Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data and Analytic Sample
2.2. Measurement
2.3. Statistical Analysis
3. Results
3.1. Descriptive Analysis
3.2. Healthy Migrant Hypothesis
3.3. Salmon Bias Hypothesis
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
General Health | Physical Health | Emotional Health | |
---|---|---|---|
Overall sample | |||
Migration status (Ref: ever-migrants) | |||
Urban residents | 0.40 ***(0.25,0.55) | 0.24 ***(0.13,0.35) | 0.08(−0.03,0.19) |
Rural residents | 0.01(−0.09,0.12) | 0.02(−0.06,0.10) | 0.08(−0.00,0.17) |
2012 | |||
Migration status (Ref: ever-migrants) | |||
Urban residents | 0.16(−0.12,0.44) | 0.02(−0.17,0.21) | 0.17(−0.01,0.36) |
Rural residents | −0.10(−0.30,0.11) | −0.02(−0.17,0.13) | 0.13(−0.01,0.28) |
2014 | |||
Migration status (Ref: ever-migrants) | |||
Urban residents | 0.41 **(0.17,0.66) | 0.25 **(0.07,0.42) | 0.21 **(0.02,0.40) |
Rural residents | 0.14 (−0.05,0.33) | 0.08(−0.06,0.22) | 0.12(−0.03,0.27) |
2016 | |||
Migration status (Ref: ever-migrants) | |||
Urban residents | 0.51 ***(0.27,0.75) | 0.35 ***(0.17,0.53) | −0.00(−0.21,0.20) |
Rural residents | 0.01(−0.16,0.19) | 0.02(−0.11,0.16) | −0.02(−0.18,0.14) |
General Health | Physical Health | Emotional Health | |
---|---|---|---|
Physical health (Ref: fair/poor) | 11.05 ***(7.88,15.48) | - | 8.95 ***(6.96,11.51) |
Emotional health (Ref: fair/poor) | 1.63 ***(1.24,2,13) | 11.91 ***(8.77,16.17) | - |
Flow distance 1 (Ref: intra-provincial) | 0.70 **(0.56,0.89) | 0.85(0.71,1.02) | 1.06(0.88,1.27) |
Gender (Ref: female) | 0.97(0.68,1.34) | 0.90(0.69,1.17) | 1.71 ***(1.29,2.26) |
Age | 0.93 ***(0.92,0.94) | 0.95 ***(0.94,0.96) | 1.01(1.00,1.02) |
Marital status (Ref: single/divorced) | 1.37(0.89,2.09) | 0.96(0.68,1.35) | 0.99(0.71,1.38) |
Education (Ref: primary or lower) | |||
Junior | 1.78 ***(1.437,2.30) | 1.66 ***(1.35,2.04) | 1.07(0.87,1.31) |
Senior | 1.66 *(1.07,2.58) | 2.18 ***(1.54,3.08) | 0.95(0.68,1.31) |
College or above | 2.10(0.65,6.75) | 3.42 **(1.58,7.41) | 0.72(0.40,1.30) |
Socioeconomic status | 1.15 ***(1.810,1.23) | 1.13 **(1.07,1.19) | 1.06 *(1.01,1.12) |
Workweek (Ref: ≤44h) | |||
>44h | 1.10(0.85,1.42) | 0.99(0.80,1.21) | 1.09(0.88,1.35) |
0h | 0.57 ***(0.41,0.78) | 0.65 **(0.50,0.84) | 0.79(0.61,1.02) |
Smoking (Ref: not smoking) | 1.21(0.89,1.66) | 1.35 *(1.04,1.74) | 0.72 *(0.55,0.94) |
Drinking (Ref: not drinking) | 1.40 *(1.04,1.87) | 1.53 ***(1.21,1.94) | 0.95(0.75,1.21) |
Health insurance (Ref: without) | 1.07(0.69,1.66) | 0.86(0.60,1.23) | 1.07(0.76,1.53) |
Living alone (Ref: with family) | 0.57(0.31,1.05) | 0.81(0.48,1.38) | 0.81(0.4821,1.36) |
Fitness facilities (Ref: without) | 1.23(0.97,1.55) | 1.07(0.89,1.30) | 1.02(0.85,1.23) |
Number of hospitals in community | 0.98(0.91,1.06) | 1.01(0.95,1.07) | 1.02(0.96,1.08) |
