Relationship between social cohesion and basic public health services utilisation among Chinese internal migrants: a perspective of socioeconomic status differentiation

ABSTRACT

Social cohesion and socioeconomic status (SES) have been widely considered important factors influencing health services utilisation, but little is known about the association between social cohesion and health services utilisation across different SES groups. Based on a nationally representative survey, this study explores the influence of social cohesion on basic public health services utilisation in Chinese internal migrants at different SES levels. It is observed that objective and subjective cohesion forms have different effects on health record establishment and health education receipt. The positive effect of objective cohesion on health services utilisation is significantly larger than that of subjective cohesion, but two cohesion forms show similar effect sizes on health services utilisation among poor-SES migrants. With the promotion of SES, the effect size of objective cohesion gradually increases while that of subjective cohesion declines, showing a distribution of ‘scissors gap'. For basic public health services utilisation, migrants not only have the agency to receive but are constrained by their SES. For migrants with poor SES, strong structural constraints hinder the utilisation of basic public health services.

KEYWORDS:

• Internal migrants
• basic public health services
• social cohesion
• SES
• China

Disclosure statement

The author(s) declared no conflict of interest.

Notes

1 Chinese who migrate from their hometown to other counties/districts/cities for at least one month but without their hukou moving in are defined as internal migrants (excluding students, soldiers and people whose couples are not migrants) in CMDS2017.

2 The Cronbach's alpha of four objective social cohesion items was 0.494. Objective social cohesion was defined in a formative not a reflective way, so it was acceptable to have a low reliability (Ke et al., 2019).

3 There were nine health education types, including occupational disease prevention and treatment, AIDS prevention and treatment, reproductive health and contraception, tuberculosis prevention and treatment, smoking control, mental health, chronic disease prevention and treatment, maternal and child health, and self-rescue in public emergencies.

4 More details on SUR can be seen in Chen's book (Chen, 2014).

Additional information

Funding

This work was supported by The National Social Science Fund of China [grant number 21ZDA104]; The 70th Batch of China Postdoctoral Science Foundation [grant number 2021M701364].