The Promotional Effect of Health Education on the Medical Service Utilization of Migrants: Evidence From China

Abstract

There were 376 million migrants in China by 2020, who made significant contributions to urban development. However, they used limited medical services and had lower self-reported health status than inflow city residents. Based on this, this study uses the cross-sectional data of the 2017 China Migrants Dynamic Survey (CMDS) to construct a multiple linear regression model to empirically study the role of health education in improving medical services utilization for migrants. It finds that compared to migrants without health education, the probability of the medical service utilization for migrants with health education has increased significantly, and counseling is more effective than other methods for health education. This promotion effect of health education has been established after a series of robustness tests. Furthermore, this study finds that the closer the migrants are to medical service resources, the greater the effect of health education on medical services utilization for migrants. The heterogeneity test shows that the effect of health education on medical services utilization for migrants is greater among the non-elderly and those with lower education levels. From the perspective of health education, the findings in this study provide empirical evidence to support the government in formulating policies to improve the utilization of medical services for migrants and reduce health inequality.

The impact of medical service on the return behavior: A city-level study in China

“…To obtain the effects of medical services on RB of migrants, this paper controlled other factors that may affect it. Based on the control variable designs of existing scholars ( 23 , 28 ), this paper selected control variables from the city and individual levels. From the city level, five variables were selected: gross regional product per capita (GRP), education status (ES), region attribution (RA), logistics infrastructure (LI), and information infrastructure (II).…”

“…Because distance is a central factor in the spatial choices of migrants from a geographic perspective ( 27 ), the cost of companionship incurred away from home, family, and friends tend to increase with distance. Considering that migrants generally have low-income levels and higher financial insecurity ( 26 ), the scarcity of health insurance in inflow urban cities and the additional costs arising from off-site hospitalization and care, all of these reasons lead to migrants paying higher costs for health care services than local residents ( 28 ), and further enhance their desire for more affordable medical services. Hence, with barriers to accessing medical services in the target areas of migration, some of the migrants have to return home to seek more cost-effective medical services ( 29 ).…”

“…At the same time, when faced with a major illness, people with poor health literacy may delay seeking medical care because they are unaware of preventive measures or symptoms of the illness, which may eventually lead to the deterioration of the condition ( 38 ). HE refers to well-planned, organized, systematic social education activities aiming to help people voluntarily adopt behaviors and lifestyles beneficial for their health ( 28 ). HE is considered an important path toward improving health literacy among the migrants ( 39 ).…”

The Impact of Public Health Education on Migrant Workers’ Medical Service Utilization

“…While public health education has gained attention, the utilization of medical services is also an important part of the Healthy China strategy [ 6 ], which refers to people’s active or passive medical behavior on health problems. A low utilization rate of medical services will lead to the deterioration of individual health status and increase health inequality [ 7 ]. Scholars explored the utilization of medical services for migrant workers from different perspectives, such as medical system reform, medical insurance coverage, and population aging [ 8 , 9 , 10 ], but few discussed the relationship between public health education and migrant workers’ medical behavior.…”

“…Meanwhile, although the quantity of health institutions, the number of medical staff, the assets of medical resources, the per capita hospitalization expenses, and the insurance covering population in China have all shown a trend of increasing year by year [ 17 ], the utilization of medical services by migrant population is still at a low level [ 7 ]. After the outbreak of COVID-19, the sense of loneliness of elderly patients, especially females living alone, has intensified, their mental health has deteriorated significantly, and the utilization rate of medical services has decreased accordingly [ 18 ].…”