{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:06:49Z","timestamp":1767197209753,"version":"3.48.0"},"reference-count":52,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Humanities and Social Sciences Fund of the Ministry of Education of the People\u2019s Republic of China","award":["22YJCZH204"],"award-info":[{"award-number":["22YJCZH204"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Systems"],"abstract":"<jats:p>In the context of China\u2019s accelerated urbanization process, the increasing number of rural-to-urban migrants has become an integral part of urban economic development. Ensuring stable housing for the floating population is essential to facilitating their integration into urban society and promoting the realization of their health rights. Drawing on data from a large-scale survey of Chinese internal migrants, this study empirically analyzes how homeownership influences health services accessibility in rural-to-urban migrants. The findings indicated that homeowners exhibited approximately 18.4% higher odds ratio of accessing public health services compared to renters. This result remained robust after addressing potential reverse causality using instrumental variable approaches and correcting for self-selection bias through propensity score weighting methods. Meanwhile, the mediating effect decomposition showed that migrants\u2019 perception of acculturation and community participation played parallel mediating roles in the relationship between homeownership and health services accessibility. Furthermore, the heterogeneity analysis revealed that the positive impact of homeownership on health services accessibility was more pronounced among individuals with lower household income and shorter migration duration. Our research underscores the importance of securing stable housing for rural-to-urban migrants as a key determinant in advancing the equitable development of urban health systems.<\/jats:p>","DOI":"10.3390\/systems14010040","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:30:32Z","timestamp":1767195032000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Homeownership Beneficial for Rural-to-Urban Migrants\u2019 Access to Public Health Services? Exploring Housing Disparities Within Urban Health Systems"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2676-2030","authenticated-orcid":false,"given":"Peng","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Sociology, School of Philosophy, Zhongnan University of Economics and Law, Wuhan 430073, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qunli","family":"Tan","sequence":"additional","affiliation":[{"name":"School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan 430073, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Hou","sequence":"additional","affiliation":[{"name":"School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan 430073, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Song, Y., Liu, J., Yan, S., Ma, M., Tarimo, C.S., Chen, Y., Lai, Y., Guo, X., Wu, J., and Ye, B. (2025). Factors influencing health service utilization among 19,869 China\u2019s migrant population: An empirical study based on the Andersen behavioral model. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1456839"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1017\/S0021932016000195","article-title":"Utilization of maternal health services among internal migrants in Mumbai, India","volume":"48","author":"Gawde","year":"2016","journal-title":"J. Biosoc. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1002\/hpm.2570","article-title":"Migration and health: A systematic review on health and health care of internal migrants in India","volume":"33","author":"Kusuma","year":"2018","journal-title":"Int. J. Health Plan. Manag."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.healthpol.2019.01.014","article-title":"Barriers to health care access and service utilization of refugees in Austria: Evidence from a cross-sectional survey","volume":"123","author":"Kohlenberger","year":"2019","journal-title":"Health Policy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40985-020-00121-w","article-title":"Involvement in maternal care by migrants and ethnic minorities: A narrative review","volume":"41","author":"Massag","year":"2020","journal-title":"Public Health Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"100277","DOI":"10.1016\/j.jmh.2024.100277","article-title":"Comparing health service usage of migrant groups in Australia: Evidence from the household income and labour dynamics survey of Australia","volume":"10","author":"Brown","year":"2024","journal-title":"J. Migr. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/j.healthpol.2021.05.018","article-title":"Migrant health and language barriers: Uncovering macro level influences on the implementation of trained interpreters in healthcare settings","volume":"125","author":"Puthoopparambil","year":"2021","journal-title":"Health Policy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.lindif.2018.07.003","article-title":"Acculturation patterns and education of refugees and asylum seekers: A systematic literature review","volume":"67","author":"Sheikh","year":"2018","journal-title":"Learn. Individ. Differ."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1093\/eurpub\/ckad051","article-title":"Disruption and selection: The income gradient in mortality among natives and migrants in Sweden","volume":"33","author":"Rehnberg","year":"2023","journal-title":"Eur. J. Public Health"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ginsburg, C., Collinson, M.A., G\u00f3mez-Oliv\u00e9, F.X., Gross, M., Harawa, S., Lurie, M.N., Mukondwa, K., Pheiffer, C.F., Tollman, S., and Wang, R. (2021). Internal migration and health in South Africa: Determinants of healthcare utilisation in a young adult cohort. