scholarly journals Migration and Health—Freedom of Movement and Social Benefits for Chinese Migrant Workers

2021 ◽  
Vol 13 (22) ◽  
pp. 12371
Author(s):  
Fengxian Qiu ◽  
Jing Liu ◽  
Heying Jenny Zhan
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Migrant Workers ◽  
Work Experience ◽  
Cumulative Effect ◽  
Social Contexts ◽  
Structural Barriers ◽  
Health Seeking ◽  
Self Rated Health ◽  
Chinese Migrant Workers

This study utilized the concept of social right to understand factors affecting migrant workers’ health and healthcare in China. Using mixed methods, this study integrated findings from a survey of 817 migrant workers and a follow-up study of 30 intensive interviews to present an in-depth understanding of cumulative disadvantage of health and healthcare of rural-to-urban migrant workers. Our quantitative results indicated that migrant workers with no more than 5 years of working experience and having a good relationship with employers were 65% and 72.8% more likely to report good self-rated health as compared to their counterparts; those with work-related injury experience and low income were 41.6% and 53.6% less likely to report good self-rated health. Qualitative findings revealed the social contexts of the cumulative effect of the length of work experience and fear of medical cost on migrant workers’ declining health. Even though the participation rate for health insurance in China is reported to be over 99%, the lack of portability in health insurance and different reimbursement rates in health care access are structural barriers in health-seeking behaviors among Chinese migrant workers and in establishing sustainability in China’s healthcare system. This study adds to the literature by delineating the process of the unequal access to social rights in general, healthcare in particular as the major explanation for migrant workers’ poor health beyond the surface of China’s universal healthcare.

scholarly journals Migration and Health: Freedom of Movement and Social Benefits for Chinese Migrant Workers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 488-488
Author(s):  
Fengxian Qiu ◽  
Heying Zhan ◽  
Jing Liu
Keyword(s):  
Health Care Access ◽  
Migrant Workers ◽  
Work Experience ◽  
Urban Areas ◽  
Cumulative Effect ◽  
Policy Implications ◽  
Structural Barriers ◽  
Health Seeking ◽  
Freedom Of Movement ◽  
Self Rated Health

Abstract Nearly 30% of China’s workforce consists of China’s rural-to-urban migrant workers, accounting for nearly 300 million of China’s population. Even though they have gained freedom of movement since the 1980s, they still have no access to healthcare in urban areas where they work. This study utilizes a mixed method of a survey with a sample of migrant workers from three Chinese emigration provinces (n=817) in 2018 and follow-up interviews with 30 migrant workers in 2020 to examine factors of migration experience affecting migrant worker’s health and healthcare. Using binary logistic regression, we found that migrant workers’ longer work experience is correlated with poorer self-rated health, their better financial status and level of hopefulness towards the future are positively correlated to self-rated health. Qualitative findings shed light on the cumulative effect of the length of work experience and fear of medical cost on migrant workers’ declining health. The lack of portability in health insurance and different reimbursement rates in health care access are structural barriers in health-seeking behaviors among migrant workers. Policy implications are presented in the global context of social rights and freedom of movement.

scholarly journals Public health insurance and birth outcomes: evidence from Punjab, Pakistan

2020 ◽  
Author(s):  
Najam uz Zehra Gardezi
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Fixed Effects ◽  
Insurance Coverage ◽  
Birth Certificate ◽  
Household Survey ◽  
Public Health Insurance ◽  
Health Seeking ◽  
Cross Sectional

