Health of Migrant Factory Workers in Shenzhen, China: Mobility, Self-reported Health and Healthcare Utilisation.

摘要

Internal migration has become a more and more prominent societal and economic phenomenon in mainland China and Shenzhen is one of the most frequently selected locales for rural-urban migrants. This thesis aims 1) to assess health status and to describe patterns of healthcare utilisation amongst migrant factory workers, 2) to follow up the sample over 6 months to understand the impact of health insurance participation on health service utilisation and health expenditures, and 3) to assess the implications for health policies.;Questionnaire surveys were used in a representative sample from factory workers in Shenzhen. The baseline and follow-up studies were conducted during April to December 2009 in Shenzhen, China.;Results show that migrant factory workers in Shenzhen represent a broad combination of geographic complexity and have special socio-demographic characteristics. The results have specified some association between self-rated health and SES, and major correlates of depressive symptoms amongst migrant factory workers. The seroprevalence of antibodies to rubella amongst female migrant workers is too low to provide immunity in the population. Sex, age, education, sleeping hours and internet use were associated with being a current smoker. The crude two-week illness rate was 21.6%. More than half and 11.6% of sick migrant workers chose self-treatment or neglected their sickness, respectively. Self-perception of disease being not severe, lack of time and economic difficulties were the major explanations for not utilizing professional care.;Cohort study found that being insured and having longer exposure of health insurance significantly increased migrant workers' likelihood to use professional healthcare in Shenzhen, decreased their total occasions of professional healthcare utilisation, and were causally associated with a decrease in professional healthcare expenditures which were paid out-of-pocket in the 6 months of follow-up by migrant workers.;Our results suggest that health strategies should take into consideration the specific health needs of the highly mobile factory migrant workers. Through insurance coverage, local health authorities may be able to help improve rural-urban migrant workers' health by improving services at community level, and incorporating psychological care in the services provided by Community Health Centres.