China Population and Development Studies

, Volume 2, Issue 1, pp 83–107 | Cite as

The social provision of healthcare to migrants in the US and in China

  • Van C. TranEmail author
  • Katharine M. Donato
Original Article


This article develops a comparative analysis of healthcare provision to migrants in the US and in China. It proceeds in three parts. First, we begin by describing the growth of the unauthorized population and trace the evolution of social provision of healthcare to immigrants, highlighting the restrictive nature of federal social provisions and greater autonomy of state and local governments in redefining eligibility criteria in the US. Second, we examine the impact of legal status on healthcare access and utilization among Mexicans, using original data from the 2007 Hispanic Healthcare Survey and the Mexican Migration Project. We find that unauthorized immigrants report the lowest level of healthcare access and utilization. Third, we then outline a China–US comparative agenda, pointing to similarities between the two migrant flows. In China, recent developments of healthcare coverage for both rural and urban populations have increased access to healthcare, but rural-to-urban migrants still report many barriers in receiving care and are often left out of this growing safety net. We then close with a discussion of lessons learned from the US experience and remaining questions for future comparative research.


Unauthorized migrants Rural-to-urban migrants Social provision Healthcare access Comparative research US and China 


  1. Abrego, L. (2013). Sacrificing Families: Navigating Laws, Labor, and Love Across Borders. CA: Stanford University Press.Google Scholar
  2. Amuedo-Dorantes, C., Puttitanun, T., & Martinez-Donate, A. P. (2013). How do tougher immigration measures affect unauthorized immigrants? Demography, 50(3), 1067–1091.CrossRefGoogle Scholar
  3. Aranda, E., Menjivar, C., & Donato, K. M. (2014). The spillover consequences of an enforcement-first US immigration regime. American Behavioral Scientist, 58(13), 1687–1695.CrossRefGoogle Scholar
  4. Armenta, A. (2017). Protect, serve, and deport: The rise of policing as immigration enforcement. Berkeley, CA: University of California.CrossRefGoogle Scholar
  5. Chen, C., Henry L., Gerald, B., & Ding, S. (2010). Internal migration and ‘rural/urban’ households in china: implications for health care. In Paper presented at the ten years of war against poverty conference, Chronic Poverty Research Center.Google Scholar
  6. Connelly, R., Roberts, K., & Zheng, Z. (2011). The settlement of rural migrants in urban China—Some of China’s migrants are not ‘floating’ anymore. Journal of Chinese Economic and Business Studies, 9(3), 283–300.CrossRefGoogle Scholar
  7. Donato, K. M., & Armenta, A. (2011). What we know about unauthorized migration. Annual Review of Sociology, 37, 529–543.CrossRefGoogle Scholar
  8. Donato, K. M., & Rodriguez, L. (2014). Police arrests in a time of uncertainty: The impact of 287(g) on arrests in a new immigrant gateway. American Behavioral Scientist, 58(13), 1696–1722.CrossRefGoogle Scholar
  9. Dreby, J. (2010). Divided by Borders: Mexican Migrants and their Children. Berkeley: University of California Press.Google Scholar
  10. Eggleston, K. (2010). ‘Kan Bing Nan, Kan Bing Gui’: Challenges for China’s healthcare system thirty years into reform. In J. C. Oi, S. Rozelle, & X. Zhou (Eds.), Growing pains: Tensions and opportunities in China’s transformation. Stanford, CA: Walter H. Shorenstein Asia-Pacific Research Center.Google Scholar
  11. Fang, K., Shia, B., & Ma, S. (2012). Health insurance coverage and impact: A survey in three cities in China. PLoS One, 7(6), e39157.CrossRefGoogle Scholar
  12. Fortuny, K., & Chaudry, A. (2011). A comprehensive review of immigrant access to health and human services. Washington, D.C.: The Urban Institute, April.Google Scholar
  13. Goldman, D. P., Smith, J. P., & Sood, N. (2005). Legal Status and Health Insurance among Immigrants. Health Affairs, 24(6), 1640–1653.CrossRefGoogle Scholar
  14. Gong, P., Liang, S., Carlton, E. J., Jiang, Q., Jianyong, W., Wang, L., et al. (2012). Urbanisation and health in China. Lancet, 379, 843–852.CrossRefGoogle Scholar
  15. Hagan, J., Brianna, C., & Rodriguez, N. (2010). The effects of US deportation policies on immigrant families and communities: Cross-border perspectives. North Carolina Law Review, 88, 1799–1823.Google Scholar
  16. Hagan, J., Eschbach, K., & Rodriguez, N. (2008). US deportation policy, family separation, and circular migration. International Migration Review, 42, 64–88.CrossRefGoogle Scholar
  17. Hartman, M., et al. (2010). Health spending growth at historic low in 2008. Health Affairs, 29(1), 147–155.CrossRefGoogle Scholar
  18. Hesketh, T., Jun, Y. X., Li, L., & Mei, W. H. (2008). Health status and access to health care of migrant workers in China. Public Health Reports, 123(2), 189–197.CrossRefGoogle Scholar
  19. Holdaway, J. (2011). A common challenge: demographic transition, social stratification and the education of the children of immigrants in China, Europe and the United States. In Paper presented at the CASS-SSRC international conference, labor migration and the integration of new and second generation, held in Beijing, August 24–25, 2010.Google Scholar
