BACKGROUND: Older migrant workers (OMWs) in China face unique challenges rooted in their early life experiences, which increase their vulnerability to psychological and behavioral problems in adulthood. By utilizing the cumulative disadvantage model and the social-ecological systems theory, this study explored the effect of childhood family adversity on adulthood depression in the mediating roles of OMWs\' social-ecological microsystem and mesosystem and further examined gender differences in these associations.
METHODS: Data were collected from the China Health and Retirement Longitudinal Study (CHARLS), involving a sample of 4,309 OMWs aged 50 and above. The measures included the Center for Epidemiological Research Depression Scale, childhood family adversity, socioeconomic status, marital quality, and physical and cognitive health.
RESULTS: Childhood family adversity was positively associated with adulthood depression among OMWs. Social microsystem (physical and cognitive health) and mesosystem (marital quality and socioeconomic status) factors significantly mediated this relationship. Multi-group analysis revealed that the mediating effects of marital quality and socioeconomic status were stronger for female OMWs, while the mediating effects of physical and cognitive health were stronger for male OMWs.
CONCLUSIONS: The findings suggest that childhood family adversity has a lasting impact on the mental health of OMWs, and that social-ecological systems factors play an important role in this relationship. The study also highlights the need for gender-specific interventions to address the mental health needs of OMWs.

Objectives: Older migrant workers (OMWs) frequently confront barriers to accessing care, as their Social Health Insurance (SHI) coverage may not extend beyond their hometown. This study seeks to investigate whether Chinese OMWs can still derive benefits from SHI in accessing healthcare services, even when their SHI is not registered in the same location as their current residence. Methods: This study used data from 2015 China Migrants Dynamic Survey and focused on OMWs aged 60 years and older (N = 3,050). Logistic regression models were employed to investigate the factors influencing healthcare use. Results: Having SHI registered in current place of residence and interprovincial migration were significantly associated with increased likelihoods of doctor visits among OMWs. However, inpatient services use did not appear to be associated with the SHI registration place and migration range. Conclusion: Chinese OMWs derive fewer benefits from SHI in accessing healthcare services when their SHI is not registered in current residence. Governments in Low- and Middle-Income Countries should consider implementing targeted policies to provide adequate protection for OMWs and expand the coverage of direct reimbursement for cross-province healthcare services.

Objectives: To identify differences in healthcare use between older migrant workers (OMWs) and older migrants (OMs) and explore associated factors and paths of healthcare use. Methods: The data came from the 2015 China Migrant Dynamic Monitoring Survey (CMDMS). CMDMS used a multi-stage stratified probability proportionate to size method as the sampling technique and conducted a desk review. The samples include OMWs, OMs for caring offspring (N = 4,439), and OMs for receiving care from family (N = 4,184). We built logistic regression and path analysis models to analyze the data. Results: Social health insurance (SHI) in current place of residence is associated with less expenditure among all subgroups. OMWs and OMs for receiving care from family with SHI in current place of residence are more likely to use healthcare. Conclusion: OMWs are particularly vulnerable in healthcare use and socioeconomic status. Having SHI registered in current place of residence helps decrease expenditure among OMs. We urge policymakers to consider a united health financing scheme across OMWs and other urban employees and streamline policies for migrants to enroll in SHI in current place of residence.