Review articlePrevalence and influencing factors of depressive symptoms among rural-to-urban migrant workers in China: A systematic review and meta-analysis
Introduction
With the rapid development of China's social economy, a large number of non-agricultural workers have flocked to the cities to work in urban construction, and these groups of workers living in cities to earn an income are known as “rural-to-urban migrant workers (Hargreaves et al., 2019; Li et al., 2020)”. Rural-to-urban migrant workers, also known as “migrant workers”, are those whose household registration is still in rural areas and who have been engaged in non-agricultural industries locally or have been working outside for 6 months or more (‘2020 Migrant Worker Monitoring Survey Report, n.d.’). Since the 1980s, rural-to-urban migrant workers have played an important role in meeting the expanding but fluctuating demand for urban labor, and have made a remarkable contribution to China's phenomenal economic development (Yang, 2014). According to the China National Bureau of Statistics (CNBS), the total number of rural-to-urban migrant workers has continued to increase over the past few decades, reaching almost 286 million in 2020, accounting for one-fifth of China's total population (‘2020 Migrant Worker Monitoring Survey Report, n.d.’).
Rural-to-urban migration involves not only a geographical departure from the actual place of residence, but more importantly also subtle changes in the psychological state of migrants (Hoffmann et al., 2019). The study found that migrants have certain advantages in mental health thanks to mutual support within the migrant family, the development of the city they move to, the availability of urban facilities and public services, and a perceived sense of well-being (Li et al., 2007). However, other studies have found that migrants are also prone to specific psychological vulnerabilities and social exclusion, which increases the risk of mental health problems (Datta, 2018). Migrants may be more prone to mental health problems such as depression than physical health, which may be related to the various stressors they face, such as difficult circumstances in deprived urban areas, difficult cultural adjustment processes or experiences of discrimination, broken social support systems, and psychological distress (Lu, 2010a, Lu, 2010b; Pyakuryal et al., 2011). A study of the psychological outcomes of Chinese migrants and their families found that depressive symptoms were the most common, which can lead to high rates of suicide and attempted suicide by migrants (Qiu et al., 2011; Lau et al., 2012; Mou et al., 2013). Furthermore, in a meta-analysis review, it was shown that in China, the prevalence of depressive symptoms at 12 months was 2.3% and the lifetime prevalence was 3.3%. In contrast, Chinese migrants are more likely to suffer from depression, however, the prevalence of depression varies greatly, ranging from 5.8% to 60.3% (Gu et al., 2013; Mou et al., 2011; Qiu et al., 2011; Zhong et al., 2015; Mo et al., 2020). Many studies suggest that the prevalence of depression is higher among migrant workers than non-migrant workers, and those migrant workers are more likely to experience psychological stress and unsolid social support than non-migrant workers; however, some studies have come to the opposite conclusion, explaining that this may be since some migrant workers leave their hometowns to improve their employment opportunities and economic situation, which can help improve depressive symptoms (Li et al., 2019b; Yang et al., 2020).
Given these mixed findings, it is necessary to accurately estimate the prevalence and influencing factors of depressive symptoms among this vulnerable group. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of depressive symptoms among rural-to-urban migrant workers in China and to identify influential factors associated with depressive symptoms across studies. Given the exploratory nature of the meta-analysis, we did not propose any prior hypotheses (Zhang et al., 2018a).
Section snippets
Materials and methods
This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement (Page et al., 2021) and registered with the PROSPERO database (registration number: CRD42022296430).
Literature search
The initial search resulted in 5695 citations from 10 electronic databases. 5665 studies were excluded because they did not meet the inclusion criteria. Finally, a total of 30 independent studies published between 2009 and 2020 were retained for this systematic review. Of these, 29 articles reported prevalence or OR values, and 95% CIs were included in the meta-analysis. Fig. 1 presents the detailed process of identifying eligible studies.
Study characteristics and methodological quality assessment
Table 1 displayed the basic characteristics of 30
Discussion
To the best of our knowledge, this is the first systematic review and meta-analysis to examine the prevalence and influencing factors of depressive symptoms among rural-to-urban migrant workers in China in both English and Chinese literature. The results of the meta-analysis showed that the overall prevalence of depressive symptoms among rural-to-urban migrant workers in China was 0.28, (95% CI: 0.22–0.34), and our results suggest that over a quarter of all of them suffer from depressive
Conclusions
The findings suggest that the prevalence of depressive symptoms among rural-to-urban migrant workers in China is not encouraging and we have summarized seven influencing factors, two of which are protective factors and five of which are risk factors. However, more high-quality studies and more representative samples are needed. Future research should focus on how to improve the mental health of rural-to-urban migrant workers such as depressive symptoms. Relevant authorities can develop policies
CRediT authorship contribution statement
Author Yang was responsible for literature searches, statistical analysis, and paper writing. Authors Chen conducted the statistical analysis and wrote the first draft of the manuscript. Author Wang managed the literature searches and screening. Author Zhang and Cai were responsible for article design, supervision, and final draft writing. All authors contributed to and approved the final manuscript.
Funding
This work was supported by the National Social Science Fund of China [grant numbers 19BSH043].
Declaration of competing interest
There is no conflict of interest.
Acknowledgments
We thank Ph.D. Huang, who kindly provided the necessary help for our data analysis.
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These authors contributed equally to this work.