Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinants
Abstract Background Internal migrants in China have long been at a disadvantage in terms of access to publicly financed services, as well as the utilization of public health services. The aim of the study was to examine inequities in the use of basic public health services between internal migrants...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | International Journal for Equity in Health |
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| Online Access: | https://doi.org/10.1186/s12939-024-02371-5 |
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| author | Xiaohui Zhai Zhongliang Zhou Sha Lai Jieyu Wang Yaxin Zhao Guanping Liu Zhichao Wang Hongbin Fan Yan Zhuang Dantong Zhao Dan Cao Peter C. Coyte |
| author_facet | Xiaohui Zhai Zhongliang Zhou Sha Lai Jieyu Wang Yaxin Zhao Guanping Liu Zhichao Wang Hongbin Fan Yan Zhuang Dantong Zhao Dan Cao Peter C. Coyte |
| author_sort | Xiaohui Zhai |
| collection | DOAJ |
| description | Abstract Background Internal migrants in China have long been at a disadvantage in terms of access to publicly financed services, as well as the utilization of public health services. The aim of the study was to examine inequities in the use of basic public health services between internal migrants and the local population and estimate the factors that contributed to inequity in use. Methods The data for this study was derived from the 2017 wave of the China Migrants Dynamic Survey. Basic public health services utilization was measured by the establishment of health records, health education and chronic disease management. We performed multivariable logistic regressions to examine inequities in the utilization of basic public health services between locals and internal migrants, and Oaxaca-Blinder decomposition was used to explore possible explanations for such inequities between the two groups. Results A total of 27,998 cases were included in the analysis. We found that the utilization rates for establishment of health records, health education and chronic disease management among internal migrants were 71.3%, 49.2% and 65.7% lower than their local counterparts, respectively. The decomposition results indicated that the inequities in the establishment of health records between locals and internal migrants were mainly explained by whether people had heard of the National Basic Public Health Services Program (NBPHSP) (17.67%) and by health insurance (5.99%). The contributors to the inequities in health education between locals and internal migrants were community involvement (14.71%) and whether people had heard of the NBPHSP (13.89%). The main factors contributing to the difference in utilization of chronic disease management between the two groups were whether people had heard of the NBPHSP (14.49%) and community involvement (8.43%). Conclusions To reduce inequities in the utilization of basic public health services between locals and internal migrants, measures need to be taken to improve knowledge about the basic public health services and to help migrants integrate into the local community. |
| format | Article |
| id | doaj-art-db4a6ee2e37c47d0b2367b9567cae2e8 |
| institution | Kabale University |
| issn | 1475-9276 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj-art-db4a6ee2e37c47d0b2367b9567cae2e82025-01-12T12:12:15ZengBMCInternational Journal for Equity in Health1475-92762025-01-0124111410.1186/s12939-024-02371-5Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinantsXiaohui Zhai0Zhongliang Zhou1Sha Lai2Jieyu Wang3Yaxin Zhao4Guanping Liu5Zhichao Wang6Hongbin Fan7Yan Zhuang8Dantong Zhao9Dan Cao10Peter C. Coyte11School of Public Health, Health Science Center, Xi’an Jiaotong UniversitySchool of Public Policy and Administration, Xi’an Jiaotong UniversitySchool of Public Policy and Administration, Xi’an Jiaotong UniversitySchool of Geography and Planning, Sun Yat-Sen UniversityCollege of Humanities & Social Development, Northwest A&F UniversitySchool of Public Policy and Administration, Xi’an Jiaotong UniversitySchool of Public Policy and Administration, Xi’an Jiaotong UniversitySchool of Public Policy and Administration, Xi’an Jiaotong UniversitySchool of Public Health, Health Science Center, Xi’an Jiaotong UniversitySchool of Humanities, Chang’an UniversitySchool of Public Administration, Xi’an University of Architecture and TechnologyInstitute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of TorontoAbstract Background Internal migrants in China have long been at a disadvantage in terms of access to publicly financed services, as well as the utilization of public health services. The aim of the study was to examine inequities in the use of basic public health services between internal migrants and the local population and estimate the factors that contributed to inequity in use. Methods The data for this study was derived from the 2017 wave of the China Migrants Dynamic Survey. Basic public health services utilization was measured by the establishment of health records, health education and chronic disease management. We performed multivariable logistic regressions to examine inequities in the utilization of basic public health services between locals and internal migrants, and Oaxaca-Blinder decomposition was used to explore possible explanations for such inequities between the two groups. Results A total of 27,998 cases were included in the analysis. We found that the utilization rates for establishment of health records, health education and chronic disease management among internal migrants were 71.3%, 49.2% and 65.7% lower than their local counterparts, respectively. The decomposition results indicated that the inequities in the establishment of health records between locals and internal migrants were mainly explained by whether people had heard of the National Basic Public Health Services Program (NBPHSP) (17.67%) and by health insurance (5.99%). The contributors to the inequities in health education between locals and internal migrants were community involvement (14.71%) and whether people had heard of the NBPHSP (13.89%). The main factors contributing to the difference in utilization of chronic disease management between the two groups were whether people had heard of the NBPHSP (14.49%) and community involvement (8.43%). Conclusions To reduce inequities in the utilization of basic public health services between locals and internal migrants, measures need to be taken to improve knowledge about the basic public health services and to help migrants integrate into the local community.https://doi.org/10.1186/s12939-024-02371-5Basic public health services utilizationInternal migrantsInequityBlinder–Oaxaca decompositionChina |
| spellingShingle | Xiaohui Zhai Zhongliang Zhou Sha Lai Jieyu Wang Yaxin Zhao Guanping Liu Zhichao Wang Hongbin Fan Yan Zhuang Dantong Zhao Dan Cao Peter C. Coyte Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinants International Journal for Equity in Health Basic public health services utilization Internal migrants Inequity Blinder–Oaxaca decomposition China |
| title | Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinants |
| title_full | Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinants |
| title_fullStr | Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinants |
| title_full_unstemmed | Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinants |
| title_short | Decomposing disparities in the utilization of basic public health services between locals and internal migrants in China: the role of social determinants |
| title_sort | decomposing disparities in the utilization of basic public health services between locals and internal migrants in china the role of social determinants |
| topic | Basic public health services utilization Internal migrants Inequity Blinder–Oaxaca decomposition China |
| url | https://doi.org/10.1186/s12939-024-02371-5 |
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