Impact Of Social Capital , Gender And Education On The Utilization Of Public Health Services: A Cross Sectional Study Based On The China Migrant Dynamic Survey

2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Health Education ◽  
Health Services ◽  
Public Health Services ◽  
Gender And Education ◽  
Internal Migrants ◽  
Cognitive Social Capital ◽  
The Impact ◽  
Structural Social Capital

Abstract Background: China is making every effort to promote equal access to public health services(PHS) for the internal migrants. Studies have demonstrated that the impact of social capital on PHS is different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of PHS for the internal migrants and provide reference for other developing countries.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 130642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of National Essential Public Health Services (NEPHS). Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such effects are moderated by gender and education. Results: The results suggest: (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different genders and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by gender. However, education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclution: This study demonstrated complex interactions between the dimensions and levels of social capital, NEPHS projects, and the population characteristics of migrants. As the government strives towards the equalization of NEPHS, these interactions should be fully considered.

scholarly journals Impact of social capital, gender and education on the utilization of public health services: A Cross sectional study based on the China Migrant Dynamic Survey

2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Health Education ◽  
Health Services ◽  
Public Health Services ◽  
Gender And Education ◽  
Internal Migrants ◽  
Cognitive Social Capital ◽  
The Impact ◽  
Structural Social Capital

Abstract Background: China is making every effort to promote equal access to public health services(PHS) for the internal migrants. Studies have demonstrated that the impact of social capital on PHS is different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of PHS for the internal migrants and provide reference for other developing countries.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 130642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of National Essential Public Health Services (NEPHS). Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such effects are moderated by gender and education. Results: The results suggest: (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different genders and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by gender. However, education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclution: This study demonstrated complex interactions between the dimensions and levels of social capital, NEPHS projects, and the population characteristics of migrants. As the government strives towards the equalization of NEPHS, these interactions should be fully considered.

scholarly journals Impact of social capital, sex and education on the utilization of public health services: a cross sectional study based on the China migrant dynamic survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhen Yang ◽  
Cheng-hua Jiang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Health Education ◽  
Health Services ◽  
Public Health Services ◽  
Cross Sectional ◽  
Internal Migrants ◽  
Cognitive Social Capital ◽  
The Impact ◽  
Structural Social Capital

Abstract Background China is making efforts to promote the equalization of National Essential Public Health Services (NEPHS) for internal migrants. Studies have demonstrated that the impacts of social capital on health services are different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of NEPHS for the internal migrants and provide reference for other countries. Methods Data from the China Migrant Dynamic Survey of 2017, involving 130,642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of NEPHS. Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such impacts are moderated by sex and education. Results (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different sexs and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by sex. However, a high education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclusion Social capital plays an important role in the access of migrants to NEPHS. Governments should vigorously promote the construction of regional social capital, encourage migrants to actively participate in community activities, especially pay attention to the enhancement of the migrants with low SES to the destination identity.

scholarly journals The impacts of social capital, migration range and regional economic development level on the internal migrants' utilization of public health services

2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Economic Development ◽  
Health Services ◽  
Regional Economic Development ◽  
Public Health Services ◽  
Regional Economic ◽  
Development Level ◽  
Internal Migrants ◽  
The Impact

Abstract Background It has been a risk of the internal migrants' (IMs') health that their utilization of National Essential Public Health Services (NEPHS) was inadequate. Studies have analyzed the impact of migration range (MR) or regional economic development level (REDL) on the IMs' utilization of NEPHS, but no studies have explored the interaction of MR and REDL on it. Methods Data from the China Migrant Dynamic Survey of 2017, involving 122656 IMs. Per capita GDP was set as the indicator for REDL, and all provinces were divided into three groups according to REDL: affluent, medium and poor. The MR was divided into inter-province and intra-province, and social capital (SC) was distinguished into cognitive (CSC) and structural social capital (SSC). Awareness of NEPHS (ANEPHS) and establishment of health record (EHR) were selected as indexes of NEPHS utilization. Then we used multiple line charts and hierarchical logistic regression to investigate the interaction of MR, REDL and SC on NEPHS utilization. Results (1) The socioeconomic status (SES) and social capital (SC) of the inter-provincial IMs were significantly lower than those of the intra-provincial IMs, and the gap was most prominent in the affluent areas. (2) From low to high, the NEPHS utilization of inter-provincial IMs was ranked as affluent, medium and poor, while the corresponding order of intra-provincial IMs was medium, poor and affluent areas. (3) SC could significantly promote the IMs' utilization of NEPHS, but there was a gap between the inter-provincial and intra-provincial IMs, and the gap was the largest in the affluent areas. Conclution: The IMs' SES, SC and NEPHS utilization were influenced by MR and REDL. The gaps of SES, SC and NEPHS utilization between the inter-provincial and the intra-provincial IMs in affluent areas were much larger than that in medium and poor areas. The government should pay more attention to the inter-provincial IMs in affluent areas.

