Undermining linking social capital: The impact of regionalisation on public health services

2005 ◽  
Author(s):  
Lyn Talbot
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhen Yang ◽  
Cheng-hua Jiang

Abstract Background China is making efforts to promote the equalization of National Essential Public Health Services (NEPHS) for internal migrants. Studies have demonstrated that the impacts of social capital on health services are different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of NEPHS for the internal migrants and provide reference for other countries. Methods Data from the China Migrant Dynamic Survey of 2017, involving 130,642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of NEPHS. Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such impacts are moderated by sex and education. Results (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different sexs and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by sex. However, a high education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclusion Social capital plays an important role in the access of migrants to NEPHS. Governments should vigorously promote the construction of regional social capital, encourage migrants to actively participate in community activities, especially pay attention to the enhancement of the migrants with low SES to the destination identity.


2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang

Abstract Background: China is making every effort to promote equal access to public health services(PHS) for the internal migrants. Studies have demonstrated that the impact of social capital on PHS is different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of PHS for the internal migrants and provide reference for other developing countries.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 130642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of National Essential Public Health Services (NEPHS). Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such effects are moderated by gender and education. Results: The results suggest: (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different genders and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by gender. However, education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclution: This study demonstrated complex interactions between the dimensions and levels of social capital, NEPHS projects, and the population characteristics of migrants. As the government strives towards the equalization of NEPHS, these interactions should be fully considered.


2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang

Abstract Background It has been a risk of the internal migrants' (IMs') health that their utilization of National Essential Public Health Services (NEPHS) was inadequate. Studies have analyzed the impact of migration range (MR) or regional economic development level (REDL) on the IMs' utilization of NEPHS, but no studies have explored the interaction of MR and REDL on it. Methods Data from the China Migrant Dynamic Survey of 2017, involving 122656 IMs. Per capita GDP was set as the indicator for REDL, and all provinces were divided into three groups according to REDL: affluent, medium and poor. The MR was divided into inter-province and intra-province, and social capital (SC) was distinguished into cognitive (CSC) and structural social capital (SSC). Awareness of NEPHS (ANEPHS) and establishment of health record (EHR) were selected as indexes of NEPHS utilization. Then we used multiple line charts and hierarchical logistic regression to investigate the interaction of MR, REDL and SC on NEPHS utilization. Results (1) The socioeconomic status (SES) and social capital (SC) of the inter-provincial IMs were significantly lower than those of the intra-provincial IMs, and the gap was most prominent in the affluent areas. (2) From low to high, the NEPHS utilization of inter-provincial IMs was ranked as affluent, medium and poor, while the corresponding order of intra-provincial IMs was medium, poor and affluent areas. (3) SC could significantly promote the IMs' utilization of NEPHS, but there was a gap between the inter-provincial and intra-provincial IMs, and the gap was the largest in the affluent areas. Conclution: The IMs' SES, SC and NEPHS utilization were influenced by MR and REDL. The gaps of SES, SC and NEPHS utilization between the inter-provincial and the intra-provincial IMs in affluent areas were much larger than that in medium and poor areas. The government should pay more attention to the inter-provincial IMs in affluent areas.


2021 ◽  
Author(s):  
Zhen Yang ◽  
Chenghua Jiang

Abstract Background: China is making every effort to promote equal access to public health services(PHS) for the internal migrants. Studies have demonstrated that the impact of social capital on PHS is different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of PHS for the internal migrants and provide reference for other developing countries.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 130642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of National Essential Public Health Services (NEPHS). Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such effects are moderated by gender and education. Results: The results suggest: (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different genders and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by gender. However, education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclution: This study demonstrated complex interactions between the dimensions and levels of social capital, NEPHS projects, and the population characteristics of migrants. As the government strives towards the equalization of NEPHS, these interactions should be fully considered.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K S Petersen ◽  
J F Pedersen ◽  
B Egilstroed ◽  
C Overgaard

Abstract Background User involvement in developing community-based public health services has been on the agenda for decades. User involvement refers to the variety of ways in which service users or public citizens participate in the development of health services: from proving information on their needs to actively being involved in decisions about future services. Former studies found that user involvement is meaningful to the people involved and could have a favorable impact on the quality of services. Thus, it is timely to systematically identify and provide a comprehensive overview of user involvement methods used in public health studies. The aim of this scoping review is to provide an overview of the current body of empirical research where user involvement methods have been used to develop community public health services and identify its possible impact on the individual as well as services. Methods A systematic scoping review of user involvement methods aiming to develop public health services followed Arksey and O'Malley, 2005 framework. Six databases: CINAHL, Cochrane Library, Embase, PsycINFO. PubMed, Scopus and ProQuest, were searched from October till November, 2019. Search terms were: user involvement, methods and health care with corresponding synonym. All hits were double screened. Results 6.044 studies were identified of which 38 studies lived up to the criteria. Preliminary findings from coding and synthesizing studies have identified a variety of user involvement Methods 19 of the studies used complex, multi-facetted packages of methods aiming to identify needs, prioritize and formulate recommendations for future services. 19 studies used different kinds of group meetings and some used certain techniques to facilitate the process. Many reported the impact, and 13 evaluated the methods. The impact of using the methods varied from impact on individual, group, or service/political level. Final results will be presented at the conference. Key messages Studies on user involvement methods in developing community public health services and its impact are sparse. User involvement is privotal in developing sustainable public health community services.


