Using the 2008 and 2009 Rural–Urban Migration in China (RUMiC) survey data, two waves of a nationally representative survey dataset, this study examined the “healthy migrant phenomenon” with regard to mental health in China. The results show that migrants exhibited better mental health than urban residents did after controlling for variables of socioeconomic status in a regression analysis. The study confirms that the “healthy migrant phenomenon” does exist under the setting of internal rural to urban migration in China, and the socioeconomic status disparities between migrants and urban natives plays a vital role in the phenomenon. Taking advantage of the unique framework of the RUMiC survey data, we were able to use not only the samples of migrants and urban residents but also those of rural residents to assess the potential channels further. Our results provide some suggestive evidence that self-selection effect and “salmon effect” are possible mechanisms causing this phenomenon.
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Because internal migrants are substantially different from immigrants, this paper references Chen (2011), who referred to the healthy immigrant effect as the healthy migrant effect/phenomenon. Some studies have used the term healthy migrant hypothesis (Tong and Piotrowski 2012). In our paper, we treat these as identical items and apply them according to the context.
We provide a detailed summary of the literature in “Conceptual background and literature review” section.
In this paper, we concentrate our discussion on the first aspect of the HIE based on the following reasons: First, we were concerned about distraction and divergence from the main points in our study if we added a more formal discussion about the YSM effect in the manuscript. Second, our data are cross-sectional and have some limitations in exploring the YSM effects; thus, cohort and YSM effects cannot be disentangled with a single cross-section of data. Last but not least, it is well known that assessing subjective mental health can be easily influenced by emotion, and when the respondents are interviewed, a study of the YSM effect of mental health needs a more sophisticated measure and delicate design.
For US evidence, see Hamilton and Hummer (2011), Huang et al. (2011), Hill et al. (2012). For Canadian evidence, see McDonald and Kennedy (2004), Newbold (2005), Kobayashi and Prus (2012), Aglipay et al. (2013), Kwak and Rudmin (2014). For Australian evidence, see Chiswick et al. (2008), Jatrana and Pasupuleti (2013). For UK evidence, see Averett et al. (2012). For Spanish evidence, see Gotsens et al. (2015), Rivera et al. (2016). For Irish evidence, see Nolan (2012). For US/UK/Canadian/Australian evidence, see Kennedy et al. (2015). For French, Italian, Spanish, and Belgian evidence, see Moullan and Jusot (2014).
We also discuss the selective migration effect and the “salmon effect” by using the migrant sample (from UMS) instead of the migrant workersR sample (from RHS). See Appendix A. This complementary discussion is only for reference.
We did not include marital status in the baseline regression because the variables capturing the basic demographic characteristics (such as age, gender, and ethnicity) were all exogenous. Marital status does not belong to this group of variables. When we included marital status in the demographic characteristics’ variables, the conclusions did not change.
We thank anonymous reviewers for suggesting valuable points in this section.
Unfortunately, a consistent measure of current or past heavy alcohol consumption and physical exercise habit information were not available.
Following the suggestion of an anonymous reviewer, we also performed an F-test to determine whether the two estimate coefficients are significantly different. It turns out that it failed to pass the test at any significant level (p value is 0.6314). Noting that the magnitudes of the t-statistics of the two coefficients are relatively close,(one is 2.05, and the other is 1.90), we could make a safe conclusion that the two effects were relatively close to each other; one passed the thresholds of the test of significance and the other failed to pass the test.
According to the definition of the healthy migrant phenomenon, the purpose of our study is to compare the urban residents and the migration workers who have already self-selected to migrate in cities. Therefore, the selective migration effect and the “salmon effect” are mechanisms that we should explain after measuring the healthy migration phenomenon rather than adjusting them before measuring. In fact, several researchers, such as Jatrana and Pasupuleti (2013), Qin et al. (2015), and Yuan (2009), have used a fixed-effect model or instrumental variables method to eliminate the self-selection problem. However, the purposes of these three studies differ significantly from ours. The three papers aimed to study the causal effect of migration on health; thus, they had to eliminate the self-selection problem to disentangle the endogenous problem, while ours focused on measuring the healthy migrant phenomenon itself.
Aglipay, M., Colman, I., & Chen, Y. (2013). Does the healthy immigrant effect extend to anxiety disorders? Evidence from a nationally representative study j immigrant minority health. Journal of Immigrant and Minority Health,15(5), 851–857.
Alegria, M., Canino, G., Shrout, P., Woo, M., Duan, N., Vila, D., et al. (2008). Prevalence of mental illness in immigrant and non-immigrant U.S. Latino Groups. American Journal of Psychiatry,165(3), 359–369.
