Background: The literature shows that migration characteristics are a potential pathway through which migration can influence basic healthcare service utilization. The goal of the study was to explore the effect of migration characteristics on the utilization of basic public health services for internal elderly migrants in China and to identify the pathways that might promote their utilization of basic public health services.Methods: We studied 1,544 internal elderly migrants. The utilization of basic public health services was determined through participation in free health checkups organized by community health service institutions in the past year. Migration characteristics were represented by years of residence and reasons for migration. Other variables included demographic characteristics and social factors, e.g., the number of local friends and exercise time per day were measured to represent social contacts. Multivariate binary logistic regression was employed to explore the association of the variables with the likelihood of using community health services.Results: A total of 55.6% of respondents were men, and the mean age was 66.34 years (SD 5.94). A low level of education was observed. A total of 59.9% of migrants had been residents for over 10 years, and the main reason for migrating was related to family. Of these migrants, 12.9% had no local friends. Furthermore, 5.2% did not exercise every day. Social contacts were complete mediators of the impact of migration characteristics on the utilization of primary healthcare.Conclusion: Our study highlighted the mediating role of social factors in the relationship between migration characteristics and the utilization of basic public health services among Chinese internal elderly migrants. The findings supported the need to increase the opportunities for social contacts between local elderly individuals and internal elderly migrants.

ObjectiveTo examine how living arrangement as a social contextual factor can affect Chinese elders’ cognitive function.Setting and participantsOur sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China’s 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80–112 in China.Outcome measuresCognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement was divided into living in an institution, living alone and living with household members. Generalised linear regressions were carried out to examine the associations between baseline characteristics and cognitive function, while controlling age, gender and residential area.ResultsA total of 2486 participants were included in the study at baseline in 2014. Of these, 1162 (46.7%) were men and 1324 (53.3%) were women. The mean age at baseline was 75.07 (±8.31) years. The mean years of schooling were 2.86 (±3.68). The number (proportion) of the three living arrangements (lived in institutions, lived alone and lived with household members) were 93 (3.8%), 463 (18.6%) and 1930 (77.6%), respectively. Among all participants, cognitive function declined over time. Those who lived alone presented with the highest MMSE scores at baseline and showed the lowest decline after 4 years. Living arrangements had significant effects on decreasing cognitive function.ConclusionChinese elders living in institutions were most vulnerable to cognitive decline. Living alone was not a risk condition in itself for the elderly in terms of cognitive decline. In addition, the benefits of living with household members to support cognitive function were not found in our study.

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