Impact of public health education on the health status of the older migrant population

Accessibility of basic public health service promotes social integration of elderly migrants in China

The social integration of elderly migrants has emerged as a significant issue in contemporary Chinese society. Improving the Accessibility of Basic Public Health Services (ABPHS) is recognized as a crucial approach to addressing this challenge. Utilizing data from the 2017 China Migrants Dynamic Survey, this study analyzed the impact of ABPHS on the social integration of elderly migrants, with a focus on the underlying mechanisms. The findings indicated that ABPHS positively influenced the social integration of elderly migrants. Heterogeneity analysis revealed more pronounced positive effects in central/western regions, dual-migration families, general cities, and intra-provincial migrants. Mechanistic analyses revealed that hometown social networks and engagement in social activities among elderly migrants served as mediating factors in the relationship between ABPHS and social integration, while migration experience positively moderated the direct effect of ABPHS on social integration and facilitated the formation of hometown society networks. From the perspective of health equity, it is imperative to further expand ABPHS to strengthen the social integration of elderly migrants. Policymakers are encouraged to develop unified platforms for social participation and establish formal support networks tailored to elderly migrants, thus enhancing their awareness of and access to public health services.

Heterogeneity in public health service utilization and its relationship with social integration among older adult migrants in China: a latent class analysis

Background

The older adult migrant population in China is on the rise, which presents challenges for the national public health service system. However, the heterogeneity of public health service utilization and its relationship with social integration among the older adult migrant population remains unclear. This study aims to explore the heterogeneity the public health service utilization and how it relates to their social integration.

Methods

A total of 6,178 older adult migrants from the China Migrants Dynamic Survey (CMDS) in 2017 were included in this study. Exploratory factor analysis was used to categorize social integration into four dimensions. Latent class analysis (LCA) was used to identify different sub-groups of public health service utilization. ANOVA and multivariate logistic regression were used to determine the characteristics of different sub-groups.

Results

Three potential classes of public health service utilization were identified: low utilization of basic public health services class (N = 3,264,52.756%), medium utilization of basic public health services class (N = 1,743,28.172%), and high utilization of basic public health services class (N = 1,180,19.072%). Gender, education, extent of mobility, and move alone or not, flow time were all predictors of the class of public health service utilization. There were significant differences in social integration across potential categories (p<0.0001).

Conclusion

The utilization of public health services of the older adult migrants is affected by many aspects. Social integration deserves attention as a significant influencing factor in the utilization of public health services. The government should pay attention to the characteristics of the older adult migrants and formulate relevant policies in a targeted manner in order to improve the utilization of public health services of the older adult migrants.

Research on the health status and influencing factors of the older adult floating population in Shanghai

Introduction

Over the past decade, against the dual background of population aging and mobility, the older adult/adults floating population has become a new type of mobile group in China, continually congregating in large cities, posing significant challenges to the socio-economic development, eldercare services, and public management of these metropolises. Shanghai, as a mega-city and the economic center of the China, is typically representative of the national population.

Methods

Based on the dynamic monitoring data of Shanghai's floating population in 2018, this research uses mathematical statistics and binary Logistic regression models.

Objective

This research analyzes the demographic characteristics and health status of the older adult/adults floating population in Shanghai in the new era and reveals its primary influencing factors.

Results and discussion

(1) A prominent contradiction in the scale and structure of the older adult/adults floating population, with widowed and low-educated mobile older adult/adults requiring attention. (2) There is a lack of health knowledge, and the proportion of local reimbursement is low. Over 90% of migrant older adult/adults self-assessed their health (with a very few unable to care for themselves), far higher than the proportion of older adult/adults who are not sick (injured) or uncomfortable (actually healthy), which exceeds 70%. The health status of migrant older adult/adults deteriorates with age, and those who have never attended school and live alone have the worst health status. (3) Older adult/adults people with advanced age and low educational levels are at risk of health issues, while a better living environment can reduce the risk of illness in the older adult/adults floating population. Low family income, poor housing affordability, and the medical burden brought about by illness can easily lead to older adult/adults floating populations falling into the trap of older adult/adults poverty, and older adult/adults people from central regions and those who migrate along have difficulty adapting to city life, leading to poor self-assessed health. Meanwhile, community/enterprise health education helps to enhance the health protection awareness of the older adult/adults floating population. Finally, based on the governance concept of "mobility publicness," several public management and service optimization strategies for social support for the older adult/adults floating population in Shanghai are proposed.