Occupational hazards (Ref: not exposed) | 1.21(0.91,1.60) | 0.72 **(0.58,0.89) | 1.04(0.84,1.30) |
Wave (Ref: 1) | |||
2 | 0.64 ***(0.47,0.86) | 0.77 *(0.60,0.98) | 1.43 **(1.14,1.79) |
3 | 0.61 **(0.45,0.82) | 0.67*(0.53,0.86) | 1.92 ***(1.51,2.44) |
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Variables | Total | Migrants | Return | Urban | Rural |
---|---|---|---|---|---|
Self-reported poor general health * (%) | 13.4 | 7.0 | 15.9 | 7.7 | 16.0 |
Self-reported poor physical health * (%) | 22.3 | 14.5 | 27.2 | 15.8 | 25.1 |
Self-reported poor emotional health * (%) | 16.7 | 16.5 | 18.4 | 13.6 | 17.7 |
Male * (%) | 46.3 | 47.1 | 59.2 | 47.3 | 44.1 |
Age * | 43.1 | 36.4 | 42.6 | 43.1 | 43.9 |
Married * (%) | 82.1 | 81.1 | 90.0 | 78.4 | 82.5 |
Education * (%) | |||||
Primary or lower | 37.7 | 30.4 | 44.6 | 10.0 | 48.2 |
Junior | 33.1 | 40.7 | 42.5 | 25.8 | 33.8 |
Senior | 16.1 | 16.7 | 10.2 | 28.4 | 12.0 |
College or above | 13.1 | 12.2 | 2.7 | 35.8 | 6.0 |
Self-rated SES * (scale 1-10) | 4.4 | 4.0 | 4.1 | 4.6 | 4.3 |
Workweek * (hour) | 30.7 | 43.9 | 48.5 | 25.8 | 29.8 |
Occupational hazards exposure * (%) | 23.1 | 37.5 | 31.1 | 21.7 | 20.2 |
Having smoking history * (%) | 26.5 | 28.2 | 42.0 | 25.1 | 24.8 |
Having drinking history * (%) | 19.4 | 23.0 | 27.3 | 20.0 | 17.7 |
Having health insurance * (%) | 87.3 | 76.2 | 93.1 | 83.2 | 89.3 |
Living alone * (%) | 3.9 | 9.6 | 2.9 | 4.8 | 3.1 |
Having fitness facilities in residential community * (%) | 62.3 | 80.0 | 52.2 | 77.1 | 56.0 |
Number of hospitals in residential community * | 2.3 | 2.6 | 1.6 | 3.2 | 2.0 |
N | 51,530 | 3511 | 4200 | 12,183 | 31,636 |
General Health | Physical Health | Emotional Health | |
---|---|---|---|
Overall sample | |||
Migration status (Ref: migrants) | |||
Returned migrants | −0.41 ***(−0.62, −0.20) | −0.66 ***(−0.81, −0.51) | 0.19 *(0.04, 0.34) |
Urban residents | 0.12(−0.08, 0.33) | −0.16(−0.31, 0.02) | 0.18 **(0.05, 0.32) |
Rural residents | −0.27 **(−0.45, −0.09) | −0.41 ***(−0.53, −0.27) | 0.20 **(0.07, 0.32) |
2012 | |||
Migration status (Ref: migrants) | |||
Returned migrants | 0.04(−0.36, 0.45) | −0.45 **(−0.72, −0.17) | −0.08(−0.34, 0.18) |
Urban residents | 0.19(−0.20, 0.58) | −0.26(−0.52, 0.01) | 0.13(−0.11, 0.37) |
Rural residents | −0.07(−0.42, 0.29) | −0.25 **(−0.46, −0.04) | 0.08(−0.14, 0.30) |
2014 | |||
Migration status (Ref: migrants) | |||
Returned migrants | −0.58 **(−0.95, −0.22) | −0.55 ***(−0.81, −0.30) | 0.30 *(0.03, 0.57) |
Urban residents | 0.04(−0.30, 0.39) | −0.07(−0.31, 0.16) | 0.37 **(0.13, 0.60) |
Rural residents | −0.24 (−0.56, 0.07) | −0.32 **(−0.57, −0.08) | 0.28 **(0.07, 0.49) |
2016 | |||
Migration status (Ref: migrants) | |||
Returned migrants | −0.64 ***(−0.98, −0.29) | −0.92 ***(−1.18, −0.67) | 0.39 **(0.11, 0.68) |
Urban residents | 0.08(−0.26, 0.42) | −0.22(−0.47, 0.02) | 0.22(−0.04, 0.47) |
