Urban social exclusion and mental health of China's rural-urban migrants – A review and call for research (original) (raw)
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International Journal of Environmental Research and Public Health
Massive rural–urban migration in China has drawn attention to the prevalence of mental health problems among migrants. Research on the mental health of Chinese migrants has a narrow focus on rural–urban migrants, emphasizing the institutional role of hukou in migrant mental health. We argue that the heterogeneity of migrants, including their place of origin and whether they are temporary or permanent migrants, should be taken into account when trying to understand the meaning of migration as an actual movement from one place to another. The data used for this study is from a cross-sectional survey (N = 855) conducted in Shenzhen to compare the differences in migrants’ mental health that arise when using the two definitions (e.g., hukou and birthplace). Binary logistic regression models were estimated to assess the associations between people’s mental health and migration, while controlling for settlement experiences, self-reported physical health, and sociodemographics. The results ...
Frontiers in Sociology, 2023
There is a well-documented scholarly discourse on how the COVID-19 outbreak adversely affects the mental health of Chinese nationals. However, there is little evidence revealing how the public health crisis negatively influenced the mental health of rural-to-urban migrants in China. The relevant literature argues that rural-to-urban migrant workers and their dependents have been experiencing discrimination, exclusion, and stigmatization in the urban labour market and social space, thereby jeopardizing their mental health to a large extent. However, whether the COVID-19 outbreak and its associated consequences further compounded rural-to-urban migrant workers’ mental health has rarely been discussed. Since 2010, the Chinese government has emphasized the importance of promoting positive mental health. Without identifying how COVID-19 specifically imposed mental health challenges on rural-to-urban migrant cohorts, Chinese policymakers cannot effectively and efficiently address the dilemmas faced by such vulnerable groups. The significant rural-to-urban migrant population (i.e. 291million), alongside their disposition to encounter social and psychological challenges, prompts the urgency to develop this narrative essay to examine whether their mental health burdens worsened during the pandemic. The author also discusses remedies for the worsened mental issues faced by migrant cohorts, and recommends policies that local Chinese governments should adopt to mitigate the mental health burdens encountered by rural-to-urban migrants.
JAMA Network Open
IMPORTANCE There were an estimated 247 million rural-to-urban migrant workers in China in 2016, yet at a national level, there is scant evidence on the association of migration with mental health among migrants and their left-behind family members. OBJECTIVE To examine the association of rural-to-urban migration with symptoms of depression among migrants and left-behind family members aged 45 years and older. DESIGN, SETTING, AND PARTICIPANTS Using representative cross-sectional data of 14 332 middle-aged and older adults from the 2015 China Health and Retirement Longitudinal Survey, regression analyses were conducted to examine the association of depressive symptoms with ruralto-urban migration status in urban areas and the association of depressive symptoms with leftbehind status in rural areas. The statistical analysis was performed from January to August 2018. EXPOSURES Migration status (defined as having a rural hukou [household registration record]) in urban areas and left-behind status (defined as having a spouse or child living in another area) in rural areas. MAIN OUTCOMES AND MEASURES Depressive symptoms measured on the 10-item Center for Epidemiological Studies Depression (CES-D-10) scale. RESULTS A total of 14 332 middle-aged and elderly participants (mean [SD] age, 59.84 [9.51] years; 7394 [51.6%] women) were included, of whom 4404 (30.7%) lived in urban areas and 9928 (69.3%) lived in rural areas. In urban areas, 1607 participants (36.2%) were rural-to-urban migrants, and the remaining 2797 participants (72.8%) were local residents. In rural areas, 3405 participants (34.3%) were left-behind family members, and the remaining 6523 participants (65.7%) were not. Compared with urban residents, rural-to-urban migrants had higher CES-D-10 scores after adjustment for covariates (β = 0.74; 95% CI, 0.08-1.40; P = .03; standard errors clustered at the household level henceforth). Compared with intact-family rural residents, left-behind spouses had higher CES-D-10 scores after adjustment for covariates (β = 0.54; 95% CI, 0.05-1.03; P = .03). CONCLUSIONS AND RELEVANCE Rural-to-urban migration in China was associated with poor mental health for migrants and their left-behind spouses. Short-term policies, such as building community social facilities, may prove effective, but long-term solutions should address issues related to economic and social exclusions and the lack of a social security system in rural China.
Mental Health Status and Related Characteristics of Chinese Male Rural–Urban Migrant Workers
Community Mental Health Journal, 2012
To explore mental health status and related characteristics in a sample of Chinese male rural-urban migrants. Subjects were 1,595 male rural-urban migrant workers selected though a multi-stage sample survey conducted in two cities (Hangzhou and Guangzhou). Data were collected by means of a self-administered questionnaire. Both life and work stressors were examined. Stress and mental health status were measured by the Chinese Perceived Stress Scale (CPSS) and the Chinese Health Questionnaire (CHQ), respectively. Unconditional logistic regression analysis was performed to identify factors associated with probable mental disorders. There are approximately 120 million rural-urban migrants in China. The prevalence of probable mental disorders in the sample population was 24.4% (95% CI: 23.3-25.5%), which was higher than among urban residents (20.2%, 95% CI: 18.8-21.7%). Logistic regression analysis revealed that five characteristics were positively associated with risk for probable mental disorders: originating in the South (OR = 2.00; 95% CI = 1.02, 4.00), higher life stress (OR = 7.63; 95% CI = 5.88, 10.00), staying in the city for 5-9 months each year (OR = 2.56; 95% CI = 1.67, 3.85), higher work stress (OR = 2.56; 95% CI = 1.96, 3.33), and separation from wife (OR = 2.43; 95% CI = 1.61, 3.57). Employment in machinery and transportation (OR = 0.54; 95% CI = 0.36, 0.81) and higher self-worth (OR = 0.42; 95% CI = 0.28, 0.62) were negatively associated. Findings support an urgent need to develop specific policies and programs to address mental health problems among Chinese rural-urban migrants.
