Urban Floating Population Using Behavioral Research Health And Medical Services

Health is a basic right for human development. It is not only one of the primary goals of development, but also has great instrumental value on other dimensions of human development. However, in China, health has always been considered as a personal matter, and only the national public health service is the responsibility of the government. Because the government does not attach importance to personal health rights, the social indicators of development, such as health and environment, have lagged far behind the economic indicators of development, or even degradation during the the reform and opening up30years.The population health and health care issues during the process of economic and social transition can not only rely on the efforts of medical institutions. First, diseases in modern times are caused by biological, psychological, behavioral and social factors. Second, the exaggerating gaps of health and health care utilization between different social groups in China have become important problems in recent years.Nowadays researchers gradually give attention to a special group, migrants’ health. The internal and international evidence both show that migrants have better health than the general population where they migrated from or migrated to. However, because of the changes migrants experienced during the migration process, as well as the institutional obstacles of access to urban public service, migrants are always at high risks of health impairment. On the other hand, the migration behavior could affect other population groups. The health and health care issues of migrants, not only relate to the development of a special group caused by geographic movement, but also imply balancing urban and rural development, social stability and social equity. Studying migrants’health and health care issues has important practical significance.This dissertation studies the health and health care utilization problems of migrants, taking Shanghai as an example. Because of the rapid economic and social development, Shanghai has absorbed a great number of migrants. And as the first mainland city entering aging societies, Shanghai must continuously absorb migrant labour force. Therefore, Shanghai has urgent need to introduce employment, housing, education, health care and medical insurance policies for migrant group.This dissertation studies the determinants of health and health care utilization of micro individuals. By comparing the migrant and local native groups, we identify unique factors which affect migrants’health and health care utilization, but not the natives. Then, we propose relevant suggestions aiming at reducing migrants’health risks, improving their health status, and eliminating the health and health care utilization disparities between migrant and native groups. The specific objectives include:First, by systematically summarizing theoretical models and empirical studies on health and health care utilization, we establish the theoretical framework of our research. The behavioral model of health care utilization is our fundamental model, which defines variables and assumes the relationships between different variables. The social determinants of health explain the relations supposing by the behavioral model. The theories about the relations between behavioral and psychological factors and health further explain the mechanism between social determinants and health. The theories about migration and health help us understanding the relations between mobility characteristics and migrants’health status.Second, by researching historial documents, this dissertation analyzes the macro environment and institutional factors which influence miagrans’health and health care utilization, including the systems of household registration, housing, employment and medical insurance.Third, using the2008health survey of Shanghai migrants and natives, we studies the influence factors of health and health care utilization behavior. About the determinants of health, living conditions, including housing and neighbourhood environment, have more significance than socio-economic status. Because migrants’ living conditions are inferior comparing to the natives, it is important to draft public policies aiming at improving migrants’living conditions, especially shabby and crowded housing and neighbourhood conditions.Fourth, about the determinants of health care utilization, health insurance coverage is not a significant factor. Instead, the security level of health insurance plays an importance role in the economic burden of health and diseases. The migrant and native groups have very different types of health insurance. It is important to narrow down the gaps of security levels between different types of health insurance.Fifth, migrants’local and trans-local social networks have different influences on their health status and health care utilization behavior. The relative deprivation theory explains that migtants’local ties in the cities would make negative effects on their health, but their trans-local ties in the hometowns would benefit their health. On the contrary, migrants’local ties would promote their utilization of health care services because local ties help expanding migrants’access to health care services and providing information channels, while trans-local ties would hinder migrant’ using health care services. This finding implies that the key to promoting migrants’ integration into the urban societies are improving their relative socioeconomic status and helping migrants building beneficial social networks.