Rural residents | −0.42 **(−0.73, −0.12) | −0.57 **(−0.79, −0.35) | 0.21(−0.02, 0.44) |
General Health | Physical Health | Emotional Health | |
---|---|---|---|
Overall sample | 35,147 | ||
Dichotomous comparison (migrants vs. rural residents) | 0.23 ***(0.05, 0.42) | 0.37 *(0.23, 0.50) | −0.22 **(−0.35, −0.09) |
By whether living alone | |||
Yes (vs. rural residents) | 1.16(−0.31, 2.63) | 0.07 *(0.01, 0.14) | −0.22 *(−0.41, −0.04) |
N | 1321 | ||
No (vs. rural residents) | 0.21 **(0.02, 0.40) | 0.35 *(0.21, 0.47) | −0.22 **(−0.35, −0.09) |
N | 33,826 |
General Health | Physical Health | Emotional Health | |
---|---|---|---|
Overall sample | |||
Migration status (Ref: Return) | |||
Out-migrants | 0.41 ***(0.20, 0.62) | 0.66 ***(0.51, 0.81) | −0.19 *(−0.34, −0.04) |
Urban residents | 0.54 ***(0.38, 0.70) | 0.50 ***(0.38, 0.62) | −0.01(−0.14, 0.12) |
Rural residents | 0.14 *(0.02, 0.27) | 0.26 ***(0.16, 0.35) | 0.01(−0.10, 0.11) |
2012 | |||
Migration status (Ref: Return) | |||
Out-migrants | −0.04(−0.45, 0.36) | 0.45 **(0.17, 0.72) | 0.08(−0.18, 0.34) |
Urban residents | 0.15(−0.17, 0.46) | 0.19 (−0.03, 0.41) | 0.21(−0.01, 043) |
Rural residents | −0.11(−0.35, 0.13) | 0.12 (−0.05, 0.29) | 0.16(−0.01, 0.33) |
2014 | |||
Migration status (Ref: Return) | |||
Out-migrants | 0.58 **(0.22, 0.95) | 0.55 ***(0.30, 0.81) | −0.30 *(−0.57, −0.03) |
Urban residents | 0.63 ***(0.35, 0.90) | 0.48 ***(0.27, 0.69) | 0.07(−0.16, 0.30) |
Rural residents | 0.34 **(0.12, 0.56) | 0.30 ***(0.13, 0.48) | −0.02(−0.21, 0.18) |
2016 | |||
Migration status (Ref: Return) | |||
Out-migrants | 0.64 ***(0.29, 0.98) | 0.93 ***(0.67, 1.18) | −0.39 **(−0.68, −0.11) |
Urban residents | 0.72 ***(0.45, 0.98) | 0.70 ***(0.50, 0.90) | −0.18(−0.42, 0.07) |
Rural residents | 0.21 *(0.01, 0.41) | 0.35 ***(0.19, 0.51) | −0.18(−0.38, 0.02) |
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Share and Cite
Yi, Y.; Liao, Y.; Zheng, L.; Li, M.; Gu, J.; Hao, C.; Hao, Y. Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016. Int. J. Environ. Res. Public Health 2019, 16, 1596. https://doi.org/10.3390/ijerph16091596
Yi Y, Liao Y, Zheng L, Li M, Gu J, Hao C, Hao Y. Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016. International Journal of Environmental Research and Public Health. 2019; 16(9):1596. https://doi.org/10.3390/ijerph16091596
Chicago/Turabian StyleYi, Yao, Yu Liao, Lingling Zheng, Mengjie Li, Jing Gu, Chun Hao, and Yuantao Hao. 2019. "Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016" International Journal of Environmental Research and Public Health 16, no. 9: 1596. https://doi.org/10.3390/ijerph16091596
APA StyleYi, Y., Liao, Y., Zheng, L., Li, M., Gu, J., Hao, C., & Hao, Y. (2019). Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016. International Journal of Environmental Research and Public Health, 16(9), 1596. https://doi.org/10.3390/ijerph16091596