scholarly journals The interaction of migration range, regional economic development level on social capital and public health services of internal migrants: evidence from the China Migrant Dynamic Survey in 2017

2021 ◽  
Author(s):  
Zhen Yang ◽  
Cheng-hua Jiang ◽  
Jiansheng Hu
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Economic Development ◽  
Health Services ◽  
Regression Model ◽  
Social Participation ◽  
Civic Participation ◽  
Public Health Services ◽  
Development Level ◽  
Internal Migrants

Abstract Background: Studies have confirmed that migration range (MR), regional economic development level (REDL) and social capital have impacts on the internal migrants' (IMs') accessibility of National Essential Public Health Services (NEPHS), but no research has explored the interaction of the four variables. Method: A cross-sectional sample of 115412 IMs from the China Migrant Dynamic Survey in 2017 was selected. The sampling method was layered, multi-stage, and probability proportional to size. Logistic regression was conducted by SPSS22.0, sex, residence duration, community type, and education as the control variables, REDL and MR as the moderating variables, social capital as independent variable and awareness of NEPHS and registration of health records (RHR) as the dependent variables. Results: In high income provinces (HIPs), the intra-provincial IMs' CSC, civic participation, social participation, NEPHS awareness and RHR were 4.73±1.736, 49.3%, 55.3%, 61.1%, and 31.9%, and the inter-provincial IMs' levels were 4.01±1.713, 40.5%, 47.2%, 54.6%, and 26.8%; In low-and middle- income provinces (LMIPs), the intra-provincial and inter-provincial IMs' levels were 5.13±1.767, 46.1%, 48.1%, 65.6%, 35.5%, and 5.02±1.775, 41.5%, 41.5%, 62.06%, 34.1%, respectively. In the complete regression model, the interaction of MR, REDL and CSC was not significant, while the interaction of MR, REDL and SSC was significant. In the group regression model, the ORs of CSC, civic participation, and social participation were significantly greater than 1 both in HIPs and LMIPs. However, the interaction of MR and SSC was significant in HIPs but not significant in LMIPs. Conclusions: The social capital and NEPHS utilization of inter-provincial IMs was significantly lower than that of intra-provincial IMs, and these gaps were more prominent in HIPs. Social capital had a positive effect on IMs' NEPHS utilization, and this effect was significantly moderated by MR and REDL. The next focus of the equalization of public services should be the primary health resources supply and the IMs' social capital construction of HIPs.

scholarly journals The Association between Social Integration and Utilization of Essential Public Health Services among Internal Migrants in China: A Multilevel Logistic Analysis

2020 ◽  
Vol 17 (18) ◽  
pp. 6524 ◽  
Author(s):  
Jing Liang ◽  
Yujia Shi ◽  
Mohammedhamid Osman ◽  
Bhawana Shrestha ◽  
Peigang Wang
Keyword(s):  
Public Health ◽  
Health Education ◽  
Health Services ◽  
Social Integration ◽  
Sociocultural Adaptation ◽  
Public Health Services ◽  
Health Records ◽  
Structural Integration ◽  
Essential Public Health Services ◽  
Internal Migrants

