheHealthStatusofInternalMigrantsinChina, https://doi.org/10.1007/978-981-15-4415-6_1