少数民族流动人口的流动特征、社会融合对基本公共卫生服务利用的影响

目的 了解少数民族流动人口的流动特征、社会融合对基本公共卫生服务利用的影响。方法 基于2017年全国流动人口动态监测调查数据，采用两水平logistic回归模型分析少数民族流动人口的流动特征、社会融合与建立居民健康档案、接受健康教育和慢性病健康管理之间的关联性。结果 少数民族流动人口中，36.54% 建立了居民健康档案，以及分别有76.48%和42.49%接受过健康教育和慢性病健康管理。多因素分析结果显示，家庭化流动（OR=1.25；95%CI:1.04~1.49）、跨省流动（OR=1.12；95%CI:1.01~1.25）、流入城市（OR=1.34；95%CI:1.23~1.47）、有社会保障（OR=1.98；95%CI:1.82~2.15）、办理了居住证（OR=1.33；95%CI:1.22~1.46）、有落户意愿（OR=1.13；95%CI:1.02~1.24）以及心理融合（OR=1.07；95%CI:1.05~1.09）与社会参与（OR=1.17；95%CI:1.14~1.21）程度越高，是建档的正向影响因素。而流动城市数在2~3个内相对于1个以内是建档的负向影响因素（OR=0.87；95%CI:0.79~0.95）。有社会保障（OR=1.23；95%CI:1.12~1.35）、居住证（OR=1.45；95%CI:1.32~1.60）及社会参与（OR=1.31；95%CI:1.26~1.37）和心理融合（OR=1.03；95%CI:1.01~1.04）越高，是接受健康教育的正向影响因素，而流动城市数在4个及以上相对于1个以内是接受健康教育的负向影响因素（OR=0.82；95%CI:0.69~0.98）。此外，有居住证（OR=1.54；95%CI:1.07~2.20）和落户意愿（OR=1.66；95%CI:1.11~2.48）对接受慢性病健康管理具有显著的正向效应。 结论 少数民族流动人口对基本公共卫生服务的利用水平总体较低。需要格外关注独自流动、省内流动、流动稳定性较差的人群，促进地区和城乡间基本公共卫生服务的均等化、均衡化发展；通过提高社会融合程度提高基本公共卫生服务的利用水平。

The Influence of the mobility characteristics and social integration of the migrant ethnic minority population on the utilization of the basic public health services

Objective To understand the influence of the mobility characteristics and social integration of the migrant ethnic minority population on the utilization of the basic public health services. Methods Based on the data of China Migrants Dynamic Survey in 2017, thetwo-level logistic regression model was used to analyze the mobility characteristicsof the migrant ethnic minority population, the relationship between social integration and the establishment of health records, health education and chronic disease health management. Results Among the minority floating population, 36.54% had established health records, and 76.48% and 42.49% had received health education and chronic disease health management, respectively. The results of multi-factor analysis showed that the flow of family(OR=1.25; 95%CI:1.04-1.49), inter-provincial flow(OR=1.12; 95%CI:1.01-1.25), flow into cities(OR=1.34; 95%CI:1.23-1.47), having social security(OR=1.98; 95%CI:1.82-2.15), having applied for residence permits(OR=1.33; 95%CI:1.22-1.46), having the willingness to settle down(OR=1.13; 95 %CI:1.02-1.24), psychological integration(OR=1.07; 95%CI:1.05-1.09) and social participation(OR=1.17; 95%CI:1.14-1.21) were the positive factors influencing the establishment of health records. However, the number of floating cities within 2-3 relative to within 1 was a negative influencing factor(OR=0.87; 95%CI:0.79-0.95). Having social security(OR=1.23; 95%CI:1.12-1.35), having residence permits(OR=1.45; 95%CI:1.32-1.60), social participation(OR=1.31; 95%CI:1.26-1.37) and psychological integration(OR=1.03; 95%CI:1.01-1.04) were the positive factors for receiving health education, while the number of the mobile cities in 4 and more relative to less than 1 was a negative influencing factor for receiving health education(OR=0.82; 95%CI:0.69-0.98). In addition, having residence permits(OR=1.54; 95%CI:1.07-2.20) and willingness to settle down(OR=1.66; 95%CI:1.11-2.48) had a significant positive effect on receiving chronic disease health management. Conclusion The utilization level of the basic public health services by ethnic minority migrating population is generally low. It is necessary to pay more attention to the people who flow independently, migrate within the province and have relatively unstable flows, so as to promote the equalized and balanced development of basic public health services between regions and urban and rural areas. And by improving the degree of social integration to improve the utilization level of basic public health services for the migrating population of ethnic minorities.