Antecol, H., & Bedard, K. (2015). Immigrants and immigrant health. In B. Chiswick & P. W. Miller (Eds.), Handbook of the economics of international migration: The immigrants (pp. 271–315). Waltham, MA: North Holland.
Averett, S., Argys, L., & Kohn, J. (2012). Immigration, obesity and labor market outcomes in the UK. IZA Journal of Migration,1(1), 1–19.
Bergeron, P., Auger, N., & Hamel, D. (2009). Weight, general health and mental health: Status of diverse subgroups of immigrants in Canada. Canadian Journal of Public Health Review,100(100), 215–220.
Chen, J. (2011). Internal migration and health: Re-examining the healthy migrant phenomenon in China. Social Science and Medicine,72(8), 1294–1301.
Chiswick, B., Lee, Y., & Miller, P. (2008). Immigrant selection systems and immigrant health. Contemporary Economic Policy,26(4), 555–578.
Cook, B., Alegría, M., Lin, J., & Guo, J. (2009). Pathways and correlates connecting Latinos’ mental health with exposure to the United States. American Journal of Public Health,99(12), 2247–2254.
Cutler, D. M., & Lleras-Muney, A. (2010). Understanding differences in health behaviors by education. Journal of Health Economics,29(1), 1–28.
Fong, V. (2008). The other side of the healthy immigrant paradox: Chinese sojourners in Ireland and Britain who return to china due to personal and familial health crises. Culture, Medicine and Psychiatry,32(4), 627–641.
Gong, P., Liang, S., Carlton, E., Jiang, Q., Wu, J., Wang, L., et al. (2012). Urbanisation and health in China. The Lancet,379(9818), 843–852.
Gotsens, M., Malmusi, D., Villarroel, N., Vives-Cases, C., Garcia-Subirats, I., Hernando, C., et al. (2015). Health inequality between immigrants and natives in Spain: The loss of the healthy immigrant effect in times of economic crisis. European Journal of Public Health,25(6), 923–931.
Hamilton, T., & Hummer, R. (2011). Immigration and the health of U.S. Black adults: Does country of origin matter? Social Science and Medicine,73(10), 1551–1561.
Hesketh, T., Jun, Y., Lu, L., & Mei, W. (2008). Health status and access to health care of migrant workers in China. Public Health Reports,123(2), 189–197.
Hill, T., Angel, J., Balistreri, K., & Herrera, A. (2012). Immigrant status and cognitive functioning in late-life: An examination of gender variations in the healthy immigrant effect. Social Science and Medicine,75(12), 2076–2084.
Hu, X., Cook, S., & Salazar, M. A. (2008). Internal migration and health in China. The Lancet,372(9651), 1717–1719.
Huang, C., Mehta, N., Elo, I., Cunningham, S., & Stephenson, R. (2011). Region of birth and disability among recent U.S. Immigrants: Evidence from the 2000 census. Population Research and Policy Review,30(3), 399–418.
Jatrana, S., Pasupuleti, S., & Richardson K. (2013). Investigating the ‘healthy immigrant effect’ in Australia using fixed effects models: Findings from a Nationally-Representative Longitudinal Survey. HILDA_2013_Papers.
Kennedy, S., Kidd, M., Mcdonald, J., & Biddle, N. (2015). The healthy immigrant effect: Patterns and evidence from four countries. Journal of International Migration and Integration,16(2), 1–16.
Kobayashi, K., & Prus, S. (2012). Examining the gender, ethnicity, and age dimensions of the healthy immigrant effect: Factors in the development of equitable health policy. International Journal for Equity in Health,11(1), 1–6.
Kwak, K., & Rudmin, F. (2014). Adolescent health and adaptation in Canada: Examination of gender and age aspects of the healthy immigrant effect. International Journal for Equity in Health,13(1), 103–112.
Lu, Y. (2008). Test of the ‘healthy migrant hypothesis’: A longitudinal analysis of health selectivity of internal migration in Indonesia. Social Science and Medicine,67(8), 1331–1339.
Lu, Y. (2010). Rural-urban migration and health: Evidence from longitudinal data in Indonesia. Social Science and Medicine,70(3), 412–419.
Lu, Y., Hu, P., & Treiman, D. J. (2012). Migration and depressive symptoms in migrant-sending areas: Findings from the survey of internal migration and health in China. International Journal of Public Health,57(4), 691–698.
Mcdonald, J., & Kennedy, S. (2004). Insights into the ‘Healthy Immigrant Effect’: Health status and health service use of immigrants to Canada. Social Science and Medicine,59(8), 1613–1627.
