Impact of Urbanization on Health Behaviors and Outcomes Among Older Rural-to-urban Migrants in China: A Qualitative Case Study

China's rapid urbanization has led to significant lifestyle changes for rural-to-urban migrants, impacting their health behaviors and outcomes. This study focuses on older rural-to-urban migrants in Nantong, China, to explore how health-related behaviors mediate the relationship between urban life exposure and health outcomes. Through in-depth interviews with four male respondents aged around 65 who migrated in the 1990s, the study examines changes in tobacco use, alcohol consumption, physical activity, and diet. Findings reveal that smoking and drinking frequencies increased after migration due to social and occupational pressures. Physical activity levels varied significantly depending on the nature of employment, with manual laborers maintaining higher activity levels compared to sedentary workers. Dietary changes were generally positive, with migrants accessing more diverse and nutritious foods, though some faced challenges with unhealthy restaurant meals due to job demands. The study concludes that physical activity is a critical factor distinguishing healthier migrants from those with poorer health outcomes, while the impact of smoking and moderate drinking appears less significant. These insights highlight the need for targeted public health strategies to support the well-being of older migrants in rapidly urbanizing contexts.