Experiences of discrimination and self-reported health in Chinese migrants: a structural equation model
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RESEARCH ARTICLE
Open Access
Experiences of discrimination and selfreported health in Chinese migrants: a structural equation model Lian Tong1,2,3* and Ichiro Kawachi2
Abstract Background: Many migrants suffer from discrimination and poor health in China. We sought to examine the associations between experiences of discrimination and self-reported health among internal migrants in China, as well as the mediators of social integration and perceived stress. Methods: The data was obtained from a specific survey of migrants, as a part of the National Health and Family Planning Dynamic Monitoring for Migrants conducted in 2014. A total of 15,999 migrants aged 15 to 59 years were recruited by a stratified, multistage clustered sampling procedure in eight Chinese cities. Structural Equation Modeling (SEM) was conducted. Results: The results indicated that experiences of discrimination were associated with worse self-reported health (β = − 0.32, P < 0.001), less social integration (β = − 0.25, P < 0.001), as well as higher perceived stress (β = 0.21, P < 0.01). Both objectively measured socioeconomic status (β = 0.21, P < 0.001) and subjective social status (β = 0.21, P < 0.01) had significantly positive correlations with self-reported health. Conclusions: The discrimination, social exclusion and perceived stress experienced by migrants have significant implications on their health. Keywords: Migrants, Discrimination, Social integration, Stress, Health
Background With rapid urbanization, the Chinese population is currently witnessing an unprecedented level of mass internal migration. According to a Migrant Population Development report, China’s internal migrant population had reached 245 million in 2016, comprising more than a sixth of the nation’ s total population [1]. The nature of such intercity migration involve migrants from both rural areas (rural migrants) and from other urban areas (urban migrants). While internal migrants endow an indispensable * Correspondence: [email protected] 1 Department of Maternal and Child Health, School of Public Health, Fudan University, Shanghai, China 2 Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA Full list of author information is available at the end of the article
contribution towards rapid economic development in China, they remain socially and economically disadvantaged in various domains of life [2]. Numerous studies have revealed that Chinese internal migrants are at elevated risk for physical and mental health problems [3, 4]. Several possible factors contributing to migrants’ debilitating health have been proposed, including experiences of discrimination, acculturative stress, and economic hardships [5]. However, the underlying mechanism behind the association of internal migration and possible deteriorations in health remains unclear. Due to significant disparities in culture, economic development, and social environments across Chinese regions, a large number of migrants, especially rural-to-urban workers experie
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