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Air pollution and refraining from visiting health facilities: a cross-sectional study of domestic migrants in China

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posted on 2023-06-28, 03:48 authored by Z Liu, Chaojie LiuChaojie Liu, Y Cui, J Liu, H Zhang, Y Feng, N Wang, M Jiao, Zheng KangZheng Kang, X Xu, J Zhao, C Wang, D Zou, L Liang, Qunhong WuQunhong Wu, Yanhua HaoYanhua Hao
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 < 0.001), a high sense of local belonging (β=-0.082, 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.

Funding

This study was supported by the National Natural Science Foundation of China (Grant Number 71974049,71673073).

History

Publication Date

2022-11-02

Journal

BMC Public Health

Volume

22

Issue

1

Article Number

2007

Pagination

13p.

Publisher

BMC

ISSN

1471-2458

Rights Statement

© The Author(s) 2022. Licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the licence, and indicate if changes were made. The images or other third party material in this article are included in the article's licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view the licence: http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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