1. Air pollution and refraining from visiting health facilities: a cross-sectional study of domestic migrants in China
- Author
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Zhixin, Liu, Chaojie, Liu, Yu, Cui, Junping, Liu, Huanyu, Zhang, Yajie, Feng, Nan, Wang, Mingli, Jiao, Zheng, Kang, Xiaoxue, Xu, Juan, Zhao, Chen, Wang, Dandan, Zou, Libo, Liang, Qunhong, Wu, and Yanhua, Hao
- Subjects
Transients and Migrants ,Air Pollutants ,China ,Public health ,Cross-Sectional Studies ,Epidemiology ,Air Pollution ,Public Health, Environmental and Occupational Health ,Health services and systems ,Humans ,Particulate Matter ,Health Facilities ,Environmental Exposure - Abstract
Background Local environmental factors are associated with health and healthcare-seeking behaviors. However, there is a paucity in the literature documenting the link between air pollution and healthcare-seeking behaviors. This study aimed to address the gap in the literature through a cross-sectional study of domestic migrants in China. Methods Data were extracted from the 2017 China Migrants Dynamic Survey (n = 10,051) and linked to the official air pollution indicators measured by particulate matter (PM2.5 and PM10) and air quality index (AQI) in the residential municipalities (n = 310) of the study participants over the survey period. Probit regression models were established to determine the association between air pollution and refraining from visiting health facilities after adjustment for variations in the predisposing, enabling and needs factors. Thermal inversion intensity was adopted as an instrumental variable to overcome potential endogeneity. Results One unit (µg/m3) increase in monthly average PM2.5 was associated with 1.8% increase in the probability of refraining from visiting health facilities. The direction and significance of the link remained unchanged when PM2.5 was replaced by AQI or PM10. Higher probability of refraining from visiting health facilities was also associated with overwork (β = 0.066, p = 0.041) and good self-related health (β = 0.171, p = 0.006); whereas, lower probability of refraining from visiting health facilities was associated with short-distance (inter-county) migration (β=-0.085, p = 0.048), exposure to health education (β=-0.142, p p = 0.018), and having hypertension/diabetes (β=-0.169, p = 0.005). Conclusion Air pollution is a significant predictor of refraining from visiting health facilities in domestic migrants in China.
- Published
- 2023
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