Abstract Public health insurance targeted towards low-income households has gained traction in many developing countries. However, there is limited evidence as to the effectiveness of these programs in countries where institutional constraints may limit participation by the eligible population. This paper evaluates a recent health insurance initiative introduced in Pakistan and discusses whether eligibility for the programme improves maternal health seeking behaviour. The Prime Minister National Health Program provides free insurance coverage to low-income families. The programme is in the early phases of implementation and has, since 2016, only been rolled out in a few eligible districts within the country. This allows for a comparison of eligible households in districts where the programme has been introduced to those that are eligible to receive insurance at a future date. Using repeated cross-sectional data from multiple rounds of representative household survey, a difference-in-difference model has been estimated. Results show that at least for a specific beneficiary group (i.e. pregnant women), there has been a positive increase in utilization of hospital services. Furthermore, we provide evidence using mother fixed effects that the programme increased the likelihood of a child’s birth being documented. Since possession of a birth certificate can secure civic rights for a child, this is an unintended but positive outcome of the programme.

scholarly journals The relationship between urban and rural health insurance and the self-rated health of migrant workers in Southwest China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dingying Fu ◽  
Li Liu ◽  
Xuewen Zhang ◽  
Chuan Yu ◽  
Huiqiang Luo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Rural Health ◽  
Urban Health ◽  
Migrant Workers ◽  
Southwest China ◽  
The Self ◽  
Self Rated Health ◽  
Basic Medical Insurance ◽  
The Relationship ◽  
Basic Medical

Abstract Background Following health insurance reforms, China’s health care system has made great progress. However, there are still huge differences between the urban and rural health insurance systems. For rural-to-urban migrant workers, there may be differences in the use of urban and rural health insurance to improve their health status. This study aimed to determine whether any disparities exist in the relationship between urban and rural health insurance and the self-rated health (SRH) of migrant workers in Southwest China from the perspective of urban and rural segmentation. Methods Using cross-sectional survey data on Southwest China in 2016, a representative data sample drawn from 8507 migrant workers was analysed. An ordinary least squares (OLS) model and instrumental variable (IV) estimation were used to analyse the relationship between urban and rural health insurance and the SRH of migrant workers. Results Using the IV method to control the endogeneity problems associated with health insurance, this study found that there are differences in the relationship between urban and rural health insurance and the SRH of migrant workers. Urban health insurance is associated with significant improvements in the SRH of migrant workers. Compared with the NRCMS, participating in urban health insurance, including urban employee basic medical insurance (UEBMI) and urban resident basic medical insurance (URBMI), increases the likelihood of migrant workers having better SRH. Conclusions There are disparities in the relationship between urban and rural health insurance and the SRH of migrant workers in China. Compared to rural health insurance, urban health insurance has a more positive correlation with the health of migrant workers. Our study shows that it is necessary to integrate urban and rural health insurance to promote social equity.

Love and Intimacy as Vulnerability to HIV Infection: A Case Study of MSM

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Archana Kaushik
Keyword(s):  
Hiv Infection ◽  
Cultural Values ◽  
Sexual Behaviors ◽  
Sex Workers ◽  
Sexual Minorities ◽  
Suicide Attempts ◽  
Service Providers ◽  
Structural Barriers ◽  
Health Seeking ◽  
Sex With Men

Sexual minorities are among the most marginalized groups in the society. Sero-positivity accentuates social exclusion among the sexual minorities. The paper aims to appraise the factors that make Men who have Sex with Men (MSM) vulnerable to HIV infection and influence their health seeking behaviors. It highlights two major domains socio-cultural and interpersonal variables. Qualitative in nature and based on ten in-depth case studies of HIV infected MSM, the study is located in Delhi, India. Factors such as age, marital status, child sexual abuse, multiple sex partners, are crucial in influencing their vulnerability. Socio-cultural milieu puts structural barriers restricting integration of MSM in the society. Cultural values do not allow talking about sex, which hampers healthy sexual behaviors. Exhibiting aggression, sexual violence, visiting sex-workers etc. are considered as important aspects to prove manhood. At the interpersonal level, possessiveness, betrayal, infidelity, heartbreak, strong emotional whirlpool when love-relations go incongruent, all takes a heavy toll of their mental and physical health. These variables socially exclude the sexual minorities from the mainstream life. Findings show positive (disclosing to family, abstinence, spiritual growth) and negative (suicide-attempts, drug-use) ways of coping among the MSM respondents. Critical areas of concern for service-providers while planning interventions for empowering people with sexual minority are delineated.

