Dialect culture and the utilization of public health service by rural migrants: Insights from China

Language barriers and health inequality: Examining access to healthcare for migrants with chronic illnesses in China

OBJECTIVES

This study examines how language barriers impact healthcare access and education for Chinese migrants with chronic diseases, focusing on linguistic challenges unique to internal migration. By addressing regional dialect diversity within a single nation, it broadens the scope of language barrier studies and contributes to understanding how linguistic inequalities shape healthcare access, offering insights for multilingual societies worldwide.

STUDY DESIGN

Cross-sectional analysis using data from the 2017 China Migrants Dynamic Survey.

METHODS

The primary analysis uses a probit model to assess the impact of language barriers on healthcare access. Logit and OLS models are also employed for robustness checks, ensuring consistency across different methodologies. Additionally, a placebo test is conducted to confirm that the observed effects are not due to random variation, validating the robustness of the findings.

RESULTS

The findings reveal that increasing language barriers significantly decrease the likelihood of migrants accessing health services and participating in health education programs. The impact is particularly pronounced among male, less-educated, and older migrants. Mechanisms contributing to these outcomes include heightened social exclusion, perceived differences in hygiene practices, and reduced awareness of health policies. These findings align with international evidence, demonstrating that language barriers universally hinder healthcare access for migrant populations in diverse linguistic contexts.

CONCLUSIONS

Language barriers hinder healthcare access for migrants with chronic diseases. By addressing linguistic challenges in internal migration, this study expands language barrier research and highlights the need for multilingual services and culturally tailored policies to improve health equity in diverse societies.

Factors influencing utilization of healthcare services for internal migrant older adults in Xuzhou, China: based on Anderson's model

Background

As population migration increases and the aging process accelerates, the number of migrant older adults is growing significantly. This trend presents a substantial challenge to urban health services in regions experiencing an influx of older adults individuals. Consequently, examining the healthcare service utilization of the migrant older adults population is crucial to promote healthy aging.

Methods

A multi-stage random sampling method was employed to select a study population of 568 migrant older adults individuals, aged 60 years and above, residing in urban Xuzhou City. Multivariate logistic regression analysis, based on Anderson's model, was conducted to explore the factors influencing outpatient and inpatient health service utilization among this population.

Results

Among the 568 migrants, 73 (12.9%) had received outpatient services within the past 2 weeks, while 109 (19.2%) had received inpatient services within the past year. Migrant older adults with education level, time to health centers, and self-assessed health status negatively influenced the outpatient services utilization among migrant older adults. Possession of pension insurance, convenience to visit, sick for the past 2 weeks, and health services need positively influenced the outpatient services utilization among migrant older adults. Furthermore, age, possession of pension insurance and health insurance, convenience to visit, number of chronic diseases, sick for the past 2 weeks, and healthcare service need positively influenced inpatient service utilization among migrant older adults. Education level, self-assessed health status, and time to health centers negatively influenced the inpatient services utilization among migrant older adults.

Conclusion

The overall utilization of healthcare services by migrant older adults in Xuzhou remains inadequate. Addressing this issue requires enhanced medical policy support and assistance, stronger health education initiatives, and improved social integration for the older adults. Additionally, efforts should be made to reduce their financial burdens and improve the accessibility of healthcare services.

Effect of health rights accessibility on the urban integration of minority rural migrants in China: a cross-sectional study

BACKGROUND

Accessing health rights is an integral component of people's aspirations for a better life. Existing discussions and evaluations regarding the accessibility of health rights for minority rural migrants are insufficient. In comparison to objective health conditions, inequalities in health rights lead to chronic and long-term depletion of human capital among minority rural migrants. This study aimed to assess the overall impact, heterogeneity effects, and mechanisms of health rights accessibility on the urban integration of minority rural migrants.

METHODS

Based on the 2017 China Migrants Dynamic Survey Data (CMDS), this study employs OLS models, 2SLS models, conditional mixed process (CMP) methods, and omitted variable tests to estimate the impact of health rights accessibility on the urban integration of minority rural migrants. Additionally, from the perspectives of migration scope and illness experience, this study explored the heterogeneity in the relationship between health rights accessibility and urban integration. Finally, using the Karlson-Holm-Breen (KHB) model, this study dissects the mechanisms through which health rights accessibility influences the urban integration of minority rural migrants.

RESULTS

Health rights accessibility significantly enhances the urban integration of minority rural migrants. Moreover, compared to minority rural migrants who move across provinces and who have no history of illness, those who migrate within the same province and who have experienced illness are more sensitive to the positive impact of health rights accessibility. However, the enhancing effect of health rights accessibility does not significantly differ between the new and old generations of minority rural migrants. Furthermore, health rights accessibility can indirectly improve the urban integration of minority rural migrants by elevating health levels, improving health habits, and reinforcing health behaviors. Among these, the indirect effects mediated by health habits are more pronounced.

