Health status and access to health care of migrant workers in China
Health status and access to health care of migrant workers in China
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DOI：
10.1177/003335490812300211
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发表时间：
2008-03-01
影响因子：
3.3
通讯作者：
Mei, Wang Hong
中科院分区：
文献类型：
--
作者：
Hesketh, Therese;Jun, Ye Xue;Mei, Wang Hong
目标。我们探讨了中国农村流动人口的生活和工作条件、健康状况和医疗保健获取情况，并将其与永久农村和城市居民进行了比较。方法。 2004年，对中国东部浙江省的1,958名城市工人、1,909名农村工人和4,452名农民工进行了问卷调查。从农民工和城市工人中采集了人类免疫缺陷病毒（HIV）和梅毒的血液样本。结果。农民工很年轻，工作时间很长，生活条件很简陋。 19% 的人拥有某种形式的健康保险，26% 的人有权享受有限的病假工资，而城市工人的这一比例分别为 68% 和 66%。在控制年龄和教育程度后，移民的自评健康状况最好，报告的急性疾病、慢性疾病和残疾最少。农民工和城镇工人均未发现艾滋病病毒感染者。然而，15 名城市工人（0.68%，95% 置信区间 [Cl] 0.35, 1.02）和 20 名流动人口（0.48%，95% CI 0.26, 0.66，p=0.06）梅毒检测呈阳性。去年，城市高昂的医疗费用成为 15% 的农民工和 8% 的城市工人获得医疗服务的障碍。 47%的流动人口不愿意缴纳医疗保险。结论。这些移民展现了“健康移民效应”。然而，恶劣的生活条件和对健康的忽视可能使流动人口长期健康状况不佳。由于医疗保险计划在可预见的未来仍将受到限制，因此应重点关注为未参保的农民工和城市贫民提供负担得起的医疗服务。
Objectives. We explored living and working conditions, health status, and health-care access in Chinese rural-to-urban migrants and compared them with permanent rural and urban residents.Methods. A questionnaire was administered to 1,958 urban workers, 1,909 rural workers, and 4,452 migrant workers in Zhejiang Province, Eastern China, in 2004. Blood samples for human immunodeficiency virus (HIV) and syphilis were taken from the migrant and urban workers.Results. Migrants were young, worked very long hours, and their living conditions were very basic. Nineteen percent had some form of health insurance and 26% were entitled to limited sick pay compared with 68% and 66%, respectively, for urban workers. Migrants had the best self-rated health and reported the least acute illness, chronic disease, and disability, after controlling for age and education. There were no HIV infections detected in either the migrant or urban workers. However, 15 urban workers (0.68%, 95% confidence interval [Cl] 0.35, 1.02) and 20 migrants (0.48%, 95% CI 0.26, 0.66, p=0.06) tested positive for syphilis. The high cost of health care in the city was a barrier to health-care access in the last year for 15% of the migrants and 8% of the urban workers. Forty-seven percent of the migrants were unwilling to make contributions to health insurance.Conclusions. These migrants demonstrated the "healthy migrant effect." However, poor living conditions and inattention to health may make migrants vulnerable to poor long-term health. Because health insurance schemes will remain limited for the forseeable future, attention should focus on providing affordable health care to both uninsured migrants and the urban poor.