Health Selectivity and Rural-Urban Migration in China: A Nationwide Multiple Cross-Sectional Study in 2012, 2014, 2016

Yao Yi, Yu Liao, Lingling Zheng, Mengjie Li, Jing Gu, Chun Hao and Yuantao Hao
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Yao Yi: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China
Yu Liao: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China
Lingling Zheng: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China
Mengjie Li: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China
Jing Gu: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China
Chun Hao: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China
Yuantao Hao: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhong Shan 2nd Road, Guangzhou 510080, China

IJERPH, 2019, vol. 16, issue 9, 1-14

Abstract: Background : China is undergoing an unprecedented rural-urban migration, which may deeply influence the health of internal migrants. Previous studies suggested that migrants are a selectively healthier population. This paper examines the evidence for and the changes of health selectivity among Chinese internal migrants. Methods : We use data from the China Labor-force Dynamics Survey (CLDS), a nationally representative survey conducted in 2012, 2014, and 2016, respectively. The health statuses of four groups of research subjects (out-migrants, returned migrants, rural residents, and urban residents) are measured by general health, physical health, and emotional health. Results : By comparing the health status of migrants with that of rural residents, we find supportive evidence for the Healthy Migrant Hypothesis that migrants exhibit better health than rural residents in their hometown. We also add strength to the Salmon Bias Hypothesis that migrants returning to their hometowns are less healthy than those still being outside. However, migrants present worse emotional health in both comparisons. The general and physical health gaps between migrants, rural residents, and returnees widened in all three rounds of the survey, which implies a possibly increasing trend of health selectivity. This study also suggests that bringing family to the destination requires better general and physical health, but not emotional health. Conclusions : Migrants are positively selected on general and physical health. The health selectivity in 2012–2016 is highly likely to increase, which means that there are increasing number of obstacles for migrants to overcome. Family migration’s high requirement for health might also contribute to it. It is urgent to establish and improve primary health care service systems in rural areas in current circumstances.

Keywords: health selectivity; healthy migrant; salmon bias; rural-urban migration (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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