Li, Yan
(2010)
Constraints on health and health services access of rural-to-urban migrants in China: a case of Dengcun village of Beijing.
PhD thesis, University of Nottingham.
Abstract
China is experiencing a dramatically increasing process of rural-urban migration, which is almost parallel with the phenomenal economic growth and development in China in the last decades. Given the massive scale of rural-urban migration in China, the health services access and health constraints not only matter to rural-urban migrants but also have important implications for broad public health concerns. However, this issue has not been paid enough attention in academic research.
This study focuses on the multifaceted reality of health constraints and health services access among migrants by originally exploring the social strata, social networks, and the understanding of health and health services among migrants. The research questions are stated as follows: What constraints and difficulties do migrants face with respect to their health and health services access? Is there a hierarchical structure in health services access and medical treatment access among migrants? When there is a shortage of financial resources, do they resort to informal social support (such as informal social networks/ guanxi) to obtain help and why? What are their understanding and experience of health and why?
Furthermore, this study investigates the health constraints and health services access of rural-urban migrants in the absence of equal social protection by the government. By conducting 36 qualitative interviews in Dengcun Village, a migrant community in Beijing, China, this paper: (1) Investigates issues concerning environmental health risks of migrants, their health seeking behaviours, and the constraints they encountered in accessing health services with respect to the social strata among migrants. It argues that the main obstacles to access health services are not only the shortage of financial resources among rural-urban migrants, but also lie in the institutional blindness regarding health security provision, rural-urban dualism and the household registration system in China. (2) Highlights the key function that social networks play in health and health services access among migrants in China, which has rarely been discussed in previous studies. Examines the range of social networks among migrants, from which they can acquire support, including financial and spiritual, when they are dealing with health problems. The study argues that social networks resemble a double-edged sword to rural-urban migrants in terms of health care access. The fact that migrants lack savings may not be the sole and essential reason for their extreme vulnerability in times of illness. Some migrants, who are in financial difficulties though, may have some assistance, including financial support and emotional support from their social networks. However, on the other hand, the assistance from social networks on their health and heath care access is limited, not only because their social networks is limited, but because the social networks should not bear the responsibility to support health services access of migrants, similar to or more than the state and migrants' employers. (3) Discusses the understanding of health among migrants, and further analyses that although many migrants have not formed proper understanding of the connotation of health and have limited knowledge of health, prime responsibility should not be put on the migrants because their poor understanding of health mainly results from their rural perspective while health and health services access depend on the social-economic environment in which they live and work.
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