Disparities in awareness and utilisation of National Essential Public Health Services between the floating population and the registered residents: a cross-sectional study in China

OBJECTIVE

There are differences between the floating population and the registered population in the awareness and use of the National Essential Public Health Services (NEPHS) due to the influence of China's household registration system. The Equalization of Basic Public Health and Family Planning Services (EBPHFPS) policy aims to reduce disparities among populations by enhancing the migrant population's access to basic public health services. The aim of this study is to examine the relationship between the EBPHFPS targeted at the floating population and the disparities in access to and utilisation of NEPHS between registered residents and the floating population.

DESIGN

A cross-sectional study.

SETTING

8 cities (regions, autonomous prefectures) in China.

PARTICIPANTS

13 998 floating population and 14 000 registered residents in eight cities (regions, autonomous prefectures) were included in the analysis.

OUTCOME MEASURES

Three binomial variables, including awareness of NEPHS, acceptance of health education and establishment of health records, were used as outcome indicators to examine the relationship between the EBPHFPS and the disparities between the floating and registered populations.

METHODS

A linear regression model, fairness gap calculation and propensity score matching were used to explore the associations.

RESULTS

The areas that implemented EBPHFPS exhibited an 8.3% increase in awareness of the NEPHS (p<0.01) and a 4.0% increase (p<0.05) in the likelihood of individuals having received health education within the previous year compared with the areas without the policy implementation. In contrast to registered residents, however, the floating population still faces significant disparities in NEPHS awareness and utilisation. Compared with areas without the equalisation policy, the inequality of opportunity in health education of the floating population in implementation areas is significantly lower (p<0.01), whereas no significant difference is observed in the inequality of opportunity regarding NEPHS awareness among the floating population (p>0.1). The floating population in the pilot areas of the policy encountered greater disparities in the establishment of health records (p<0.01).

CONCLUSIONS

Positive associations between the EBPHFPS policy and NEPHS awareness and utilisation among the floating population were demonstrated to some extent; however, the floating population was still confronted with a degree of inequality of opportunity. The government needs to develop target-oriented policies and a guaranteed mechanism to ensure access to NEPHS among the floating population.

A study on the impact and mechanism of action of public health education on the health of the migrant population: evidence from the 2018 China migrants dynamic survey

Background

China has the world's largest mobile population. As mobility increases, ensuring the health protection of this population is receiving more attention. Strengthening public health education is a crucial measure to improve their health and achieve equal access to basic public health services in China. Previous research has demonstrated that public health education has an impact on the health of mobile populations. However, there has been limited investigation into the mediating pathways through which health education influences the health of mobile populations, and few studies have examined the heterogeneity of this effect.

Objectives

The aim of this study was to analyze the impact of public health education on the health of the mobile population and its mechanism of action. Additionally, we aimed to explore the differences in this impact among different subdivided groups.

Methods

This paper analyses the impact of public health education on the health of the mobile population using the 2018 China Migrant Dynamic Survey (CMDS) Data,. The data was cleaned and 4,034 people were included in the analysis. The study employed ordered logistic regression modeling to analyze the mediating pathways through which health education affects health. Additionally, binary logistic regression model, probit model, propensity score matching method and instrumental variables were used to verify the robustness of the results.

Results

The self-assessed health status of the mobile population was good, and 82.10% of them accepted public health education. However, 17.89% of the mobile population did not receive any health education. Acceptance of health education can help improve the health status of the mobile population (OR = 1.178, 95% CI = 0.979-1.418). The study found that public health education can positively impact the health of mobile populations by influencing their health and hospitalization behaviors, as well as their social support. The analysis of heterogeneity revealed that the impact of public health education is more significant among rural, middle-aged, low-education, and low-income groups of the mobile population.

Conclusion

Public health education can have a positive impact on the health of the migrant populations. To further improve health education for this group, it is necessary to actively promote the establishment of health records for the migrant population, to facilitate the contracting of family doctors by the migrant population, to improve the accessibility to hospitalization services, reduce the burden of hospitalization costs, and enhance social support. Simultaneously, it is essential to offer precise and varied health education to the migrant population based on their characteristics, to promote equity among diverse groups of individuals. These findings not only help to enrich theoretical research on health education for migrant populations and the health of migrant populations but also help to improve the level of public health education for migrant populations and improve the health protection of migrant populations.