Young internal migrants' major health issues and health seeking barriers in Shanghai, China: a qualitative study

Abstract

Background: China is experiencing a sizeable rural-urban flow, which may influence the health of internal migrant youth deeply. Disadvantages in the city are highly likely to contribute to health issues among the young internal migrant population. The current qualitative study is to explore how internal migrant young people view the health issues they face, and the services and opportunities they could seek in their host community.

Methods: Data were collected from 90 internal migrant youth aged between 15 and 19 years old and 20 adult service providers who worked with them in a community of Shanghai, where the population of internal migrants was relatively large. Four types of qualitative research methods were used, including key informant interviews with adults, in-depth interviews with adolescents, a photovoice activity with adolescents and community mapping & focus group discussions with adolescents. Guided by the ecological systems framework and the acculturation theory, thematic analysis was conducted using ATLAS.Ti 7.0 software.

Results: While younger migrants had a limited understanding of health, elder migrant youths were more sensitive to societal and political factors related to their health. Mental health and health risk behaviors such as smoking, violence and premarital unsafe sex were thought as major health issues. Internal migrant youths rarely seek health information and services initiatively from formal sources. They believed their health concerns weren't as pressing as the pressure coming from the high cost of living, the experience of being unfairly treated and the lack of opportunities. Participants also cited lack of family and social support, lack of awareness and supportive policies to get access to community and public services as impacting health factors.

Conclusions: The study's findings provide the insight to the social contexts which influence the health experience, health seeking behaviors, and city adaptation of young internal migrants in their host community. This research stresses the importance of understanding social networks and structural barriers faced by migrant youth in vulnerable environments. A multidimensional social support is essential for internal migrant youth facing present and potential health risks.

Keywords: Health equity; Health seeking barriers; Internal migrant youth; Qualitative study; Thematic analysis.

Fig. 1

Keep healthy by taking exercise. “Playing basketball is a healthy lifestyle for adolescents, it can keep you fit, can help you grow taller, it also can help relieve stresses. We should promote such a lifestyle.” (Photographed and explained by a female PV participant of 16 years old.)

Fig. 2

The inconvenience after the rain. “There is a sunken area without a drainage system besides our neighborhood. It causes inconvenience to the passers-by every time it rains.” (Photographed and explained by a female PV participant of 18 years old.)

Fig. 3

A community map indicating migrants’ living environments and accessible facilities. The places where internal migrants live concentratedly were drawn on the lower left part of the paper, meaning migrants’ living places were in the fringe area of the community. (Drawn by internal migrant youth of CMG activity, female, 18–19 years old group.)

Fig. 4

Tired of the work of moving goods. “He is very young; he is trying to make money by uploading and downloading goods. You could see that the floating young people’s life here is not easy at all. With no skills and poor education, it seems hard for him to get a better job.” (Photographed and explained by a female PV participant of 16 years old.)