Chinese Rural-Urban Migrant Workers' Health Issues

In the last three decades, China has experienced a lot of internal mobility which has been necessitated by the need for better employment conditions and terms in the urban areas. Specifically, in the 21st century, the Chinese living in the rural areas have migrated to the urban areas where they can get employment opportunities in the manufacturing, mining and other informal sectors (Holdaway, Krafft, & Wang, 2011). The search for better pay has meant that the nature of living standards in the urban areas has deteriorated due to increased populations. Therefore, the government of China reintroduced the household registration or what is termed as hukou in order to regulate the population flows. Despite this, according to Holdaway, Krafft, & Wang (2011), most of the migrants still did not hold any professional qualifications which could help them get professional jobs. Additionally, their health status could not be monitored by the rural or urban authorities who are tasked with those responsibilities. As such, their access to healthcare services was limited. This is mainly caused by the separation of the rural and urban healthcare systems. The physical, mental, and general healthcare of the migrant population was thereby highly affected (Holdaway, Krafft, & Wang, 2011). This research will assess the health issues that coupled the Chinese rural-urban migrant workers. Specifically, it will look at the physical and mental health issues that were occasioned by the migration.

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Physical Health

The massive immigration from the rural to the urban area resulted in confusion to the already existing healthcare plans that the government had put in place. Notably, the Chinese government had started effective healthcare systems that operated in the rural and urban areas (Gong et al., 2012). Specifically, the Cooperative Medical System provided effective and extensive medical healthcare services that were offered in public health clinics by the barefoot doctors. In addition, the services were free and basic as the healthcare providers moved from one household to the other hence the term barefoot (Gong et al., 2012). However, the urban residents received free healthcare from the government through one of the two government-run healthcare schemes. This system was based on the wrong assumption that there were no movements from the rural areas to the urban areas. Additionally, it left the rural population without any access to healthcare. The introduction of the household responsibility system further worsened the condition as there was no collective financing for the healthcare services (Cao, 2012). Individual families were now responsible for their health care which was expensive for the rural population. As such, healthcare became a concern for it contributed to illnesses which in turn led to increased poverty. Therefore, one of the health issues was the relationship between health and poverty (Cao, 2012).

Over the last decade or so, the physical health of the Chinese migrants has been a concern for the health system due to problems in the monitoring, prevention, and treatment of such huge populations. A variety of health risks such as the environment, the living conditions, as well as the mobile states of the immigrants were responsible for the health issues. The migrants had little or no skills compared to the conventional urban population. As such, after the migration to the urban areas, they involved themselves in employment opportunities that posed risk of occupational injury and sickness (Gransow, 2010). Specifically, they searched and indeed secured jobs in the high risk sectors of mining, construction and the manufacturing industries. All these jobs presented what is termed as the physical health risks. In addition, according to Gransow (2010), they also involved themselves in same businesses that are hardly regulated and thereby, exposed themselves to even more risks. Due to their lack of professional qualifications and indeed skills, they feared to complain about the risks. Additionally, they preferred to work in health risk jobs which had larger pay for a very short period of time. A study conducted by the Ministry of Health (MOH) in conjunction which the ministry of agriculture found at least one occupational hazard in 83% of the Town and Village Enterprises surveyed, and estimated that at least one third of workers were exposed to health risks (Holdaway, Krafft, & Wang, 2011). Further, 11% of those workers in such industries surveyed were found to have physical health complications related to the nature of their work.

The State Administration of Work Safety established in 2005 that 15000 deaths were reported yearly from occupational injury. Pearl River Delta area alone accounted for over 30,000 work related health issues from its employees. Concisely, 1-2% of all immigrant workers had work related injuries (Gransow, 2010) In the occupational illnesses that were related lung disease pneumoconiosis accounts for over 70% with over half a million cases reported by 2001. In 2009, over 14, 000 new cases were reported which is 90% of the incidences in the coal mining industries (Holdaway, Krafft, & Wang, 2011). Chronic occupation poisoning ranked second in the list of occupational illnesses that were related to the kind of jobs that the migrants were engaged in. These figures just show the kind of health issues that the migrant workers have undergone since the beginning of the industrial revolution. Indeed, the occupation of the migrants led to various physical health issues because of the conditions in the mining, manufacturing and other industries involving physical work.

