From health advantage to health disadvantage: the epidemiological paradox in rural migrants

LI Jianmin1,2 WANG Ting1 SUN Zhishuai1

(1.School of Economics, Nankai University)
(2.Collaborative Innovation Center for China Economy, Nankai University)

【Abstract】Using the data from China Labor-force Dynamics Survey, this paper analyzed the change of health gap between rural migrants and urban residents as well as the mechanisms causing this change in the process of rural-urban migration. By applying the logit model and Fairlie non-linear decomposition method, we have the following findings. (1) There is a health loss mechanism during the rural-urban migration process in accordance with the “epidemiological paradox.” A transition is observed from health advantage into health disadvantage for rural migrants comparing to urban residents, suggesting that rural-urban migration has a negative impact on the health conditions of rural migrants. (2) The health maintenance factor and the health loss factor are important reasons for the health gap between rural migrants and urban residents, while the health loss factor is more important. Variables such as living environment, individual income deprivation, workload, and living with spouse have great contribution to the health gap. (3) The changing trend of health conditions of male and female rural migrants is consistent with the whole sample. The relationship of the health conditions between male and female rural migrants is in line with the “gender paradox of health,” with different factors affecting the health conditions of male and female rural migrants.

【Keywords】 rural migrants; urban residents; epidemiological paradox; health maintenance factor; health loss factor;


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    [1]. (1) In this paper, “China” refers specifically to Chinese mainland (editor’s note). [^Back]

    [2]. (2) The migrants (floating population) refers to a group of people whose permanent residence are different from their household registration places and have left the household registration places for more than half a year. In view of the purpose of this study, samples of urban-rural migrants, urban-urban migrants, rural residents, and migrants who had returned to their hometowns were excluded. [^Back]

    [3]. (3) Another commonly used method to classify self-rated health is to assign a score of 0 to the options “very healthy,” “healthy” and “fair,” and assign a score of 1 to the options “unhealthy” and “very unhealthy.” This study also used this classification method to fit the data. The results were consistent with the basic conclusions of this paper. [^Back]

    [4]. (4) Kakwani’s formula for calculating the deprivation of individual income yi is as follows:Among them, Y is a group with the sample number of n, arranged in ascending order of income, namely, y1y2 ≤ . . . ≤ yn. The income vector is y = (y1, y2, . . . yn), and MY is the mean of the group Y. [^Back]

    [5]. (5) The data was compiled by the authors according to the China Health and Family Planning Statistical Yearbook 2017. [^Back]

    [6]. (6) BMI = [^Back]

    [7]. (7) This study used the variance inflation factor (VIF) to perform multi-collinearity test. The maximum VIF was 1.61, which is much smaller than the empirical rule of 10. Therefore, there was no multi-collinearity. [^Back]


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This Article


CN: 11-1170/C

Vol 29, No. 03, Pages 34-52+5-6

June 2015


Article Outline


  • 1 Introduction
  • 2 Literature review
  • 3 Research hypotheses
  • 4 Models
  • 5 Data and variables
  • 6 Full sample empirical analysis
  • 7 Empirical analysis by sex
  • 8 Robustness test
  • 9 Conclusion and discussion
  • Footnote