Health Disparity between the Older Rural-to-Urban Migrant Workers and Their Rural Counterparts in China

Li, Dan; Zhou, Zhongliang; Shen, Chi; Zhang, Jian; Yang, Wei; Nawaz, Rashed

doi:10.3390/ijerph17030955

Cited by 17 publications

(26 citation statements)

References 39 publications

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“…Numerous variables are available in CHARLS. Followed by prior empirical investigations [9,[23][24][25][26], all possible variables that may produce SAH of the elderly were considered in our study. The definition and measurement of variables in this study were all shown in Table 1.…”

Section: Description Of Variablesmentioning

confidence: 99%

Health Disparities between the Rural and Urban Elderly in China: A Cross-Sectional Study

Zhang¹,

Li²,

Gao³

2021

IJERPH

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Background: China is becoming an aging society, and the proportion of the population aged 60 years and above is increasing. There is a dualistic urban–rural economic structure between urban and rural areas in China, but there are few comparative health studies on the self-assessed health (SAH) status of the elderly between urban and rural areas. The aim of this study is to explore the SAH status of the elderly in China, and to identify the health disparity between the urban and rural elderly. Methods: The data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were adopted. A total of 9630 participants aged 60 and above were included in this study. SAH was used as the indicator, measuring the health status. Fairlie decomposition analysis was conducted to find the SAH disparity. Results: The proportion of good SAH of the rural elderly (24.01%) was significantly higher than the urban elderly (19.99%). The association of SAH was widely different between the rural and urban elderly. There was a stronger association between SAH and sleeping time in the urban elderly (Odds ratios (OR) = 3.347 of 4–8 hours; OR = 3.337 of above 8 hours) than the rural elderly (OR = 1.630 of 4–8 hours; OR = 2.293 of above 8 hours). Smoking and social activity were significant only in the urban elderly, while region and assets were significant only in the rural elderly. Drinking (11.45%), region (−33.92%), and assets (73.50%) were the main factors contributing to the urban–rural health disparities. Conclusions: This is the first comparative study examining SAH disparity, focusing on the elderly aged 60 and above in China. From the perspective of drinking, region, and assets, our study highlighted substantial urban–rural health disparities, and provided evidence for policy making on narrowing the health gap between urban and rural areas in China.

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Section: Description Of Variablesmentioning

confidence: 99%

Health Disparities between the Rural and Urban Elderly in China: A Cross-Sectional Study

Zhang¹,

Li²,

Gao³

2021

IJERPH

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“…Migration for work is not randomly assigned and there is "self-selection based upon personal circumstances" [22], a crude comparison of the health services utilization using only logistic regression may ignore the confounding factors. Our study tackled a methodological issue in assessing the "causal effect" on the change in status by CEM, because older rural-tourban migrant workers and rural counterparts can become (or very close to) identical in relation to individual characteristics after CEM [2,23]. In our study, the employment status (be employed outside the country for 6 months or more in the past year) is matched.…”

Section: Coarsened Exact Matchingmentioning

confidence: 99%

“…As far, rural-to-urban migrant workers have made great contributions to the development of urbanization and industrialization in China. Aging and migration have signi cantly shaped the population composition in China, where older rural-to-urban migrant workers (age 50 and above) make up increasingly large proportions of the population [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…A growing body of studies have drawn attention to older rural-to-urban migrant workers, and a common nding showed that, compared to older rural residents, older rurul-to-urban migrant workers overall seem to suffer from chronic diseases and mental orders [2][3][4][5]. However, there is a shortage of research on the discussion of their health service utilization, not to mention the comparison on health service utilization between older rural-to-urban migrant workers and older rural residents.…”

Section: Introductionmentioning

confidence: 99%

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Decomposing Differences in Health Service Utilization between Older Rurul-to-Urban Migrant Workers and Older Rural Residents：What is Driving the Differences?

