Voting with Your Feet: The Impact of Urban Public Health Service Accessibility on the Permanent Migration Intentions of Rural Migrants in China

Qingjun Zhao, Meijing Song () and Hanrui Wang ()
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Qingjun Zhao: College of Economics and Management, Nanjing Agricultural University, Nanjing 210095, China
Meijing Song: College of Finance and Economics, Hainan Vocational University of Science and Technology, Haikou 571126, China
Hanrui Wang: College of Economics and Management, Nanjing Agricultural University, Nanjing 210095, China

IJERPH, 2022, vol. 19, issue 22, 1-20

Abstract: The accessibility of urban public health services is not only relevant to the health status of rural migrants but also plays an increasingly important role in their migration decisions. Most existing studies have focused on the effects of the level of public health service provision and parity on rural migrants’ migration behavior, ignoring the role of public health service accessibility. This paper systematically examines the overall impact, heterogeneous impact and mechanism of action of public health service accessibility on rural migrants’ intentions to migrate permanently based on data from the 2017 China Mobile Population Dynamics Monitoring Survey using probit, IVprobit, eprobit, omitted variable test model and KHB mediating effect model. It was found that: (1) public health service accessibility significantly increased rural migrants’ intentions to migrate permanently, and the results remained robust after using instrumental variables to mitigate endogeneity problems and omitted variable tests. (2) Heterogeneity analysis shows that public health service accessibility has a greater effect on enhancing the intentions to migrate permanently among females and rural migrants born in 1980 and later. (3) Further mechanism testing revealed that public health service accessibility could indirectly increase rural migrants’ intentions to migrate permanently by improving health habits, health status, identity, and social integration, with identity playing a greater indirect effect. The findings of this paper not only provide empirical evidence for the existence of Tiebout’s “voting with your feet” mechanism in China but also contribute to the scientific understanding of the role of equalization of public health services in the process of population migration.

Keywords: public health service accessibility; permanent migration intention; rural migrants; China; voting with your feet (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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Citations: View citations in EconPapers (3)

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