Well-being and health-related quality of life in new-generation migrant workers in Zhejiang province, China

According to the 2016 Report on China’s Migrant Population Development [1], the number of migrant population reached 253 million in 2015 in China, more than half of which were the new-generation migrant workers (NGMW).The migrant workers had made tremendous contributions to the rapid development of the local economy in urban areas. Although many industries in the city had become increasingly dependent on the migrant workers, due to the restrictions of the household registration system, they could not enjoy the same treatment as the urban residents. On the other hand, low educational degree and income of migrant workers aggravated the dilemma and they were on the edge of the social network [2].

New-generation migrant workers were born in the 1980s and began to flow around the 1990s. Compared with the first-generation migrant workers, the group characteristics mainly included that they had higher education levels, had no or less family burden, went out directly after graduating from school and had few farming experiences, they paid more attention to changing lifestyles and pursued better development opportunities [3].Some researchers pointed out that the main dilemmas faced by the NGMW include personal marriage, identity, career development and the barriers arising from economic, quality and social welfare [2].

The pursuit of happiness is a long-enshrined tradition that has recently become the cornerstone of the American Positive Psychology movement [4]. With the acceleration of China’s reform and opening up process, urbanization and the living standards of residents have continuously improved. The improvement of life satisfaction and quality of life and happiness will become the goal pursued by the residents. “Pursuit of happiness” and realizing the goal of life are the main purpose of the NGMW. Studies have shown that the subjective well-being of migrant workers is not only lower than that of urban residents, but also lower than that of rural residents, mainly because they have a strong sense of relative deprivation [5].

The contemporary studies of happiness in the developed world demonstrate the change in the focus of research interest from objective well-being to subjective well-being and from the economic rationale of happiness to the psychological rationale of happiness [6]. Numerous studies have found that although subjective well-being (SWB) and psychological well-being (PWB) show many differences, they have shown a trend of mutual integration. For a better and more comprehensive understanding of happiness, integrating SWB and PWB will be a major trend in the study of future happiness [7]. Miao YJ developed a comprehensive scale (Multiple Happiness Questionnaire, MHQ) in Chinese population, which integrated SWB and PWB [8]. MHQ was a reliable and valid measure for well-being [8‐10]. Most of these investigations suggested that the main influential factors to well-being in migrant workers included income level, age, education, social support, Health-Related Quality of Life (HRQOL) and so on [5, 11, 12]. Previous studies reported that there were significant positive correlation between HRQOL and well-being [13, 14].

In this study, well-being of NGMW was assessed by comparing with first-generation migrant workers (FGMW) and urban workers (UW). The relationship of well-being and HRQOL and main influential factors in NGMW on well-being were analyzed by investigation.

Previous studies showed that the Multiple Happiness questionnaire (MHQ) has good reliability and validity among different population such as college students, middle school students and elderly population [8‐10]. Our study showed that the reliability of the overall scale, two summary scores and nine domains were very good (Cronbach’s a coefficient was above 0.7). With regard to construct validity, the subscores of MHQ were found to be satisfactory. Nine factors extracted by EFA were consistent with the theoretical structure and there was a good fit for the data of the questionnaire based on CFA (CFI = 0.909, TLI = 0.902, SRMR = 0.049, RMSEA = 0.051). For the CFI and TLI, the recommended cut-off for acceptable values are > 0.90. The model is well fitting for SRMR< 0.08. For the RMSEA, values of < 0.05 indicate a close fit and values below 0.11 are an acceptable fit [19, 20]. So MHQ is a reliable and valid measure for well-being in new-generation migrant workers.