Menezes, N., Georgiades, K., & Boyle, M. (2011). The influence of immigrant status and concentration on psychiatric disorder in canada: A multi-level analysis. Psychological Medicine,41(10), 2221–2231.
Meng, X., Manning, C., Li, S., & Effendi, T. N. (2010). The great migration: Rural-urban migration in China and Indonesia. Cheltenham: Edward Elgar Publishing.
Mou, J., Cheng, J., Zhang, D., Jiang, H., Lin, L., & Griffiths, S. (2009). Health care utilisation amongst Shenzhen migrant workers: Does being insured make a difference? BMC Health Services Research,9(1), 214.
Moullan, Y., & Jusot, F. (2014). Why is the ‘Healthy Immigrant Effect’ different between European countries? European Journal of Public Health,24(1), 80–86.
Mu, R. (2014). Regional disparities in self-reported health: Evidence from Chinese older adults. Health Economics,23(5), 529–549.
Newbold, K. (2005). Self-rated health within the Canadian immigrant population: Risk and the healthy immigrant effect. Social Science and Medicine,60(6), 1359–1370.
Niu, J. (2013). Migration and its impact on the differences in health between rural and urban residents in China. Social Science in China,2, 46–63. (in Chinese).
Nolan, A. (2012). The ‘healthy immigrant’ effect: Initial evidence for Ireland. Health Economics, Policy and Law,7(3), 343–362.
Qin, L., Chen, C., Liu, X., Wang, C., & Jiang, Z. (2015). Migration health status and earnings of migrant workers from rural China. China and World Economics,23(2), 84–99.
Rivera, B., Casal, B., & Currais, L. (2016). The healthy immigrant effect on mental health: Determinants and implications for Mental Health Policy in Spain. Administration and Policy in Mental Health and Mental Health Services Research,43(4), 616–627.
Salant, T., & Lauderdale, D. (2003). Measuring culture: A critical review of acculturation and health in Asian immigrant populations. Social Science and Medicine,57(1), 71–90.
Shan, L., Zhao, M., Ning, N., Hao, Y., Li, Y., Liang, L., et al. (2018). Dissatisfaction with current integration reforms of health insurance schemes in China: Are they a success and what matters? Health Policy and Planning,33(3), 345–354.
Straiton, M., Grant, J., Winefield, H., & Taylor, A. (2014). Mental health in immigrant men and women in Australia: The North West Adelaide health Study. BMC Public Health,14(1), 1–15.
Tong, Y., & Piotrowski, M. (2012). Migration and health selectivity in the context of internal migration in China, 1997–2009. Population Research and Policy Review,31(4), 497–543.
Van Hook, J., & Zhang, W. (2011). Who stays? Who goes? Selective emigration among the foreign-born. Population Research and Policy Review,30(1), 1–24.
Wen, M., Fan, J., Jin, L., & Wang, G. (2010). Neighborhood effects on health among migrants and natives in Shanghai. China. Health & Place,16(3), 452–460.
Yuan, H. (2009). Health and incomes of migrant workers: Based on Beijing migrant workers Survey. Management World,5, 56–66. (in Chinese).
Zhou, X., & Lu, M. (2016). The rural migrant workers’ health: China’s success or regret? China Journal of Economics,3, 79–98. (in Chinese).
We are grateful to the editor and the three reviewers for their considered and detailed comments on our manuscript, which have helped us to improve it significantly. We thank for Andrew Foster, Xi Chen, Hong Liu, Yanyan Xiong, Lingguo Cheng, Suqin Ge, and other participants in 2018 2nd Biennial Conference of CHPAMS (China Health Policy and Management Society) at Yale University, 2017 Conference on Health and Development at Institute of Economics, Academia Sinica, and seminars at Yale University, Shanghai University of Finance and Economics, Southeast University and Nanjing University for their helpful comments. Ling Zhou and Zuyu Wang provided excellent research assistance to this paper. We also thank for the financial support of the National Natural Science Foundation of China (Grant No. 71603046), the MOE Project of Key Research Institute of Humanities and Social Sciences at Universities (Grant No. 17JJD630002), National Social Science Foundation of China (Grant No. 13CJY091), and ZhiShan Young Scholar Program of Southeast University (Grant No. 001).
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Ma, C., Qu, Z. & Xu, Z. Internal Migration and Mental Health: An Examination of the Healthy Migration Phenomenon in China. Popul Res Policy Rev 39, 493–517 (2020). https://doi.org/10.1007/s11113-019-09552-z
- Healthy migrant phenomenon
- Mental health
- Rural–urban migrants