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10590-6"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e987","DOI":"10.1016\/S2468-2667(22)00206-7","article-title":"Strengthening public health systems in China","volume":"7","author":"Meng","year":"2022","journal-title":"Lancet Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/0044118X10393484","article-title":"Ethiopian emerging adult immigrants in Israel: Coping with discrimination and racism","volume":"44","author":"Walsh","year":"2012","journal-title":"Youth Soc."},{"key":"ref_13","unstructured":"National Bureau of Statistics (2025, April 25). The Primary Data of the 7th National Population Census, Available online: https:\/\/www.stats.gov.cn\/sj\/zxfb\/202302\/t20230203_1901080.html."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1097\/MLR.0b013e31817a835d","article-title":"National health surveys and the behavioral model of health services use","volume":"46","author":"Andersen","year":"2008","journal-title":"Med. Care"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Suo, Z., Shao, L., and Lang, Y. (2023). A study on the factors influencing the utilization of public health services by China\u2019s migrant population based on the Shapley value method. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-17193-3"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"116148","DOI":"10.1016\/j.socscimed.2023.116148","article-title":"Equality of public health service and family doctor contract service utilisation among migrants in China","volume":"333","author":"Chen","year":"2023","journal-title":"Soc. Sci. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Meng, X. (2019). Does a Different Household Registration Affect Migrants\u2019 Access to Basic Public Health Services in China?. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16234615"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"118523","DOI":"10.1016\/j.socscimed.2025.118523","article-title":"Housing crowding and sleep health in urban China: A mediation analysis of psychosocial pathways using nationally representative data","volume":"384","author":"Yan","year":"2025","journal-title":"Soc. Sci. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Wang, Z., Wu, Q., and Ming, J. (2020). The Relationship Between Homeownership and the Utilization of Local Public Health Services Among Rural Migrants in China: A Nationwide Cross-Sectional Study. Front. Public Health, 8.","DOI":"10.3389\/fpubh.2020.589038"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Wu, Y., Xu, M., Li, S., Wang, H., and Dong, Q. (2024). The land of homesickness: The impact of homesteads on the social integration of rural migrants. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0307605"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104128","DOI":"10.1016\/j.cities.2022.104128","article-title":"Housing cost burden, homeownership, and self-rated health among migrant workers in Chinese cities: The confounding effect of residence duration","volume":"133","author":"Wang","year":"2023","journal-title":"Cities"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"101614","DOI":"10.1016\/j.ssmph.2024.101614","article-title":"Social integration as a mediator of the association between housing tenure and health inequalities among China\u2019s migrants: A housing discrimination perspective","volume":"25","author":"Jia","year":"2024","journal-title":"SSM-Popul. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1007\/s11442-023-2155-1","article-title":"Housing tenure and type choices of urban migrants in China","volume":"33","author":"Liu","year":"2023","journal-title":"J. Geogr. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e2374","DOI":"10.1002\/psp.2374","article-title":"Beyond neighbouring: Migrants\u2019 place attachment to their host cities in China","volume":"27","author":"Lin","year":"2021","journal-title":"Popul. Space Place"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Xu, X., Zhang, Q., You, H., and Wu, Q. (2022). Awareness, Utilization and Health Outcomes of National Essential Public Health Service Among Migrants in China. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.936275"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1057\/s41271-025-00567-9","article-title":"Evaluating Chinese migrant workers\u2019 housing conditions by diarrhea disease prevalence","volume":"46","author":"Lyu","year":"2025","journal-title":"J. Public Health Policy"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11113-023-09752-8","article-title":"Self-rated Health and Objective Health Status Among Rural-to-Urban Migrants in China: A Healthy Housing Perspective","volume":"42","author":"Zhou","year":"2023","journal-title":"Popul. Res. Policy Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1086\/214592","article-title":"Human Migration and the Marginal Man","volume":"33","author":"Park","year":"1928","journal-title":"Am. J. Sociol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"101991","DOI":"10.1016\/j.ijintrel.2024.101991","article-title":"Acculturation of rural\u2013urban migrants in China: Strategies and determinants","volume":"101","author":"Xie","year":"2024","journal-title":"Int. J. Intercult. Relat."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e2600","DOI":"10.1002\/psp.2600","article-title":"Housing characteristics and health in urban China: A comparative study of rural migrants and urban locals","volume":"29","author":"Zhou","year":"2023","journal-title":"Popul. Space Place"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s10901-020-09728-6","article-title":"Homeownership and happiness in urban China","volume":"36","author":"Fong","year":"2021","journal-title":"J. Hous. Built Environ."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Huang, L., Said, R., Goh, H.C., and Cao, Y. (2023). The Residential Environment and Health and Well-Being of Chinese Migrant Populations: A systematic review. