Effect Of Social Capital On Health Service Use In Rural-to-urban Migrant Workers

BackgroundAccording to the statistical bulletin of the People’s Republic of China on national economic and social development issued by the State Bureau of Statistics in 2017,the total number of rural-to-urban migrant workers reached 28.65 million in 2017.According to incomplete statistics,there are 2 million 30 thousand rural-to-urban migrant workers in Ji’nan.Although the State Council has issued a series of opinions to strengthen the work of rural-to-urban migrant workers,and Jinan City has made great efforts to provide comprehensive services for rural-to-urban migrant workers,but due to various factors,rural-to-urban migrant workers can not fully enjoy the social security system at this stage,the using of health services is lower than the normal level of ordinary residents.According to past studies,social capital is positively related to health and health services accessibility.ObjectiveTo analyze social capital and health service use behavior of the rural-to-urban migrant workers of Jinan,and the effect of social capital on health service use in rural-to-urban migrant workers,so as to put forward some targeting policies.MethodsThe data of this study consist of field survey data and second-hand materials.Second-hand materials are rural-to-urban migrant workers social capital policies through the search engine.The field survey have been done by the Medical volunteers.According to the level of economic development,Lixia District,Shizhong District and Huaiyin District of Jinan were selected as the research sites.Two construction sites and two restaurants were randomly selected from each of the three districts then do the cluster sampling.401 migrant workers were investigated.After contacting with the head of construction site and the restaurant,a volunteer service team was formed to enter the investigation site,provide physical examination services and complete the investigation.The general demographic characteristics,economic status,living and working conditions,social capital status,and health service utilization status of rural-to-urban migrant workers were collected and the interviewed with key persons has been done.Dates were analyzed by quantitative and qualitative analysis methods.Quantitative analysis methods include descriptive statistical analysis,single-factor statistical analysis and logistic regression analysis.The qualitative analysis methods is summarize the interview dates for the research objectives.ResultsAmong the 401 rural-to-urban migrant workers,on the general demographic characteristics,252 were males,accounting 62.8%,84.3%were under 50 years old,75.3%were married,92.5%of them were only high school qualification or lower level,214 were construction workers,only 12.7%had the urban social insurance.On the living and working conditions,41.9%of the rural-to-urban migrant workers smoked,40.9%drank alcohol,71.6%felt healthy or better,the average working hours was 9.4 among one day and the average working days was 27.5 among one month,the average time from working place to medical institutions was 19.1 minutes.On the economic situations,the average household incomes of rural-to-urban migrant workers in 2015 was 70000 yuan,of which the average personal income was 42100 yuan,and the average household expenditure of rural-to-urban migrant workers in 2015 was 38600 yuan,of which the average food expenditure was 20100 yuan.On the social capital variables,the average scores of the objective social support,subjective social support,utilization of social support and total social support were 5.4,23.2,7.4 and 35.9 respectively.The number of close relatives was 3.4,and the number of close friends was 3.1.84.04%of the surveyed rural-to-urban migrant workers often chat with their families and friends.In the past year,75.8%of the rural-to-urban migrant workers participated collective activities less than three times,28.4%were always discussed with other persons when they had personal problems,18.2%were always been take care when they were sicked,and 80.3%of the rural-to-urban migrant workers work were introduced by their relatives or workers.Of the 401 rural-to-urban migrant workers,49 felt unwell before the two weeks of investigation account for 12.2%.Among them,23 rural-to-urban migrant workers took medical action account for 46.9%.Among the 23 rural-to-urban migrant workers,9 persons were seeing the doctor,the two-week morbidity rate was 2.2%,The two week consultation rate of patients was 18.4%.By the comparing analyze between the health services using group and the non-health services using group,the differences on general demographic variables and economic variables had no statistical significance.On the living and working condition variables,The proportion of smoking and The proportion of drilking were 21.8%and 26.1%respectively on the health services using group,lower than 61.5%and 53.9%of the non-health services using group.The difference between the two variables had statistically significant.On the social capital variables,the average score of objective social support,subjective social support,utilization of social support and total social support was 6.1,31.4,9.1 and 31.5 respectively,which were higher than 4.5,20.9,6.8,22.2 respectively on the non-health services using group.The four variables differences between the health services using group and the non-health services using group had statistically significant.The variables which contained the average number of close relatives,the average number of close friends,the proportion of chatting with friends high frequency,the proportion of discussing with other person when had personal questions,and the proportion of been take care when sicked were 4.0,3.2,73.9%,30.4%and 13.0%respectively,higher than 2.7,2.2,46.2%,11.5%,7.7%of the non-health services using group.Except the variable the proportion of discussing with other person when had personal questions,other four variables difference between the two group had statistically significant.The logistic regression analysis between the two group found.The higher of the subjective social scores,the more possibility the patients using the healthy services(OR=0.375).The comparing analyze between the see doctor group and the non-see doctor group found,only the difference of variables which were the average time from the work place to the medical institutions and the score of subjective social support had statistically significant.The number of the two variable were 18.5 minutes and 30.7 respectively of two-week see doctor group and the number of the two variable were 27.3 and 24.7 of two-week none see doctor group.Conclusion and suggestionsThe study found that the general demographic of rural-to-urban migrant workers in Jinan city is basically consistent with the monitoring data of rural-to-urban migrant workers in China.Most of them were young.And the work intensity of rural-to-urban migrant workers was higher.The proportion of social insurance was not high.Rural-to-urban migrant workers did not value there healthy.The social capital did not optimistic.The healthy serves using did not optimistic too.The healthy services using group did better than the non healthy services using group at no smoking,no drinking,and they have better social support and better networking and reciprocity.The factors influence see doctor are the average time from the work place to the medical institutions and the score of subjective social support.Based on the conclusions of this study,the following recommendations are suggested.1)Strengthen the labor security of rural-to-urban migrant workers,improve the social insurance coverage rate,protect the legitimate rights2)strengthen the health education for rural-to-urban migrant workers and enhance the health consciousness.3)Encourage the development of social organizations for rural-to-urban migrant workers,expand their interpersonal network,carry out social activities for them,and enhance their social capital.4)Balancing health resources reasonably,setting up medical and health service centers in larger rural-to-urban migrant workers’ gathering areas,increasing the availability of medical and health services for them,and improving the health equity level of them.