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. 2025 Aug 13;25(1):1071.
doi: 10.1186/s12913-025-13123-8.

Does the public health education affect health inequality among the migrant population in China?

Lanyan Cheng  1 , Deshui Zhou  2 , Zangyi Liao  3
Affiliations

Does the public health education affect health inequality among the migrant population in China?

Lanyan Cheng et al. BMC Health Serv Res. .

Abstract

Background: As an essential component of public health infrastructure, public health education plays an important role in advancing health equity. In China, the large migrant population, while contributing substantially to socioeconomic development, continues to face significant health risks and inequalities due to frequent rural-to-urban mobility and occupational transitions. These issues not only undermine the well-being of migrants but also impede balanced social and economic progress. In this context, the present study systematically investigated the impact of public health education on health inequalities among the migrant population and explored the underlying mechanisms through which it exerts its influence.

Methods: Based on data from the China Migrants Dynamic Survey, this study employed the Recentred Influence Function regression method-a two-dimensional decomposition technique-combined with Instrumental Variable approaches to examine how public health education influences health inequality and to explore the underlying mechanisms.

Results: The findings indicated that health inequality among migrants followed a pro-rich socioeconomic gradient, with substantial regional heterogeneity. Participation in public health education programs was associated with a significant reduction in health inequality. After accounting for endogeneity, receiving two or more types of public health education was linked to a 0.102-unit decline in the Wagstaff-Erreygers Index (p < 0.001), implying that the income-related health concentration curve might have narrowed by approximately 47.4% relative to the equality line. Heterogeneity analysis showed that these effects were more pronounced among non-interprovincial migrants and self-employed individuals. Further analysis suggested that the inequality-reducing effect of public health education was mediated primarily through improved healthcare availability, which exerted stronger mediating effects than enhanced healthcare accessibility.

Conclusion: Enhancing the provision and effectiveness of public health education and safeguarding the health rights of vulnerable groups are vital to narrowing health disparities. Accelerating the development of an inclusive public health system tailored to the migrant population will support the reduction of health inequality and contribute to the coordinated advancement of the Healthy China initiative.

Keywords: Health inequality; Migrant population; Public health education.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study design was approved by the ethical review committee of Anhui University of Finance & Economics. All participants gave written informed consent. All methods were performed in accordance with the relevant guidelines and regulations. The China Migrants Dynamic Survey 2018 was officially approved for release by the National Bureau of Statistics of China (Population Mobility Dynamics Survey Report, National Statistics [2018] No. 45). Detailed information can be obtained from the following website: https://doi.org/ https://doi.org/10.12213/11.A000T.202205.84.V1.0 . Additionally, written informed consent was obtained from all participants during the data collection process. The data used in this study were also approved by the Mobility Service Center of the National Health and Wellness Commission of China. It is important to note that all procedures conducted in this study adhered to the ethical standards outlined in the 1964 Declaration of Helsinki and its subsequent amendments. The authors declared that no generative AI or large language models were used in any stage of preparing this manuscript, including but not limited to writing, editing, or data analysis. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of public health education participation among migrants
See this image and copyright information in PMC

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