  20. Hong, Y., Li, X., Stanton, B., Lin, D., Fang, X., Rong, M., et al. (2006). Too costly to be ill: Access to health care and health seeking behaviors among rural-to-urban migrants in China. World Health and Population, 5(1), 19–31.Google Scholar
  21. Hopkins, D. J. (2010). Politicized places: Explaining where and when immigrants provoke local opposition. The American Political Science Review, 104(1), 40–60.CrossRefGoogle Scholar
  22. Joseph, T. D., & Marrow, H. B. (2017). Introduction to the special issue: Lessons from the affordable care act for the health of immigrants and minorities in the United States. Journal of Ethnic and Migration Studies, 43(12), 1965–1984.CrossRefGoogle Scholar
  23. Krogstad, J. M., Passel, J. S., & Cohn, D. (2017). Five facts about illegal immigration in the US. Pew Research Center Report. Access on 2 Mar 2018.Google Scholar
  24. Lam, K. K. F., & Johnston, J. M. (2012). Health insurance and healthcare utilisation for Shenzhen residents: A tale of registrants and migrants? BMC Public Health, 12, 868.CrossRefGoogle Scholar
  25. Li, X., Stanton, B., Fang, X., & Lin, D. (2006). Social stigmatization and mental health among rural-to-urban migrants in China: A conceptual model and some future research needs. World Health and Population, 8(3), 14–31.CrossRefGoogle Scholar
  26. Marrow, H. B. (2012). Deserving to a point: Unauthorized immigrants in San Francisco’s universal access healthcare model. Social Science and Medicine, 74(6), 846–854.CrossRefGoogle Scholar
  27. Massey, D. S., Durand, J., & Malone, N. J. (2002). Smoke and mirrors: Mexican immigration in an era of economic integration. New York: Russell Sage Foundation.Google Scholar
  28. Meng, Q., Ling, X., Zhang, Y., Qian, J., Cai, M., Xin, Y., et al. (2012). Trends in access to health services and financial protection in China between 2003 and 2011: A cross-sectional study. Lancet, 379, 805–814.CrossRefGoogle Scholar
  29. Mou, J., Cheng, J., Zhang, D., Jiang, H., Lin, L., & Griffiths, S. M. (2009). Health care utilisation amongst shenzhen migrant workers: Does being insured make a difference? BMC Health Service Research, 9, 214.CrossRefGoogle Scholar
  30. Newton, L. (2012). Policy innovation or vertical integration? A view of immigration federalism from the states. Law and Policy, 34(2), 113–137.CrossRefGoogle Scholar
  31. Niu, J., & Zheng, Z. (2017). Hukou-restricted migration and migrant’s health: Evidence and policy implication. China Population and Development Studies, 1(2), 81–103.Google Scholar
  32. Niu, J., Zheng, Z., Zhang, L., & Zeng, X. (2011). Labor migrants’ working and living environments and the related health impacts: Evidence from Shenzhen. Population Research, 3, 64–75. (in Chinese).Google Scholar
  33. Passel, J. S., & Cohn, D. (2011). Unauthorized immigrant population: National and state trends, 2010. Washington, DC: Pew Hispanic Center, February.Google Scholar
  34. Portes, A., Fernández-Kelly, P., & Light, D. (2012). Life on the edge: Immigrants confront the american health system. Ethnic and Racial Studies, 35(1), 3–22.CrossRefGoogle Scholar
  35. Provine, D. M., & Varsanyi, M. W. (2012). Scaled down: perspectives on state and local creation and enforcement of immigration law. Introduction to the special issue of law & policy. Law and Policy, 34(2), 105–112.CrossRefGoogle Scholar
  36. Roberts, K. (1997). China’s ‘tidal wave’ of migrant labor: What can we learn from Mexican undocumented migration to the United States? International Migration Review, 31(2), 249–293.Google Scholar
  37. Rodríguez, N., & Hagan, J. (2004). Fractured Families and Communities: Effects of Immigration Reform in Texas, Mexico and El Salvador. Journal of Latino Studies, 2(3), 328–351.CrossRefGoogle Scholar
  38. Searles, C. (2012). Beyond health care reform: Immigrants and the future of medicine. Ethnic and Racial Studies, 35(1), 135–149.CrossRefGoogle Scholar
  39. US Bureau of Primary Care. (2008). Health centers: America’s primary care safety net. Rockville, MD: US Bureau of Primary Care.Google Scholar
  40. Varsanyi, M. W., Lewis, P. G., Provine, D. M., & Decker, S. (2012). A multilayered jurisdictional patchwork: Immigration federalism in the United States. Law and Policy, 34(2), 138–158.CrossRefGoogle Scholar
  41. Viladrich, A. (2012). Beyond welfare reform: Reframing undocumented immigrants’ entitlement to health care in the United States, a critical review. Social Science and Medicine, 74(6), 822–829.CrossRefGoogle Scholar
  42. Warner, D. C. (2012). Access to health services for immigrants in the USA: From the great society to the 2010 health reform act and after. Ethnic and Racial Studies, 35(1), 40–55.CrossRefGoogle Scholar
  43. Willen, S. S. (2012). Migration, "Illegality," and Health: Mapping Embodied Vulnerability and Debating Health-Related Deservingness. Social Science and Medicine, 74(6), 805–811.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of SociologyColumbia UniversityNew YorkUSA
  2. 2.School of Foreign ServiceGeorgetown UniversityWashingtonUSA

Personalised recommendations