The Plight of Rural Migrant Workers in Urban China
Social Science Research Network, 2016
Proactiveness in seeking health care services among psychopaths lies at the core of selfefficacy, improvements in health services utilization can cause better control of psychological depression among rural to urban female migrant workers. However, a paucity of literatures have shown the proactiveness of seeking health services in the context of psychological depression control among female migrant workers. A cross-sectional survey was carried out in the selected urban region from one province in China, and 781 participants were interviewed between January and September in 2018 with stratified multiple-stage sampling to examine the interrelationship between psychological depression control and socio-demographic and economic variables as well as proactiveness of female migrant workers in seeking health care services. The primary outcome for this research was psychological depression control (depression score < 50 for each individual). Out of the total 781 participants with almost more than 6 years of education, the number of proactive health care service seekers was 1.463 times greater than the passive seekers (odds rate (OR)=1.463, 95% confidence interval (CI)=1.061-2.016, p=0.020). In all subgroups, participants actively seeking were more likely to have healthy psychological status than those passively utilizing health care services. Proactiveness in seeking contributes to the control of psychological depression and improvements in psychological health status among female migrant workers.
International journal of environmental research and public health, 2017
Rural-to-urban migration, which has achieved a huge scale during China's economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen's behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant ch...
BMC Public Health, 2021
Background: Migrants experience substantial changes in their neighborhood physical and social environments along their migration journeys, but little is known about how perceived changes in their neighborhood environment pre-and post-migration correlate with their mental health. Our aim was to examine the associations between recalled changes in the perceived neighborhood physical and social environments and migrants' mental health in the host city. Methods: We used cross-sectional data on 591 migrants in Shenzhen, China. We assessed their risk of mental illness using the General Health Questionnaire (GHQ). Neighborhood perceptions were collected retrospectively pre-and post-migration. We used random forests to analyze possibly non-linear associations between GHQ scores and changes in the neighborhood environment, variable importance, and for exploratory analysis of variable interactions. Results: Perceived changes in neighborhood aesthetics, safety, and green space were non-linearly associated with migrants' mental health: A decline in these characteristics was associated with poor mental health, while improvements in them were unrelated to mental health benefits. Variable importance showed that change in safety was the most influential neighborhood characteristic, although individual-level characteristics-such as self-reported physical health, personal income, and hukou (i.e., the Chinese household registration system)-appeared to be more important to explain GHQ scores and also strongly interacted with other variables. For physical health, we found different associations between changes in the neighborhood provoked by migration and mental health.
Community-based approaches to social exclusion among rural-to-urban migrants in China
China Journal of Social Work, 2015
Rural-to-urban migrants in China face numerous forms of social exclusion. This article argues that community-based approaches offer innovative ways with which to tackle the problems of social exclusion for rural-to-urban migrants, yet these approaches have been neglected. This article first provides an overview of the concept of social exclusion, as developed by Western European scholarship and policy discourse. Next, it examines the ways in which these concepts are relevant to the context of rural-tourban migrants within China. Finally, this article conceptualizes the social exclusion paradigm from a community practice perspective and offers the implications of this paradigm for community-level interventions.
Trans-local ties, local ties and psychological well-being among rural-to-urban migrants in Shanghai
Social Science & Medicine, 2012
During the past three decades, an estimated 200 million rural residents have moved to urban centers in China. They are "sojourners" in the cities and maintain close ties with their home communities, which we term trans-local ties. This paper examines the relationship between migrants' social ties and their mental health, and contrasts the trans-local ties with migrants' ties in the receiving communities, which are termed local ties. We expect that for the migrants, trans-local ties foster better mental health not only through providing emotional support but also through generating favorable social comparisons; whereas local ties may furnish important social support, but may also produce negative social comparisons. We use data collected in Shanghai to test our expectations. We compare the migrants to a sample of Shanghai natives to assess patterns of relationship between social ties and mental health that are unique to the migrants. We find that for the migrants, more numerous trans-local ties are associated with better mental health, whereas the number of local ties is not a significant predictor. This pattern is not observed among the Shanghai natives. Moreover, for migrants, trans-local ties foster a favorable evaluation of their status in Shanghai and buffer their perception of discrimination; in contrast, more numerous local ties tend to be associated with a more negative perception of social status. The findings highlight an oftenoverlooked pathway between social ties and health outcomes, namely, through influencing social comparison and perceived social status. This study also suggests that in addition to reducing institutional and personal discrimination, facilitating close bonds between the migrants and their home communities may be a productive way to foster their well-being, in the context of contemporary urban China.