Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016
Background: China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chines...
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| Published in | International journal of environmental research and public health Vol. 16; no. 9; p. 1596 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
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MDPI AG
07.05.2019
MDPI |
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| ISSN | 1660-4601 1661-7827 1660-4601 |
| DOI | 10.3390/ijerph16091596 |
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| Abstract | Background: China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods: We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results: By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions: Migrants are positively selected on general and physical health. The health selectivity in 2012–2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration’s high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances. |
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| AbstractList | Introduction Studies on the relationship between immigration to the United States and health status have revealed a “Hispanic Health Paradox:” although Hispanic immigrants have relatively low socioeconomic status and less access to health care and resources, their health status is better than non-migrant counterparts in their home countries and in the U.S. [1,2,3]. Migrants represent a selectively healthier population as indicated by birthweight, mortality rates [10], and adult health status, though the health advantage tends to dissipate over time because of acculturation [11,12] and downward assimilation in health [13,14,15]. [...]the rural-urban migration is distinct from urban-urban migration with regard to the causes and settlement. For physical health status: “During the past four weeks, did physical health problems affect your work or other regular daily activities?” For emotional health status: “During the past four weeks, did emotional problems (for instance, depression or anxiety) affect your work or other regular daily activities?” For the last two questions, the answers “none/few” and “sometimes/ frequently/always” were regarded to mean good health and poor health respectively. Background : China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods : We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results : By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions : Migrants are positively selected on general and physical health. The health selectivity in 2012–2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration’s high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances. Background: China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods: We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results: By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions: Migrants are positively selected on general and physical health. The health selectivity in 2012-2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration's high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances.Background: China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods: We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results: By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions: Migrants are positively selected on general and physical health. The health selectivity in 2012-2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration's high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances. Background: China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods: We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results: By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions: Migrants are positively selected on general and physical health. The health selectivity in 2012–2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration’s high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances. : China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. : We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. : By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. : Migrants are positively selected on general and physical health. The health selectivity in 2012-2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration's high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances. |
| Author | Yi, Yao Li, Mengjie Hao, Yuantao Liao, Yu Hao, Chun Gu, Jing Zheng, Lingling |
| AuthorAffiliation | 1 Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China; yiyao@mail2.sysu.edu.cn (Y.Y.); liaoy43@mail2.sysu.edu.cn (Y.L.); zhengll8@mail2.sysu.edu.cn (L.Z.); limengjie@mail.sysu.edu.cn (M.L.); gujing5@mail.sysu.edu.cn (J.G.); haochun@mail.sysu.edu.cn (C.H.) 3 Guangdong Key Laboratory of Health Informatics, Sun Yat-sen Global Health Institute, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China 2 Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China |
| AuthorAffiliation_xml | – name: 2 Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China – name: 1 Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China; yiyao@mail2.sysu.edu.cn (Y.Y.); liaoy43@mail2.sysu.edu.cn (Y.L.); zhengll8@mail2.sysu.edu.cn (L.Z.); limengjie@mail.sysu.edu.cn (M.L.); gujing5@mail.sysu.edu.cn (J.G.); haochun@mail.sysu.edu.cn (C.H.) – name: 3 Guangdong Key Laboratory of Health Informatics, Sun Yat-sen Global Health Institute, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China |
| Author_xml | – sequence: 1 givenname: Yao surname: Yi fullname: Yi, Yao – sequence: 2 givenname: Yu surname: Liao fullname: Liao, Yu – sequence: 3 givenname: Lingling surname: Zheng fullname: Zheng, Lingling – sequence: 4 givenname: Mengjie surname: Li fullname: Li, Mengjie – sequence: 5 givenname: Jing surname: Gu fullname: Gu, Jing – sequence: 6 givenname: Chun surname: Hao fullname: Hao, Chun – sequence: 7 givenname: Yuantao orcidid: 0000-0001-8024-5312 surname: Hao fullname: Hao, Yuantao |
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| Keywords | healthy migrant rural-urban migration health selectivity salmon bias |
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| Snippet | Background: China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested... : China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that... Introduction Studies on the relationship between immigration to the United States and health status have revealed a “Hispanic Health Paradox:” although... Background : China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested... |
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| SubjectTerms | Adult Bias China - epidemiology Cross-Sectional Studies Female Health Status Humans Hypotheses Immigration Male Noncitizens Population Dynamics Rural Population - statistics & numerical data Rural urban migration Studies Transients and Migrants Urban Population - statistics & numerical data |
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| Title | Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016 |
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