Awareness, Utilization and Health Outcomes of National Essential Public Health Service Among Migrants in China

Abstract

BackgroundThe national essential public health service (NEPHS) has been in operation for more than a decade. Numerous studies examined the utilization of NEPHS by migrants and the factors that influence it, but few examined the effect of NEPHS awareness and utilization on the health of inhabitants, particularly migrants. The purpose of this study is to ascertain the level of awareness and utilization of NEPHS, as well as to examine their health-improving effects on migrants.MethodsBased on the data from the 2017 China Migrants Dynamic Survey, linear probability model, ordered logit model and the propensity score matching methods were employed to investigate impact of awareness and utilization of NEPHS on the health among Chinese migrants. Mediating effect model were used to identify the mechanism of the impact of NEPHS on health.ResultsThe findings indicated that migrants' awareness and utilization of NEPHS are still insufficient. After adjusting for other factors, the study discovered that increased awareness and use of NEPHS had a beneficial influence on migrants' self-rated health. Further heterogeneity analysis revealed significant disparities in the health consequences of NEPHS awareness and utilization across subgroups. The effect of increased awareness and usage of NEPHS on health is stronger for middle-aged and elderly people, women, and low-educated migrants with urban household registration. The estimated results of the mediating effect model supported the mechanism that increased NEPHS awareness among the floating population could encourage its utilization and further improve the floating population's health.ConclusionsGiven that migrants' NEPHS utilization is still low and that NEPHS utilization has a positive effect on health, some targeted strategies, such as a variety of new media communication methods, health education related to occupational disease and tuberculosis prevention, and targeted NEPHS projects for specific groups, such as men, young and middle-aged groups, those with a high level of education, and rural migrants, should be conducted to improve the health of migrants.

The impact of public health education on people's demand for commercial health insurance: Empirical evidence from China

“…Furthermore, we uncover the “black box” of public health education to promote the purchase of commercial health insurance. We confirmed that health education can promote the purchase of commercial health insurance through three mediating variables: health literacy, health risk perception, and health risk attitudes ( 12 , 28 , 39 ). Through public health education, the health literacy of residents is improved, therefore, they may actively seek medical care ( 71 , 72 ).…”

“…Public health education aims to improve residents' health literacy ( 17 ), encourage people to change bad habits, and actively seek medical care. It is effective in increasing health literacy ( 12 , 18 ), changing hygiene habits ( 19 , 20 ), improving personal hygiene for protection from infectious diseases, and further reducing the risk of acute illness ( 21 ). Seeking medical treatment is an effective measure to treat diseases and improve health at the cost of increasing medical expenses.…”

“…Health education can effectively improve people's health literacy, thereby encouraging them to prevent and alleviate most “civilization diseases” by improving their living habits, strengthening physical exercise, and actively seeking medical care ( 11 ). Health education is essential for health awareness, disease prevention, and health promotion ( 12 ). Public health education can improve health risk perceptions ( 13 ), influence health risk attitudes, and increase health risk aversion ( 14 ).…”

Impact of public health education on the health status of the older migrant population

“…The results of this study showed that the acceptance rate of public health education for the migrant population was 40.81%, which was lower than the overall acceptance rate of health education for the older migrant population, which was 59.56% (22); this rate was also lower than the utilization rate of public health education for the migrant population. The reason for this finding may be due to a limited health awareness among the older migrant population and that they are busy with their livelihoods and other reasons, as proposed by previous scholars (23). Moreover, the older migrant population are likely to be more affected by a gradual deterioration in their physiological, psychological, and cognitive state due to aging, leading to this population having a low rate of health education.…”

Disparities in awareness and utilisation of National Essential Public Health Services between the floating population and the registered residents: a cross-sectional study in China

“…While the NEPHS attempts to ensure that all floating population and registered residents have equal access to NEPHS awareness and utilisation, most floating population is excluded from NEPHS in the initial stage of policy implementation, and they are unable to access basic public health services as registered residents 18. Consequently, the NEPHS utilisation by the floating population is relatively low compared with that of local residents 19–23. This is intricately connected to the characteristics of China’s health system and the floating population.…”