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Self-reported Symptoms of Depression Among Chinese Rural-to-Urban Migrants and Left-Behind Family Members.
JAMA Netw Open. 2019 05 03; 2(5):e193355.JN

Abstract

Importance

There were an estimated 247 million rural-to-urban migrant workers in China in 2016, yet at a national level, there is scant evidence on the association of migration with mental health among migrants and their left-behind family members.

Objective

To examine the association of rural-to-urban migration with symptoms of depression among migrants and left-behind family members aged 45 years and older.

Design, Setting, and Participants

Using representative cross-sectional data of 14 332 middle-aged and older adults from the 2015 China Health and Retirement Longitudinal Survey, regression analyses were conducted to examine the association of depressive symptoms with rural-to-urban migration status in urban areas and the association of depressive symptoms with left-behind status in rural areas. The statistical analysis was performed from January to August 2018.

Exposures

Migration status (defined as having a rural hukou [household registration record]) in urban areas and left-behind status (defined as having a spouse or child living in another area) in rural areas.

Main Outcomes and Measures

Depressive symptoms measured on the 10-item Center for Epidemiological Studies Depression (CES-D-10) scale.

Results

A total of 14 332 middle-aged and elderly participants (mean [SD] age, 59.84 [9.51] years; 7394 [51.6%] women) were included, of whom 4404 (30.7%) lived in urban areas and 9928 (69.3%) lived in rural areas. In urban areas, 1607 participants (36.2%) were rural-to-urban migrants, and the remaining 2797 participants (72.8%) were local residents. In rural areas, 3405 participants (34.3%) were left-behind family members, and the remaining 6523 participants (65.7%) were not. Compared with urban residents, rural-to-urban migrants had higher CES-D-10 scores after adjustment for covariates (β = 0.74; 95% CI, 0.08-1.40; P = .03; standard errors clustered at the household level henceforth). Compared with intact-family rural residents, left-behind spouses had higher CES-D-10 scores after adjustment for covariates (β = 0.54; 95% CI, 0.05-1.03; P = .03).

Conclusions and Relevance

Rural-to-urban migration in China was associated with poor mental health for migrants and their left-behind spouses. Short-term policies, such as building community social facilities, may prove effective, but long-term solutions should address issues related to economic and social exclusions and the lack of a social security system in rural China.

Authors+Show Affiliations

Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.Institute of Health Economics, Edmonton, Alberta, Canada.Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31050782

Citation

Nikoloski, Zlatko, et al. "Self-reported Symptoms of Depression Among Chinese Rural-to-Urban Migrants and Left-Behind Family Members." JAMA Network Open, vol. 2, no. 5, 2019, pp. e193355.
Nikoloski Z, Zhang A, Hopkin G, et al. Self-reported Symptoms of Depression Among Chinese Rural-to-Urban Migrants and Left-Behind Family Members. JAMA Netw Open. 2019;2(5):e193355.
Nikoloski, Z., Zhang, A., Hopkin, G., & Mossialos, E. (2019). Self-reported Symptoms of Depression Among Chinese Rural-to-Urban Migrants and Left-Behind Family Members. JAMA Network Open, 2(5), e193355. https://doi.org/10.1001/jamanetworkopen.2019.3355
Nikoloski Z, et al. Self-reported Symptoms of Depression Among Chinese Rural-to-Urban Migrants and Left-Behind Family Members. JAMA Netw Open. 2019 05 3;2(5):e193355. PubMed PMID: 31050782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-reported Symptoms of Depression Among Chinese Rural-to-Urban Migrants and Left-Behind Family Members. AU - Nikoloski,Zlatko, AU - Zhang,Anwen, AU - Hopkin,Gareth, AU - Mossialos,Elias, Y1 - 2019/05/03/ PY - 2019/5/4/entrez PY - 2019/5/6/pubmed PY - 2020/3/3/medline SP - e193355 EP - e193355 JF - JAMA network open JO - JAMA Netw Open VL - 2 IS - 5 N2 - Importance: There were an estimated 247 million rural-to-urban migrant workers in China in 2016, yet at a national level, there is scant evidence on the association of migration with mental health among migrants and their left-behind family members. Objective: To examine the association of rural-to-urban migration with symptoms of depression among migrants and left-behind family members aged 45 years and older. Design, Setting, and Participants: Using representative cross-sectional data of 14 332 middle-aged and older adults from the 2015 China Health and Retirement Longitudinal Survey, regression analyses were conducted to examine the association of depressive symptoms with rural-to-urban migration status in urban areas and the association of depressive symptoms with left-behind status in rural areas. The statistical analysis was performed from January to August 2018. Exposures: Migration status (defined as having a rural hukou [household registration record]) in urban areas and left-behind status (defined as having a spouse or child living in another area) in rural areas. Main Outcomes and Measures: Depressive symptoms measured on the 10-item Center for Epidemiological Studies Depression (CES-D-10) scale. Results: A total of 14 332 middle-aged and elderly participants (mean [SD] age, 59.84 [9.51] years; 7394 [51.6%] women) were included, of whom 4404 (30.7%) lived in urban areas and 9928 (69.3%) lived in rural areas. In urban areas, 1607 participants (36.2%) were rural-to-urban migrants, and the remaining 2797 participants (72.8%) were local residents. In rural areas, 3405 participants (34.3%) were left-behind family members, and the remaining 6523 participants (65.7%) were not. Compared with urban residents, rural-to-urban migrants had higher CES-D-10 scores after adjustment for covariates (β = 0.74; 95% CI, 0.08-1.40; P = .03; standard errors clustered at the household level henceforth). Compared with intact-family rural residents, left-behind spouses had higher CES-D-10 scores after adjustment for covariates (β = 0.54; 95% CI, 0.05-1.03; P = .03). Conclusions and Relevance: Rural-to-urban migration in China was associated with poor mental health for migrants and their left-behind spouses. Short-term policies, such as building community social facilities, may prove effective, but long-term solutions should address issues related to economic and social exclusions and the lack of a social security system in rural China. SN - 2574-3805 UR - https://www.unboundmedicine.com/medline/citation/31050782/Self_reported_Symptoms_of_Depression_Among_Chinese_Rural_to_Urban_Migrants_and_Left_Behind_Family_Members_ L2 - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2019.3355 DB - PRIME DP - Unbound Medicine ER -