CONCLUSION

The research conclusions underscore the issue of health accessibility and urban integration among minority rural migrants, providing a reexamination and clarification of the policy effects of health rights in promoting the urban integration of minority rural migrants. Relevant policy design should commence with improving the health rights of minority rural migrants, enhancing their health integration capabilities, and effectively boosting their ability to integrate into urban life.

How does choice of residential community affect the social integration of rural migrants: insights from China

The construction of public space is a new and important way to integrate rural migrants into urban society. Existing studies mainly discussed the factors affecting the social integration of rural migrants from the micro-individual and macro-system levels. Still, they seldom analyzed the differences between rural migrants' residential communities and the roles these differences play in their social integration, especially from the perspective of residential space. Based on the data of the 2014 China Migrants Dynamic Monitoring Survey, this paper systematically examines the impact of residential community selection on the social integration of rural migrants and its possible effects using OLS, 2SLS, CMP, omitted variable test method, and KHB mediating effect model. It is found that the choice of residential community has a significant positive impact on the social integration of rural migrants, and the social integration of rural migrants living in formal communities has increased by 2.44%-3.20%. To overcome the potential endogeneity problems and selection bias of the empirical model, the study further adopted an instrumental variable estimation approach, combined with the omitted variable method for robustness check; the results still revealed the positive effect of living in formal communities on the social integration of rural migrants. The heterogeneous results showed that living in formal communities has a greater effect on the social integration of women and older-generation rural migrants. The farther the migration range and the longer the residence time of rural migrants, the greater the effect of living in the formal community on their social integration. Further mechanism testing revealed that living in formal communities not only directly enhances the social integration of rural migrants but also indirectly improves their social integration through public resource allocation, human capital accumulation, social status screening, and social network expansion. The indirect effect of capital accumulation is even greater. Therefore, to accelerate the full integration of rural migrants into urban society and achieve real urbanization and citizenship, the study proposes that the government should scientifically plan the layout of rural migrants' living space and the construction of supporting facilities.

Effect of childbearing-age women's family status on the health status of three generations: evidence from China

It is widely recognized that inequalities in social status cause inequalities in health. Women in a family often directly influence three generations-women themselves, their children and their parents -yet the effect of women's family status on their own health status and that of the two generations before and after is not clear. Taking data from the China Family Panel Studies, this study used an ordered response model to investigate the effect of childbearing-age women's family status on the health status of three generations. The results showed that increases in childbearing-age women's family status improved the health status of the women themselves and their children. Unlike previous studies, however, we found that higher family status did not improve parents' health status but decreased it. The mechanism analysis indicated that women's family status influenced the health status of three generations through economic conditions, resource allocation, and child discipline. The results held after robustness testing. Our findings contribute to knowledge in related fields and provide theoretical support for policies that empower women.

Exploring the relationship between mental health and dialect use among Chinese older adults: a moderated mediation estimation

Background

Mental health, conceptualized as psychological status that includes rational cognition, emotional stability, and interpersonal harmony, is highly relevant to the expected health and well-being of all humans. China is facing the dual risk of increased aging and mental health disorders in older adults, while the established studies have rarely focused on the influence of dialect on the mental health of Chinese older adults. The present study aims to capture the relationship between dialect and mental health in Chinese older adults.

Methods

We use cross-sectional data from the nationally representative China Family Panel Studies, which encompasses the dialect use, mental health, and other socioeconomic features of 4,420 respondents. We construct a moderated mediation model that uses dialects and mental health as the independent and dependent variables and income inequality and subjective well-being as the mediator and moderator to reveal the relationship between dialect and mental health in Chinese older adults.

Results

(1) Dialects are shown to have a negative influence on the mental health of older adults in the current study (coefficient = -0.354, 95% CI = [-0.608, -0.097]). (2) Income inequality positively mediates the correlation between dialects and mental health (coefficient = 0.019, 95% CI = [0.010, 0.045]). (3) Subjective well-being negatively moderates the potential mechanism between dialects and mental health (coefficient = -0.126, 95% CI = [-0.284, -0.010]).

Conclusion

The use of dialects is associated with worse mental health outcomes in Chinese older adults, while this negative influence is positively mediated by income inequality and negatively moderated by subjective well-being, simultaneously. This study contributes to the knowledge enrichment of government workers, older adults with mental disorders, medical staff, and other stakeholders.