This study investigated the association between social integration and utilization of essential public health services among internal migrants. Data were from the 2017 China Migrants Dynamic Survey. Social integration was measured through four dimensions: economic integration, structural integration, sociocultural adaptation, and self-identity. Multilevel logistic regressions were used taking into account heterogeneity in the level of regional development. The utilization of health records and health education was less than 40% and varied widely across regions. Social integration was related to a higher likelihood of utilization of health records and health education. Moreover, sociocultural adaptation had a stronger effect on the utilization of health records in developed regions than in developing regions, and structural integration was strongly and positively related to the utilization of health education in developed regions. Hence, it appears that the relationship of some dimensions of social integration and utilization of essential public health services is moderated by the level of economic development. Promoting structural integration and sociocultural adaptation could strongly improve utilization of essential public health services in developed regions.

scholarly journals Social capital, neighbourhood characteristics and utilisation of local public health services among domestic migrants in China: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014224 ◽  
Author(s):  
Zhiyuan Hou ◽  
Senlin Lin ◽  
Donglan Zhang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Health Services ◽  
Public Health Services ◽  
Cross Sectional ◽  
Health Records ◽  
Local Public Health ◽  
Neighbourhood Characteristics ◽  
Structural Social Capital ◽  
Domestic Migrants

ObjectivesWe examined the association between structural social capital and public health services use, and explored the modifiable effect of neighbourhood factors on this association among domestic migrants in China.MethodsData were from a 2014 nationally representative cross-sectional sample of domestic migrants aged 15–59 years in China. Survey-weighted logistic regression models were applied to assess the association between structural social capital, measured by participation in social organisations and social activities, and use of public health services. Interaction terms between neighbourhood urban status, neighbourhood composition and social capital were further assessed in the models.ResultsMigrants who participated in social organisations were more likely to establish health records (OR 1.467, 95% CI 1.201 to 1.793) and receive health education information (OR 1.729, 95% CI 1.484 to 2.016) than those who did not. Participation in social activities was positively associated with establishing health records only in urban communities (OR 1.853, 95% CI 1.060 to 3.239), and it was positively linked to receiving health education information among those living with a higher percentage of local neighbours (OR 1.451, 95% CI 1.044 to 2.017).ConclusionsStructural social capital was related to an increased utilisation of local public health services among migrants. The findings of this study provided new evidence for the differential influences of social capital by neighbourhood characteristics in China, which suggested the importance to enhance social capital in rural/suburban communities and communities where the majority of the residents were migrants.

scholarly journals Public Health Services Utilization and Its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey

2017 ◽  
Author(s):  
Jingya Zhang ◽  
Senlin Lin ◽  
Di Liang ◽  
Yi Qian ◽  
Donglan Zhang ◽  
...  
Keyword(s):  
Public Health ◽  
Socioeconomic Status ◽  
Health Education ◽  
Health Services ◽  
Health Services Utilization ◽  
Public Health Services ◽  
Local Public Health ◽  
Services Utilization ◽  
Internal Migrants ◽  
Nationally Representative

Background: Internal migrants had obstacles in accessing local public health services in China. This study aimed to estimate the utilization of local public health services and its determinants among internal migrants. Methods: Data were from the 2014 and 2015 nationally representative cross-sectional survey of internal migrants in China. Multivariate logistic regressions were used to estimate the relationship between socioeconomic, migration, demographic characteristics and public health services utilization. Results: Internal migrants in more developed eastern regions used less public health services. Those with higher socioeconomic status were more likely to use public health services. The broader and shorter they migrated, the less they used public health services. Compared to migration within the city, migration across provinces is negatively associated with health records (OR=0.88, 95% CI: 0.86-0.90), health education (OR=0.97, 95% CI: 0.94-1.00), and health education on NCDs (OR=0.92, 95% CI: 0.89-0.95) or through Internet channel (OR=0.96, 95% CI: 0.94-0.99). Conclusion: Public health services coverage for internal migrants has seen great improvement due to government subsides. Internal migrants with lower socioeconomic status and across provinces need to be targeted. More attention should be given to the local government in the developed eastern regions in order to narrow the regional gaps.

scholarly journals The interaction of migration range, regional economic development level on social capital and public health services of internal migrants: evidence from the China Migrant Dynamic Survey in 2017