Our results indicated that NGMW’s scores of PWB, HC and SV were much higher than FGMW’s. Compared to urban workers, NGMW’s GWB, SWB, LS, PR and AC scores were lower and NA score was higher (Table 3). NGMW had many differences with FGMW in their family environment, age, education, marital status, personal traits and farming experience. In addition, compared to FGMW, NGMW show new features in their work and life, such as they hope to improve their quality of life, realize their ideals, learn more knowledge and technology rather than survive and improve the family’s economic situation. NGMW also desire to get decent work and be close to the citizens rather than only earn more money than farming. Most NGMW wanted to live in city long time and gain long-term development rather than return to original countryside sooner or later [21]. Well-being of NGMW was higher than that of FGMW, especially in psychological well-being (PWB), health concern (HC) and subjective vitality (SV). NGMW had a strong sense of identity with the city, and their lifestyles were close to those of urban residents, greatly reducing the incompatibility of FGMW to urban life. However, NGMW’s general well-being (GWB), subjective well-being (SWB), life satisfaction (LS), positive relation (PR) and altruism commitment (AC) scores were lower and their negative affect (NA) was higher than that of urban workers. Although NGMW have received better education than FGMW, their social life circle is still narrow and it is more difficult to get social support than urban workers, which affect the happiness of NGMW. Due to the gap of high consumption of urban life and NGMW’s low income, they are vulnerable to feel “relative deprivation” [22]. Some of them suffered prejudice and discrimination from urban dwellers and produced stronger negative emotions.

There were significant differences in HRQOL (PCS and MCS) between NGMW and FGMW whether or not the confounding factors were adjusted (Table 3). Compared to FGMW, NGMW’s PCS score was higher, however MCS score was lower. Li et al. found that with the increase of age in city dwellers, both male and female, the PCS scores showed a downward trend, but their MCS scores showed an upward trend, which might be due to the greater social, work and life pressure on young and middle-aged people [16]. Except for LS and AC, correlation was found between well-being and HRQOL (Table 2), which was similar with other population study [13, 14, 23]. There was a negative correlation between NA and HRQOL, while other domains of MHQ (except for LS and AC) had positive correlation with PCS and MCS. The present results revealed the main factor that influenced NGMW’s well-being was HRQOL. The effect of MCS and PCS ranked first and second in the included variables (Table 4). Well-being is a positive subjective and psychological experience of self-existence and development, which is caused by the combination of objective conditions and demand value of individuals. Health-related quality of life directly determines the overall satisfaction of individuals in their own lives. Well-being and HRQOL are consistent from a certain point of view, they both assess health status and satisfaction based on subjective feelings. Similar studies showed that mental health and physical function were influencing factors of subjective well-being of the elderly [24]. There was very little research on the relationship between the well-being and HRQOL in NGMW. Compared to low social status, medium and high social status had positive influence on well-being. Xu et al. revealed that social status not only affected happiness, but also contributed more to the happiness of Chinese residents than income. The impact of social status on well-being increased as income increased [25]. GWB scores of married and cohabiting individuals were higher than those of single, divorced, separated and widowed individuals, which was similar to previous studies [26]. Stable marriage relationships often provided more material and emotional support. A negative relationship was found between age and well-being, and this result may be different from other studies [26, 27]. The discrepancy may be attributable to the different age ranges. NGMW were born after 1980 year, with different age ranges for different investigation years. NGMW were 15–38 years old in this study rather than the usual 15–30 or other ranges. Well-being was higher in high income workers compared to low income population. Although as people’s income increased, the impact of income on happiness gradually declined, economic factors still had played a fundamental role in the well-being of residents and higher income groups could experience more happiness [25, 26]. Inequality in income will lead to a sense of inferiority in resources and bring a strong sense of deprivation, which have a negative impact on happiness [26]. Nearly two-thirds population in high-income NGMW believed that raising income levels was one of the ways to improve happiness [28], the primary reason why NGMW left from rural to city was to increase the income to improve their quality of life. However their low level of skills made them earn lower salaries than the city dwellers. Some migrant workers sometimes suffered unfair event from employer such as “arrears of wages” and “deduction of wages” [26]. So the government should strengthen supervision mechanism to ensure that migrant workers receive legal income on schedule.

In order to further to improve the happiness and quality of life of the NGMW, government should improve the social security system and basic medical facilities to meet the needs of health and sanitation. The income of migrant workers should gradually increase, narrow the gap between urban workers and achieve equal pay for equal work. Better implementation of relevant laws should be strengthened. The society and the community work together to create a social atmosphere of equality, harmony and mutual assistance, and promote social integration.

The study demonstrated an acceptable reliability and validity of MHQ in specific population. The findings of this study highlighted the differences of well-being and HRQOL between the new-generation migrant workers and control groups (first-generation migrant workers and urban workers). This analysis provided additional evidence supporting that well-being in NGMW was higher than in FGMW, but was lower than in UW. A positive correlation was found between well-being and HRQOL. The main influential factors on well-being were MCS, PCS, self-reported social status, marital status, age and monthly income.