School of Public Health, Nanjing Medical University, Nanjing, China.
Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China.
Front Public Health. 2022 Jul 11;10:936275. doi: 10.3389/fpubh.2022.936275. eCollection 2022.
The national essential public health service (NEPHS) has been in operation for more than a decade. Numerous studies examined the utilization of NEPHS by migrants and the factors that influence it, but few examined the effect of NEPHS awareness and utilization on the health of inhabitants, particularly migrants. The purpose of this study is to ascertain the level of awareness and utilization of NEPHS, as well as to examine their health-improving effects on migrants.
Based on the data from the 2017 China Migrants Dynamic Survey, linear probability model, ordered logit model and the propensity score matching methods were employed to investigate impact of awareness and utilization of NEPHS on the health among Chinese migrants. Mediating effect model were used to identify the mechanism of the impact of NEPHS on health.
The findings indicated that migrants' awareness and utilization of NEPHS are still insufficient. After adjusting for other factors, the study discovered that increased awareness and use of NEPHS had a beneficial influence on migrants' self-rated health. Further heterogeneity analysis revealed significant disparities in the health consequences of NEPHS awareness and utilization across subgroups. The effect of increased awareness and usage of NEPHS on health is stronger for middle-aged and elderly people, women, and low-educated migrants with urban household registration. The estimated results of the mediating effect model supported the mechanism that increased NEPHS awareness among the floating population could encourage its utilization and further improve the floating population's health.
Given that migrants' NEPHS utilization is still low and that NEPHS utilization has a positive effect on health, some targeted strategies, such as a variety of new media communication methods, health education related to occupational disease and tuberculosis prevention, and targeted NEPHS projects for specific groups, such as men, young and middle-aged groups, those with a high level of education, and rural migrants, should be conducted to improve the health of migrants.
国家基本公共卫生服务（NEPHS）已经运行了十多年。许多研究考察了流动人口对 NEPHS 的利用情况及其影响因素，但很少有研究考察 NEPHS 知晓和利用对居民健康的影响，特别是对流动人口的影响。本研究旨在确定流动人口对 NEPHS 的知晓率和利用率，并考察其对流动人口健康的改善效果。
基于 2017 年中国流动人口动态监测调查数据，采用线性概率模型、有序逻辑回归模型和倾向得分匹配方法，考察流动人口对 NEPHS 的知晓和利用对其健康的影响。采用中介效应模型来确定 NEPHS 对健康影响的作用机制。
研究结果表明，流动人口对 NEPHS 的知晓率和利用率仍然较低。在调整其他因素后，研究发现，提高对 NEPHS 的知晓率和利用率对流动人口的自评健康有积极影响。进一步的异质性分析发现，NEPHS 知晓率和利用率对健康的影响在不同亚组之间存在显著差异。对于中老年人、女性和具有城市户籍的低学历流动人口，提高对 NEPHS 的知晓率和利用率对健康的影响更大。中介效应模型的估计结果支持了流动人口对 NEPHS 的知晓率增加可以鼓励其利用，从而进一步改善流动人口健康的机制。
鉴于流动人口对 NEPHS 的利用率仍然较低，且 NEPHS 的利用对健康有积极影响，应采取一些有针对性的策略，如利用各种新媒体传播方式、开展与职业病和结核病防治相关的健康教育、针对特定人群（如男性、青年和中年人群、高学历人群以及农村流动人口）开展有针对性的 NEPHS 项目，以提高流动人口的健康水平。
