Study On Health Status And Health Service Utilization Of Migrants From The Yangtze River Three Gorge Reservoir Area

BackgroundThe Three Gorges Project of the Yangtze River is a magnificent project which will benefit future generations. It has Comprehensive benefits such as flood control, power generation, shipping and so on. The construction of the project faces problems such as conservation, ecological and environmental protection, migration, geological disasters, national security, especially migration. Migration is the key work of the project. Satisfied placement of the huge number of migrants is a prerequisite and a strong guarantee for the successful completion of the Three Gorges Project. Migration may cause psychological stress and increase social and cultural pressures, and then produce a lot of social problems and mental health problems, secondary to physical and mental illnesses. Study on health status and health service utilization of migrants has great significance to immigrants'resettlement.ObjectiveThis paper studies on the health status and health service utilization of migrants from the Yangtze River Three Gorge Reservoir Area. Select 16～79 year old Three Gorges migrants and non-immigrants in Shandong and Chongqing as subjects. Their health status and health service utilization such as the incidence and treatment of common diseases, the prevalence and treatment of chronic diseases, Quality of life, anxiety, depression, hospitalization were studied to examine the status and gap of migrants health and the shortage of health service utilization of them. Corresponding policy recommendations were advanced so that the aim of "migrating, social stability and economic prosperity" can be realized.MethodsBoth quantitative research and qualitative research methods were used. The cluster randomized sampling method was used to collect data. Quantitative research method and interview were used. The questionnaire included basic information of family members, two weeks prevalence, hospitalization cases over the past year and so on. The interviewees were leaders at all levels who responsible for resettlement work and understanding of migration and individual migrants. Semi-structured interviews were carried out. Quality Control was done and the data was twice enrolled. Excel 2007 and SPSS 16.0 for Windows were used to process and analyze the quantitative data. The main statistical analysis methods are Descriptive statistics,χ2 test, t test, analysis of variance, rank sum test and Logistic regression analysis and so on.Results1. This study investigated 758 migrants (45.6%),903 (54.4%) non-immigrant, a total of 1661 people in Shandong Province; 1241 migrants (62.4%),748 (37.6%) non-immigrant, a total of 1989 people in Chongqing City. Compared with local residents, migrants have lower education level, more workers out of county. Degree of life adjustment, satisfaction with relationships and income of migrants were worse.2. In Shandong Province, the morbidity of chronic diseases of migrants and non-migrants self-reported is 31.6% and 31.0% respectively. In Chongqing City, the morbidity of chronic diseases of migrants and non-migrants self-reported is 33.2% and 30.2% respectively. Age, degree of life adjustment and satisfaction with personal income are the main factors of chronic diseases of migrants. In Shandong Province, the two-week prevalence of migrants and non-migrants self-reported is33.2%,30.2%. In Chongqing City, the two-week prevalence of migrants and non-migrants self-reported is 15.7%,16.8%. Age, health care and personal income satisfaction are the main factors of the two-week prevalence of Shandong migrants. Age, occupation and personal income satisfaction are the main factors of the two-week prevalence of Chongqing migrants.Mental health indicators were more sensitive than physical health indicators. The SF-36 score of migrants was lower than local residents. Some of the migrants were anxiety or depression.3. The two week doctor visit rate of Shandong migrants, non-migrants and Chongqing migrants, non-migrants was 105.54‰,130.68‰,41.90‰,44.12‰. Self-treatment, mild sickness and economic difficulties are the main reasons for not using medical service. The hospitalization rate of Shandong migrants, non-migrants and Chongqing migrants, non-migrants is 47.49‰,42.09‰,85.41‰,60.16‰. The inpatient medical service expense of Shandong migrants, non-migrants and Chongqing migrants, non-migrants in recent one year is￥8599.44,￥9615.39,￥6272.36,￥6745.02 on average. Patients discharged not cured accounted for a certain percentage. The main reason is economic hardship.ConclusionThe health status and health service utilization of migrants is good in general. The difference of health indicators between migrants and non-migrants is not big. Similar to local residents, age and income are the main factors of health status and health service utilization of migrants. The difference of living custom adoption, satisfaction with interpersonal relationships and income between migrants and non-migrants is significant. Attention should be given to the local life adaptation of migrants, focus on the humane care of migrants, promoting the employment of migrants and income increase of immigration, improving the degree of life adjustment, and satisfaction with relationships with local residents. Then the health status and health service utilization of migrants will be improved.