Heterogeneity in Public Health Service Utilization and Its Relationship with Social Integration Among Older Adult Migrants in China: a Latent Class Analysis

Overview

Journal Front Public Health

Specialty Public Health

Date 2024 Aug 22

PMID 39171305

Authors

Xiaolong Bu

Ting Wang

Qian Dong

Cuiping Liu

Affiliations

Soon will be listed here.

Abstract

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 ( = 3,264,52.756%), medium utilization of basic public health services class ( = 1,743,28.172%), and high utilization of basic public health services class ( = 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 (<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.

References

Fei C, Zhu Y, Jiang L, Zhou H, Yu H . Social integration, physical and mental health and subjective well-being in the floating population-a moderated mediation analysis. Front Public Health. 2023; 11:1167537. PMC: 10356978. DOI: 10.3389/fpubh.2023.1167537. View

Lu H, Kandilov I, Nie P . Heterogeneous Impact of Social Integration on the Health of Rural-to-Urban Migrants in China. Int J Environ Res Public Health. 2022; 19(16). PMC: 9407958. DOI: 10.3390/ijerph19169999. View

Luo Q, Chen X, Zhao L, Hu Q, Du J, Shao S . Association between social capital and utilization of essential public health services among elderly migrants: a multilevel logistic study based on the 2017 China migrant dynamic survey (CMDS). BMC Public Health. 2024; 24(1):1252. PMC: 11092042. DOI: 10.1186/s12889-024-18726-0. View

Wang W, Song J, Fan C, Li Q, Ma D, Yin W . Cross-sectional study of factors affecting the receipt of mental health education in older migrants in China. BMC Public Health. 2023; 23(1):376. PMC: 9945688. DOI: 10.1186/s12889-023-15287-6. View

Schreiber J . Issues and recommendations for exploratory factor analysis and principal component analysis. Res Social Adm Pharm. 2020; 17(5):1004-1011. DOI: 10.1016/j.sapharm.2020.07.027. View

Xu X, Zhang Q, You H, Wu Q . Awareness, Utilization and Health Outcomes of National Essential Public Health Service Among Migrants in China. Front Public Health. 2022; 10:936275. PMC: 9309480. DOI: 10.3389/fpubh.2022.936275. View

Zeng W, Wang C, Chen H, Tong B, Li D, Zou Z . Health status and public health education for internal older migrants in China: Evidence from a nationally representative survey. Front Public Health. 2022; 10:937361. PMC: 9353578. DOI: 10.3389/fpubh.2022.937361. View

Xi S, Song Y, Li X, Li M, Lu Z, Yang Y . Local-Migrant Gaps in Healthcare Utilization Between Older Migrants and Local Residents in China. J Am Geriatr Soc. 2020; 68(7):1560-1567. DOI: 10.1111/jgs.16421. View

Kim M, Kim K, Han H, Huh B, Nguyen T, Lee H . Prevalence and Predictors of Depression in Korean American Elderly: Findings from the Memory and Aging Study of Koreans (MASK). Am J Geriatr Psychiatry. 2015; 23(7):671-83. PMC: 4442756. DOI: 10.1016/j.jagp.2014.11.003. View

10.

Tang D, Wang J . Basic Public Health Service Utilization by Internal Older Adult Migrants in China. Int J Environ Res Public Health. 2021; 18(1). PMC: 7795646. DOI: 10.3390/ijerph18010270. View

11.

Tang S, Long C, Wang R, Liu Q, Feng D, Feng Z . Improving the utilization of essential public health services by Chinese elderly migrants: strategies and policy implication. J Glob Health. 2020; 10(1):010807. PMC: 7125420. DOI: 10.7189/jogh.10.010807. View

12.

Zhou J, Zhu L, Zhang J . Social Integration and Health Among Young Migrants in China: Mediated by Social Mentality and Moderated by Gender. Front Psychol. 2022; 13:863443. PMC: 9082418. DOI: 10.3389/fpsyg.2022.863443. View

13.

Liu S, Qin B, Wang D . How does social integration work when older migrants obtain health services from community? Evidence from national database in China. Front Public Health. 2024; 11:1283891. PMC: 10773583. DOI: 10.3389/fpubh.2023.1283891. View

14.

Wang Q . Health of the Elderly Migration Population in China: Benefit from Individual and Local Socioeconomic Status?. Int J Environ Res Public Health. 2017; 14(4). PMC: 5409571. DOI: 10.3390/ijerph14040370. View

15.

Zhang J, Lin S, Liang D, Qian Y, Zhang D, Hou Z . Public Health Services Utilization and Its Determinants among Internal Migrants in China: Evidence from a Nationally Representative Survey. Int J Environ Res Public Health. 2017; 14(9). PMC: 5615539. DOI: 10.3390/ijerph14091002. View

16.

Sun X, Chen J, Xie S . Becoming Urban Citizens: A Three-Phase Perspective on the Social Integration of Rural-Urban Migrants in China. Int J Environ Res Public Health. 2022; 19(10). PMC: 9141490. DOI: 10.3390/ijerph19105946. View

17.

Park H, Morgan T, Wiles J, Gott M . Lonely ageing in a foreign land: Social isolation and loneliness among older Asian migrants in New Zealand. Health Soc Care Community. 2018; 27(3):740-747. DOI: 10.1111/hsc.12690. View

18.

Lin Y, Chu C, Chen Q, Xiao J, Wan C . Factors influencing utilization of primary health care by elderly internal migrants in China: the role of social contacts. BMC Public Health. 2020; 20(1):1054. PMC: 7333340. DOI: 10.1186/s12889-020-09178-3. View

19.

Zeng L, Chen Y . Intergenerational differences and influential factors of basic public health service utilization for floating population. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021; 46(5):511-520. PMC: 10930222. DOI: 10.11817/j.issn.1672-7347.2021.200635. View

20.

Yi Y, Liang Y . The effect of socioeconomic status and social inclusion on the mental health of Chinese migrants: A comparison between interprovincial and intra-provincial migrants. J Health Psychol. 2017; 25(3):387-399. DOI: 10.1177/1359105317718058. View