Zhang

2021

Preprint

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Background: In recent years, the widening gap of health service utilization between different groups in mainland China has become an important issue that cannot be avoided. Yet the related study on the health services utilization for older rural-to-urban migrant workers and comparative study on older rural-to-urban migrants in China is still in its infancy. Our study explored the health service utilization of the older rural-to-urban migrant workers based on a sinicization of the latest Andersen model, by comparison with the older rural dwellers. Further, our study revealed the facets and causes by decomposing the differences in the health service utilization into determinants.Methods: The data of China Labor-Force Dynamic Survey in 2016, the data of Urban Statistical Yearbook in 2016, and Statistical Bulletin were used. Our study applied the lasted Andersen Model according to China's currency situation. Before we studied the health service utilization, we used Coarsened Exact Matching to control the confounding factors to enhance the comparability of the two groups. The matched data were used to analyze the influencing factors. Fairlie decomposition method was used to analyze the differences and the sources of health service utilization between older rural-to-urban migrant workers and their rural counterparts.Results: After matching, the probability of two weeks outpatient of older rural-to-urban migrant workers (5.59%) was significantly lower than older rural dwellers (7.57%). The probability of inpatient of older rural migrant workers (5.59%) was significantly lower than older rural dwellers (9.07%). 17.98% of the total difference of two weeks outpatient utilization was due to the observed influence factors. 71.88% of the total difference of inpatient utilization was due to the observed influence factors. Income quantiles (49.57%), self-assessed health (80.91%), and sex ratio in the community (-102.29%) were significant in the differences of inpatient utilization.Conclusions: The findings have important implications for the difference in the health services utilization between older rural-to-urban migrant workers and older rural residents in China, urging the government to take full account of the heterogeneity. The results provide references for the healthcare policy reform in the process of active ageing in China.

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“…Limit studies on older rural-to-urban migrant workers in mainland China has primarily focused on their health; however, research regarding the comparison between older rural-to-urban migrant workers in mainland China and their rural and urban counterparts is scarce. To our best of knowledge, only Dan et al had specially focused on the health of older rural-to-urban migrant workers in mainland China, and their study showed that older rural-to-urban migrant workers had higher self-assessed health status, compared with older rural dwellers [ 16 ]. A growing number of comparative studies on depressive symptoms between rural-urban migrants verse urban and rural counterparts had presented a conflicting picture.…”

Section: Introductionmentioning

confidence: 99%

Decomposing differences in depressive symptoms between older rural-to-urban migrant workers and their counterparts in mainland China

Yang

Gao

et al. 2020

BMC Public Health

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Background There has been an increase in older rural-to-urban migrant workers (aged 50 and above) in mainland China, little known about their depressive symptoms. The aim of this study was to identify depressive symptoms among older rural-to-urban migrant workers, as well as explored the factors leading to differences in depressive symptoms between older rural-to-urban migrant workers and their rural counterparts (older rural dwellers) and urban counterparts (older urban residents) in mainland China. The results provided a comprehensive understanding of the depressive symptoms of older rural-to-urban migrant workers, and had great significance for improving the depressive symptoms for this vulnerable group. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015, and coarsened exact matching (CEM) method was employed to control confounding factors. This study employed a Chinese version 10-item short form of the Center for Epidemiologic Studies-Depression Scale (CES-D 10) to measure depressive symptoms, and used the Social-Ecological Model as a framework to explore influential factors related to depressive symptoms. Specifically, the approach of Fairlie’s decomposition was used to parse out differences into observed and unobserved components. Results After matching, our findings indicated that the prevalence of depressive symptoms in older rural-to-urban migrant workers was lower than older rural dwellers; and the prevalence of depressive symptoms in older rural-to-urban migrant workers was higher than older urban residents. Fairlie’s decomposition analysis indicated that type of in-house shower, sleeping time at night and ill in the last month were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older rural dwellers; self-reported health and sleeping time at night were proved to be major contributors to the differences in depressive symptoms between older rural-to-urban migrant workers and older urban residents. Conclusions Differences in depressive symptoms between older rural-to-urban migrant workers and their rural and urban counterparts did exist. Our findings contributed to a more reliable understanding in depressive symptoms among older rural-to-urban migrant workers. Our findings would be of referential significance for improving older rural-to-urban migrant workers’ depressive symptoms.

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Health Disparity between the Older Rural-to-Urban Migrant Workers and Their Rural Counterparts in China

Cited by 17 publications

References 39 publications

Health Disparities between the Rural and Urban Elderly in China: A Cross-Sectional Study

Health Disparities between the Rural and Urban Elderly in China: A Cross-Sectional Study

Decomposing Differences in Health Service Utilization between Older Rurul-to-Urban Migrant Workers and Older Rural Residents：What is Driving the Differences?

Decomposing differences in depressive symptoms between older rural-to-urban migrant workers and their counterparts in mainland China

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