2021 ◽  
Author(s):  
Zhen Yang ◽  
Cheng-hua Jiang ◽  
Jiansheng Hu

Abstract Background: Studies have confirmed that migration range (MR), regional economic development level (REDL) and social capital have impacts on the internal migrants' (IMs') accessibility of National Essential Public Health Services (NEPHS), but no research has explored the interaction of the four variables. Method: A cross-sectional sample of 115412 IMs from the China Migrant Dynamic Survey in 2017 was selected. The sampling method was layered, multi-stage, and probability proportional to size. Logistic regression was conducted by SPSS22.0, sex, residence duration, community type, and education as the control variables, REDL and MR as the moderating variables, social capital as independent variable and awareness of NEPHS and registration of health records (RHR) as the dependent variables. Results: In high income provinces (HIPs), the intra-provincial IMs' CSC, civic participation, social participation, NEPHS awareness and RHR were 4.73±1.736, 49.3%, 55.3%, 61.1%, and 31.9%, and the inter-provincial IMs' levels were 4.01±1.713, 40.5%, 47.2%, 54.6%, and 26.8%; In low-and middle- income provinces (LMIPs), the intra-provincial and inter-provincial IMs' levels were 5.13±1.767, 46.1%, 48.1%, 65.6%, 35.5%, and 5.02±1.775, 41.5%, 41.5%, 62.06%, 34.1%, respectively. In the complete regression model, the interaction of MR, REDL and CSC was not significant, while the interaction of MR, REDL and SSC was significant. In the group regression model, the ORs of CSC, civic participation, and social participation were significantly greater than 1 both in HIPs and LMIPs. However, the interaction of MR and SSC was significant in HIPs but not significant in LMIPs. Conclusions: The social capital and NEPHS utilization of inter-provincial IMs was significantly lower than that of intra-provincial IMs, and these gaps were more prominent in HIPs. Social capital had a positive effect on IMs' NEPHS utilization, and this effect was significantly moderated by MR and REDL. The next focus of the equalization of public services should be the primary health resources supply and the IMs' social capital construction of HIPs.


Author(s):  
Meng

On the basis of the China Migrants Dynamic Survey Data of 2015, the author provides an analysis of how a different household registration impacts migrants’ access to preventive care provided by public health services, such as health records and medical knowledge, in areas of immigration. This study shows that eliminating the distinction between agricultural and non-agricultural permanent residence registration could raise the rate of establishing health files, but it has no significant effect on migrants’ health knowledge. In fact, encouraging those with non-agricultural registration to move to different counties that belong to the same city or to different cities that belong to the same province can notably eliminate the impact of a different household registration status. Improving the income level of low-income migrants can have the same impact. Recommendations to enable migrants to obtain basic public health services include abolishing the separation of agricultural and non-agricultural household registration, increasing the permanent settlement rate of resident migrants, promoting basic medical security systems across the whole country, strengthening career training, and enhancing the education level of migrants.


2021 ◽  
Vol 9 ◽  
Author(s):  
Yanwei Lin ◽  
Tingxian Wang ◽  
Tingting Zhu

Background: The literature shows that migration characteristics are a potential pathway through which migration can influence basic healthcare service utilization. The goal of the study was to explore the effect of migration characteristics on the utilization of basic public health services for internal elderly migrants in China and to identify the pathways that might promote their utilization of basic public health services.Methods: We studied 1,544 internal elderly migrants. The utilization of basic public health services was determined through participation in free health checkups organized by community health service institutions in the past year. Migration characteristics were represented by years of residence and reasons for migration. Other variables included demographic characteristics and social factors, e.g., the number of local friends and exercise time per day were measured to represent social contacts. Multivariate binary logistic regression was employed to explore the association of the variables with the likelihood of using community health services.Results: A total of 55.6% of respondents were men, and the mean age was 66.34 years (SD 5.94). A low level of education was observed. A total of 59.9% of migrants had been residents for over 10 years, and the main reason for migrating was related to family. Of these migrants, 12.9% had no local friends. Furthermore, 5.2% did not exercise every day. Social contacts were complete mediators of the impact of migration characteristics on the utilization of primary healthcare.Conclusion: Our study highlighted the mediating role of social factors in the relationship between migration characteristics and the utilization of basic public health services among Chinese internal elderly migrants. The findings supported the need to increase the opportunities for social contacts between local elderly individuals and internal elderly migrants.


2020 ◽  
Vol 20 (176) ◽  
Author(s):  

The impact of the COVID-19 pandemic and the tightening of global financial conditions have disrupted the, until recently, favorable macroeconomic conditions. The near-term outlook has significantly weakened, with growth expected to decline to -1½ percent in 2020, and the fiscal and the current account deficits widening considerably this year. These projections are subject to more than the usual uncertainty. The authorities’ response has been timely and proactive, focusing on strengthening the provision of public health services, limiting domestic contagion, and introducing targeted economic relief measures aimed at assisting viable businesses and vulnerable people weather the crisis.


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