Is Homeownership Beneficial for Rural-to-Urban Migrants’ Access to Public Health Services? Exploring Housing Disparities Within Urban Health Systems

In the context of China’s accelerated urbanization process, the increasing number of rural-to-urban migrants has become an integral part of urban economic development. Ensuring stable housing for the floating population is essential to facilitating their integration into urban society and promoting the realization of their health rights. Drawing on data from a large-scale survey of Chinese internal migrants, this study empirically analyzes how homeownership influences health services accessibility in rural-to-urban migrants. The findings indicated that homeowners exhibited approximately 18.4% higher odds ratio of accessing public health services compared to renters. This result remained robust after addressing potential reverse causality using instrumental variable approaches and correcting for self-selection bias through propensity score weighting methods. Meanwhile, the mediating effect decomposition showed that migrants’ perception of acculturation and community participation played parallel mediating roles in the relationship between homeownership and health services accessibility. Furthermore, the heterogeneity analysis revealed that the positive impact of homeownership on health services accessibility was more pronounced among individuals with lower household income and shorter migration duration. Our research underscores the importance of securing stable housing for rural-to-urban migrants as a key determinant in advancing the equitable development of urban health systems.