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20042968"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.geoforum.2020.04.008","article-title":"Social integration of migrants across Chinese neighbourhoods","volume":"112","author":"Lin","year":"2020","journal-title":"Geoforum"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ma, N., Sun, W., and Wang, Z. (2022). Host identity and consumption behavior: Evidence from rural\u2013urban migrants in China. Sustainability, 14.","DOI":"10.3390\/su141912462"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Peng, B., and Ling, L. (2023). Health service behaviors of migrants: A conceptual framework. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1043135"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3647","DOI":"10.1111\/jan.16693","article-title":"Transnational Healthcare Practices Among Migrants: A concept analysis","volume":"81","author":"Metersky","year":"2025","journal-title":"J. Adv. Nurs."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12992-018-0370-9","article-title":"Use of health services among international migrant children\u2014A systematic review","volume":"14","author":"Markkula","year":"2018","journal-title":"Glob. Health"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Dong, E., Yan, Y., Ji, S., Li, J., Wang, T., Shi, J., Xu, T., Gao, W., Liu, Y., and Zhang, S. (2025). The influences of acculturation strategies on physician trust among internal migrants in Shanghai, China: A cross-sectional study in 2021. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1506520"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1146\/annurev.psych.49.1.65","article-title":"Intergroup contact theory","volume":"49","author":"Pettigrew","year":"1998","journal-title":"Annu. Rev. Psychol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1177\/0791603519863295","article-title":"Social values and civic behaviour among youth in Ireland: The influence of social contexts","volume":"28","author":"Silke","year":"2020","journal-title":"Ir. J. Sociol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e034255","DOI":"10.1136\/bmjopen-2019-034255","article-title":"Effect of social integration on the establishment of health records among elderly migrants in China: A nationwide cross-sectional study","volume":"9","author":"Jing","year":"2019","journal-title":"BMJ Open"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Zhao, Q., Xu, S., Aziz, N., He, J., and Wang, Y. (2022). Dialect culture and the utilization of public health service by rural migrants: Insights from China. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.985343"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"235","DOI":"10.24920\/004254","article-title":"A dataset on the dynamic monitoring of health and family planning of China\u2019s internal migrants: A multi-wave large-scale, national cross-sectional survey from 2009 to 2018","volume":"38","author":"Zhang","year":"2023","journal-title":"Chin. Med. Sci. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/biomet\/70.1.41","article-title":"The central role of the propensity score in observational studies for causal effects","volume":"70","author":"Rosenbaum","year":"1983","journal-title":"Biometrika"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/07350015.2016.1227711","article-title":"Unobservable selection and coefficient stability: Theory and evidence","volume":"37","author":"Oster","year":"2019","journal-title":"J. Bus. Econ. Stat."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.jclinepi.2021.01.025","article-title":"Hypothetical case replacement can be used to quantify the robustness of trial results","volume":"134","author":"Frank","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1177\/0049124113494572","article-title":"Total, Direct, and Indirect Effects in Logit and Probit Models","volume":"42","author":"Breen","year":"2013","journal-title":"Sociol. Methods Res."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Zhao, Q., Wu, G., Wang, H., and Aziz, N. (2024). How does choice of residential community affect the social integration of rural migrants: Insights from China. BMC Psychol., 12.","DOI":"10.1186\/s40359-024-01617-9"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1186\/s13690-023-01218-9","article-title":"The effect of housing tenure on health status of migrant populations in China: Are health service utilization and social integration mediating factors?","volume":"81","author":"Jia","year":"2023","journal-title":"Arch. Public Health"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Xu, H., Yang, H., Wang, H., and Li, X. (2021). The Association of Residence Permits on Utilization of Health Care Services by Migrant Workers in China. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18189623"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Pabbla, A., Duijster, D., Aartman, I.H.A., and Agyemang, C. (2024). Predictors of oral healthcare utilization and satisfaction among Indian migrants and the host population in the Netherlands. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04988-y"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1186\/s12939-021-01584-2","article-title":"Sociodemographic disparities in the establishment of health records among 0.5 million migrants from 2014 to 2017 in China: A nationwide cross-sectional study","volume":"20","author":"Wang","year":"2021","journal-title":"Int. J. Equity Health"}],"container-title":["Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-8954\/14\/1\/40\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T16:02:51Z","timestamp":1767196971000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-8954\/14\/1\/40"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,30]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["systems14010040"],"URL":"https:\/\/doi.org\/10.3390\/systems14010040","relation":{},"ISSN":["2079-8954"],"issn-type":[{"value":"2079-8954","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,30]]}}}