2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Economic Development ◽  
Health Services ◽  
Regional Economic Development ◽  
Public Health Services ◽  
Regional Economic ◽  
Middle Income ◽  
Development Level ◽  
Internal Migrants

Abstract Objectives Studies have confirmed that both migration range (MR) and regional economic development level (REDL) have significant impacts on the accessibility of National Essential Public Health Services (NEPHS) for the internal migrants (IMs), but no studies have explored the interaction between MR and REDL, nor discussed the mechanism behind their influence.Method A sample of 115412 respondents from the China Migrant Dynamic Survey in 2017 was adopted, aged 18-59 years and residence duration more than one year. Beijing, Tianjin and Shanghai were excluded. The MR was divided into inter-provincial and intra-provincial migration. Social capital (SC) was divided into cognitive social capital (CSC) and structural social capital (SSC). The REDL was divided into high income provinces (HIPs) and low-middle income provinces (LMIPs). Cross-table, chi-square test, logistic regression and other statistical methods were used to analyze impacts of MR and REDL on IMs' SC, awareness of NEPHS and establishment of health records (EHR).Results (1) The SC of inter-provincial IMs is always lower than that of intra-provincial IMs. The CSC of IMs in HIPs is lower but their SSC is not the same. The MR difference of IMs' SC is greater in HIPs. (2) The IMs' level of NEPHS utilization in the inter-provincial group and the HIPs group is lower, and the MR difference of IMs' level of NEPHS utilization is greater in the HIPs. (3) The IMs' SC can significantly promote their NEPHS utilization level, but this relationship is affected by the dimensions of SC, MR and REDL.Conclusions MR and REDL may affect the IMs' SC through cultural exclusion and institutional exclusion, and further affect the IMs' NEPHS utilization. When promoting equalization of NEPHS in HIPs, it is necessary for HIPs to expand more primary health facilities to increase the NEPHS supply, and take measures to stimulate the inter-provincial IMs' sense of identity and social participation.

scholarly journals Does economic development widen or narrow the gap of public health service utilization among different subgroups of internal migrants? Evidence from the China Migrant Dynamic Survey in 2017

2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang
Keyword(s):  
Public Health ◽  
Social Capital ◽  
Economic Development ◽  
Public Health Services ◽  
Major Barrier ◽  
Multiple Line ◽  
Essential Public Health Services ◽  
Internal Migrants ◽  
The Government ◽  
The Impact

Abstract Background: China is promoting the equalization of National Essential Public Health Services (NEPHS) for the internal migrants (IMs). Studies have analyzed the impact of migration range (MR) and regional economic development level (REDL) on the IMs' NEPHS utilization (NEPHSU), but no studies have explored the interaction of MR and REDL on it.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 122656 IMs. Per capita GDP was set as the indicator for REDL, and 28 provinces were divided into three groups according to REDL: affluent, medium and poor. The MR was divided into inter-province and intra-province, and social capital (SC) was distinguished into cognitive (CSC) and structural social capital (SSC). Awareness of NEPHS (ANEPHS) and establishment of health record (EHR) were selected as indexes of NEPHSU. Multiple line charts and hierarchical logistic regression were used to investigate the interaction of MR, REDL and SC on NEPHSU.Results: (1) The socioeconomic status (SES) and social capital (SC) of inter-provincial IMs were significantly lower than those of intra-provincial IMs, and the gap was most prominent in affluent areas. (2) From low to high, the NEPHSU of inter-provincial IMs was ranked as affluent, medium and poor, while the corresponding order of intra-provincial IMs was medium, poor and affluent areas, and the gap of NEPHSU between inter-provincial and intra-provincial IMs was the largest in affluent areas. (3) SC could significantly promote the IMs' NEPHSU, but there was a gap between inter-provincial and intra-provincial IMs, and the gap was the largest in affluent areas.Conclution: REDL can significantly affect the gaps of SES and SC among subgroups of IMs with different MR. Inter-provincial migrants in affluent areas have relatively lower SES and SC, which may be a major barrier to their access to NEPHS, and the government should pay special attention to this vulnerable group when promoting equalization of NEPHS for IMs.

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