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      Do Migration Characteristics Influence the Utilization of Basic Public Health Services in Internal Elderly Migrants in China?

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          Abstract

          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.

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          The primary health-care system in China

          Xi Li, Jiapeng Lu, Shuang Hu … (2017)
          China has made remarkable progress in strengthening its primary health-care system. Nevertheless, the system still faces challenges in structural characteristics, incentives and policies, and quality of care, all of which diminish its preparedness to care for a fifth of the world's population, which is ageing and which has a growing prevalence of chronic non-communicable disease. These challenges include inadequate education and qualifications of its workforce, ageing and turnover of village doctors, fragmented health information technology systems, a paucity of digital data on everyday clinical practice, financial subsidies and incentives that do not encourage cost savings and good performance, insurance policies that hamper the efficiency of care delivery, an insufficient quality measurement and improvement system, and poor performance in the control of risk factors (such as hypertension and diabetes). As China deepens its health-care reform, it has the opportunity to build an integrated, cooperative primary health-care system, generating knowledge from practice that can support improvements, and bolstered by evidence-based performance indicators and incentives.
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            Social contacts as a possible mechanism behind the relation between green space and health.

            Jolanda Maas, Sonja M E van Dillen, Robert A. Verheij … (2009)
            This study explored whether social contacts are an underlying mechanism behind the relationship between green space and health. We measured social contacts and health in 10,089 residents of the Netherlands and calculated the percentage of green within 1 and a 3km radius around the postal code coordinates for each individual's address. After adjustment for socio-economic and demographic characteristics, less green space in people's living environment coincided with feelings of loneliness and with perceived shortage of social support. Loneliness and perceived shortage of social support partly mediated the relation between green space and health.
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              Immigrants and health care: sources of vulnerability.

              Kathryn Derose, José J. Escarce, Nicole Lurie (2015)
              Immigrants have been identified as a vulnerable population, but there is heterogeneity in the degree to which they are vulnerable to inadequate health care. Here we examine the factors that affect immigrants' vulnerability, including socioeconomic background; immigration status; limited English proficiency; federal, state, and local policies on access to publicly funded health care; residential location; and stigma and marginalization. We find that, overall, immigrants have lower rates of health insurance, use less health care, and receive lower quality of care than U.S.-born populations; however, there are differences among subgroups. We conclude with policy options for addressing immigrants' vulnerabilities.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 06 August 2021
                Publication date Collection: 2021
                Volume: 9
                Electronic Location Identifier: 514687
                Affiliations
                [1] 1Department of Health Sociology, School of Humanities and Management, Guangdong Medical University , Dongguan, China
                [2] 2School of Public Health, Guangdong Medical University , Dongguan, China
                Author notes

                Edited by: Jonathan Ling, University of Sunderland, United Kingdom

                Reviewed by: Marisa Gilles, Western Australian Center for Rural Health (WACRH), Australia; Ines Fronteira, Universidade NOVA de Lisboa, Portugal

                *Correspondence: Yanwei Lin 40867585@ 123456qq.com

                This article was submitted to Public Health Policy, a section of the journal Frontiers in Public Health

                Article
                DOI: 10.3389/fpubh.2021.514687
                PMC ID: 8377672
                PubMed ID: 34422735
                SO-VID: 884bf5a7-5a8d-4343-bf52-e3d14f2ae7fc
                Copyright © Copyright © 2021 Lin, Wang and Zhu.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 25 November 2019
                Date accepted : 06 July 2021
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 37, Pages: 11, Words: 7178
                Funding
                Funded by: National Natural Science Foundation of China 10.13039/501100001809
                Award ID: 71373058
                Award ID: 71804029
                Funded by: Guangdong Medical Research Foundation 10.13039/501100003785
                Award ID: C2018081
                Categories
                Subject: Public Health
                Subject: Original Research

                Keywords: internal elderly migrants,china,migration characteristics,social contacts,the utilization of basic public health services
                Data availability:
                Keywords: internal elderly migrants, china, migration characteristics, social contacts, the utilization of basic public health services

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