https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)61880-1.pdf

Early appraisal of China's huge and complex health-care reforms

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)61878-3.pdf

Urbanisation and health in China

Summary Cancer is one of the major non-communicable diseases posing a threat to world health. Unfortunately, improvements in socioeconomic conditions are usually associated with increased cancer incidence. In this Commission, we focus on China, India, and Russia, which share rapidly rising cancer incidence and have cancer mortality rates that are nearly twice as high as in the UK or the USA, vast geographies, growing economies, ageing populations, increasingly westernised lifestyles, relatively disenfranchised subpopulations, serious contamination of the environment, and uncontrolled cancer-causing communicable infections. We describe the overall state of health and cancer control in each country and additional specific issues for consideration: for China, access to care, contamination of the environment, and cancer fatalism and traditional medicine; for India, affordability of care, provision of adequate health personnel, and sociocultural barriers to cancer control; and for Russia, monitoring of the burden of cancer, societal attitudes towards cancer prevention, effects of inequitable treatment and access to medicine, and a need for improved international engagement.

/pdf/challenges-to-effective-cancer-control-in-china-india-and-2ymujc95yg.pdf

Challenges to effective cancer control in China, India, and Russia

Internal migration and health: Re-examining the healthy migrant phenomenon in China

In the last 30 years, China has undergone one of the largest rural-to-urban migrations in human history, with many children left behind because of parental migration. We present a meta-analytic review of empirical studies on Chinese children's rural-to-urban migration and on rural children left behind because of parental migration. We examine how these events relate to children's emotional, social, and academic developmental outcomes. We include publications in English and in Chinese to uncover and quantify a part of the research literature that has been inaccessible to most Western scholars in the field of child and family studies. Overall, both migrant children and children left behind by migrant parents in China show significantly less favorable functioning across domains than other Chinese children. It appears that, similar to processes found in other parts of the world, the experience of economic and acculturation stress as well as disrupted parent-child relations constitute a risk for nonoptimal child functioning in the Chinese context. Further, we found evidence for publication bias against studies showing less favorable development for migrant children and children left behind. We discuss the results in terms of challenges to Chinese society and to future empirical research on Chinese family life.

http://journals.sagepub.com/doi/pdf/10.1177/1745691615600145

Child Development in the Face of Rural-to-Urban Migration in China: A Meta-Analytic Review.

As one of the most populous metropolitan areas in the Pearl River Delta of South China, Shenzhen attracts millions of migrant workers annually. The objectives of this study were to compare health needs, self-reported health and healthcare utilisation of insured and uninsured migrant workers in Shenzhen, China, where a new health insurance scheme targeting at migrant workers was initiated. A cross-sectional survey using multi-staged sampling was conducted to collect data from migrant factory workers. Statistical tests included logistic regression analysis were used. Among 4634 subjects (96.54%) who responded to the survey, 55.11% were uninsured. Disease patterns were similar irrespective of insurance status. The uninsured were more likely to be female, single, younger and less educated unskilled labourers with a lower monthly income compared with the insured. Out of 1136 who reported illness in the previous two weeks, 62.15% did not visit a doctor. Of the 296 who were referred for inpatient care, 48.65% did not attend because of inability to pay. Amongst those who reported sickness, 548 were insured and 588 were uninsured. Those that were insured, and had easier access to care were more likely to make doctor visits than those who were uninsured. Health care utilisation patterns differ between insured and uninsured workers and insurance status appears to be a significant factor. The health insurance system is inequitably distributed amongst migrant workers. Younger less educated women who are paid less are more likely to be uninsured and therefore to pay out of pocket for their care. For greater equity this group need to be included in the insurance schemes as they develop.

/pdf/health-care-utilisation-amongst-shenzhen-migrant-workers-4p9y0oeh1d.pdf

Hanping Jiang

Papers

Health care utilisation amongst Shenzhen migrant workers: does being insured make a difference?