scholarly journals The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215338
Author(s):  
Jamilah Meghji ◽  
Stefanie Gregorius ◽  
Jason Madan ◽  
Fatima Chitimbe ◽  
Rachael Thomson ◽  
...  
Keyword(s):  
Low Income ◽  
Disease Onset ◽  
Treatment Completion ◽  
Well Being ◽  
Urban Setting ◽  
Financial Strain ◽  
First Episode ◽  
Health Seeking ◽  
Tb Treatment

BackgroundMitigating the socioeconomic impact of tuberculosis (TB) is key to the WHO End TB Strategy. However, little known about socioeconomic well-being beyond TB-treatment completion. In this mixed-methods study, we describe socioeconomic outcomes after TB-disease in urban Blantyre, Malawi, and explore pathways and barriers to financial recovery.MethodsAdults ≥15 years successfully completing treatment for a first episode of pulmonary TB under the National TB Control Programme were prospectively followed up for 12 months. Socioeconomic, income, occupation, health seeking and cost data were collected. Determinants and impacts of ongoing financial hardship were explored through illness narrative interviews with purposively selected participants.Results405 participants were recruited from February 2016 to April 2017. Median age was 35 years (IQR: 28–41), 67.9% (275/405) were male, and 60.6% (244/405) were HIV-positive. Employment and incomes were lowest at TB-treatment completion, with limited recovery in the following year: fewer people were in paid work (63.0% (232/368) vs 72.4% (293/405), p=0.006), median incomes were lower (US$44.13 (IQR: US$0–US$106.15) vs US$72.20 (IQR: US$26.71–US$173.29), p<0.001), and more patients were living in poverty (earning <US$1.90/day: 57.7% (211/366) vs 41.6% (166/399), p<0.001) 1 year after TB-treatment completion compared with before TB-disease onset. Half of the participants (50.5%, 184/368) reported ongoing dissaving (use of savings, selling assets, borrowing money) and 9.5% (35/368) reported school interruptions in the year after TB-treatment completion. Twenty-one participants completed in-depth interviews. Reported barriers to economic recovery included financial insecurity, challenges rebuilding business relationships, residual physical morbidity and stigma.ConclusionsTB-affected households remain economically vulnerable even after TB-treatment completion, with limited recovery in income and employment, persistent financial strain requiring dissaving, and ongoing school interruptions. Measures of the economic impact of TB disease should include the post-TB period. Interventions to protect the long-term health and livelihoods of TB survivors must be explored.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

scholarly journals Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

2021 ◽  
Vol 58 ◽  
pp. 004695802110281
Author(s):  
Minsung Sohn ◽  
Minsoo Jung ◽  
Mankyu Choi
Keyword(s):  
Socioeconomic Status ◽  
Health Insurance ◽  
Health Status ◽  
Regression Models ◽  
Private Health Insurance ◽  
Public And Private ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Interaction Terms ◽  
Healthcare Coverage

To investigate the effects of public and private health insurance on self-rated health (SRH) status within the National Health Insurance (NHI) system based on socioeconomic status in South Korea. The data were obtained from 10 867 respondents of the Korea Health Panel (2008-2011). We used hierarchical panel logistic regression models to assess the SRH status. We also added the interaction terms of socioeconomic status and type of health insurance as moderators. Medical aid (MA) recipients were 2.10 times more likely to have a low SRH status than those who were covered only by the NHI, even though the healthcare utilization was higher. When the interaction terms were included, those not covered by the NHI and had completed elementary school or less were 16.59 times more likely to have a low SRH status than those covered by the NHI and had earned a college degree or higher. Expanding healthcare coverage to reduce the burden of non-payment and unmet use to improve the health status of MA beneficiaries should be considered. Particularly, the vulnerability of less-educated groups should be focused on.

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