According to a study conducted by the researchers at Chinese Academy of Social Sciences, the immigrant employees worked for long hours even close to 50% more than the urban residents (Gransow, 2010). Specifically, 81% of the migrants worked for more than six days a week giving them no time for rest or even spending with their families (Holdaway, Krafft, & Wang, 2011). Additionally, they saved more, and as such, skipped on foods; did not buy new clothes often and other necessities. More surprisingly, the migrants are unable to pay for any health insurance cover as well as out of pocket medical expenses. The frugality might benefit the workers in the short time by they are detrimental to their physical healthcare in the long run. One third of the population of Beijing and Shaghai as well as other modern cities such as Shenzhen are all migrant workers. This huge population has led to the inadequacy of sanitation services especially water and sewerage services. As such, this has posed grievous heath challenges for the urban population. Additionally, most migrants live in dormitories which are susceptible to fire hazards (Gransow, 2010). 63% of the migrant workers live in houses without bathrooms; this is very high compared to only 16% of the original urban residents (Holdaway, Krafft, & Wang, 2011). The increased population led to the inadequate sanitation and higher rates of malaria, hepatitis, and other infectious diseases which are associated with the lack of necessary infrastructure as well as sanitation.

Mental Health

Generally, as stated in the above paragraph, the immigrant workers worked for long hours more than the original urban residents. These long hours exposed them to a lot of work related stress which in turn affected their mental health (Zhong et al., 2015). Indeed, most of the workers were diagnosed with repetitive stress disorders as a result of the long working hours. Working for six days a week gave them no time to rest unlike the urban resident who worked in the formal sector for a maximum of 5 days (Qiu et al., 2011). According to Zhong et al. (2015), the repetitive disorders were also caused by the planning of their families since the amount they earned could not sustain their huge families. Indeed, those factors did not favor the mental health of the migrant workers. Their mental health status was further worsened by the fact that they did not seek medical attention due to lack of financial resources (Qiu et al., 2011). This lack of early diagnosis and treatment worsened their condition.

The other occupational aspect that affected the heath condition of the immigrant workers is excessive noise from the industries (Mou et al., 2011). In this regard, the noise from the machinery in the mining, manufacturing and other factories made the workers susceptible to mental illnesses. Specifically, most of the immigrant workers in the industries were found to have issues with their mental state due to the excessive noise (Mou et al., 2011). The Apple contractor Foxconn in Shenzhen reported a lot of spates of suicide cases which were a dramatic proof of stress related health issues. The isolation that they got from the other urban residents was another cause of stress which affected the mental status of the immigrant workers. Separation from families due to the long working hours was also another cause of this mental stress. Concisely, the physical heath of the immigrants was not the only one affected but also the mental health.

Healthcare

Due to the health issues state above, the various state organs tasked with healthcare had to devise measures which would ensure the safety of the migrant population. First, the government declared that the rural to urban migration was a major step in the alleviation o poverty in the rural areas. SARS epidemic in 2003 galvanized the government into action when they realized that the migrant workers were the main carriers of the disease (Zhu, Ngok, & Li, 2014). In 2006, the State Council announced that it would ensure that migrants legal status and access to public services was improved. In obeying this directive, the Ministry of Labor and Social Security (MOLSS) produced a document whose effect was to incorporate the migrant workers into the health insurance scheme. Specifically, according to Zhu, Ngok, & Li (2014), the document was focused on the industries where the migrant workers were concentrated. By the end of 2006, over 20million migrant workers had enrolled into the heath policy. Two years later, in 2010, over 43 million migrant workers had enrolled in the healthcare policy scheme. Further, the ministry of health is focused on the occupational health risks that the migrant workers undergo (Zhu, Ngok, & Li, 2014). As such, the ministries of heath as well as other non-governmental organizations have started educating the workers on the importance of occupational health and safety.

In conclusion, the migration of the Chinese workers from the rural to the urban areas increased the urban populations to unprecedented levels. This in turn led to the inadequacy of the infrastructural facilities. Due to lack of skills, the migrant workers were employed in the informal sector when they are exposed to various occupational health risks. Additionally, they worked for long hours hence having no time for their families. These two issues led to the compromise of their physical and mental health. Both women and men were exposed to psychological stress which led to high incidences of suicide. However, the intervention of the government in2008 led to the enrolment of all the works in the healthcare scheme. Additionally, more focus was made to the various industries so that they could observe health and safety standards.

References

Cao, L. (2012). The Prospect for Health Care Rights in China (Doctoral dissertation, University of Toronto).Gong, P., Liang, S., Carlton, E. J., Jiang, Q., Wu, J., Wang, L., & Remais, J. V. (2012). Urbanisation and health in China. The Lancet, 379(9818), 843-852.

Gransow, B. (2010). Body as armor: Health risks and health consciousness among rural...