The effects of social connections on self-rated physical and mental health among internal migrant and local adolescents in Shanghai, China

BACKGROUND: China is in the midst of history's largest flow of rural-urban migration in the world; a flow that includes growing numbers of children and adolescents. Their health status is an important public health issue. This study compares self-rated physical and mental health of migrant and local adolescents in China, and examines to what extent layered social connections account for health outcomes. METHODS: In 2010, we conducted a cross-sectional study among middle school students in Pudong New Area, Shanghai. Information about health status, social connections, and demographic factors were collected using a questionnaire survey. After controlling for sociodemographic factors, we used the t-test, Chi-square analysis, and a series of regression models to compare differences in health outcomes and explore the effects of social connections. RESULTS: Migrant adolescents reported significantly higher rates of good physical health. However, they also had significantly fewer social connections, lower self-esteem, and higher levels of depression than their native peers. Family cohesion was associated with depressive symptoms and low self-esteem among all adolescents; peer association and social cohesion played major roles in migrants' well-being. Gender, age, and socioeconomic (SES) factors also affected adolescents' self-rated physical and mental health. CONCLUSIONS: Self-rated data suggest that migrant adolescents enjoy a physical health advantage and a mental health disadvantage. Layered social connections, such as peer association and social cohesion, may be particularly important for migrants. A public health effort is required to improve the health status of migrant youth.