Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, 210023 Nanjing, People's Republic of China.
Int J Equity Health. 2014 Jan 15;13:5. doi: 10.1186/1475-9276-13-5.
The continuing urbanization in China has resulted in a loss of land and rights among farmers. The social security of landless farmers has attracted considerable research attention. However, only few studies measure the health-related quality of life (HRQOL) of landless farmers by employing scientific standardized scales. By using five-dimensional European quality of life (EQ-5D) scales, this study measures the HRQOL of landless farmers from a new perspective and examines how the social security policies affect their HRQOL.
This study is based on a 2013 household survey that has been conducted among 1,500 landless famers who are residing in six resettlement areas in three cities within the Yangtze River Delta region, namely, Nanjing, Hangzhou, and Yangzhou. This study adopts EQ-5D scales to measure the HRQOL of these farmers. More than 50% of the respondents are in poor or non-serious health conditions, and over 50% are not satisfied with their current social security policies. The health conditions and social security policies are analyzed by multinomial regression analysis and the relationship between these two factors are analyzed via structural equation modeling (SEM).
First, the descriptive statistical analysis shows that more than 50% of the respondents are in poor or non-serious health conditions, and that the largest proportion of these farmers are suffering from anxiety or depression, which is the most serious of the five dimensions. Second, multinomial regression analysis shows that the satisfaction of landless farmers with their social security policies improves their living conditions, particularly in their capacity for self-care, in their ability to perform daily activities, and in the reduction of pain, anxiety, and depression. Third, SEM model analysis shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. Among the five dimensions of EQ-5D, daily activities produce the greatest influence on the HRQOL of landless farmers. As regards social security policies, the land acquisition compensation policy and the employment security policy produce the greatest and weakest influences on the HRQOL of landless farmers, respectively.
The rapid urbanization in China has deprived many farmers of their lands and of the benefits of urbanization. These farmers are often in a disadvantaged position in the land acquisition process. Statistic analysis in this paper shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. The implementation and improvement of social security policies is very important for the long-term and sustainable development of these landless farmers.
中国持续的城市化进程导致农民失去土地和权利。无地农民的社会保障引起了相当多的研究关注。然而，只有少数研究使用科学标准化量表来衡量无地农民的健康相关生活质量（HRQOL）。本研究采用五维欧洲生活质量（EQ-5D）量表，从新的角度衡量无地农民的 HRQOL，并考察社会保障政策如何影响他们的 HRQOL。
本研究基于 2013 年对居住在长江三角洲地区三个城市（南京、杭州和扬州）六个安置区的 1500 名无地农民进行的一项家庭调查。本研究采用 EQ-5D 量表衡量这些农民的 HRQOL。超过 50%的受访者健康状况不佳或非严重，超过 50%的受访者对当前的社会保障政策不满意。通过多项回归分析对健康状况和社会保障政策进行分析，并通过结构方程模型（SEM）分析这两个因素之间的关系。
首先，描述性统计分析表明，超过 50%的受访者健康状况不佳或非严重，其中最大比例的农民患有焦虑或抑郁，这是五个维度中最严重的。其次，多项回归分析表明，无地农民对社会保障政策的满意度提高了他们的生活条件，特别是在自我护理能力、日常生活活动能力以及减轻疼痛、焦虑和抑郁方面。第三，SEM 模型分析表明，无地农民对社会保障政策的满意度对其 HRQOL 有积极影响。在 EQ-5D 的五个维度中，日常生活活动对无地农民的 HRQOL 影响最大。就社会保障政策而言，征地补偿政策和就业保障政策对无地农民的 HRQOL 影响最大和最弱。
中国快速的城市化进程剥夺了许多农民的土地和城市化带来的利益。这些农民在征地过程中往往处于不利地位。本文的统计分析表明，无地农民对社会保障政策的满意度对其 HRQOL 有积极影响。社会保障政策的实施和完善对这些无地农民的长期可持续发展非常重要。
