Social capital, objective social integration, subjective social integration, and utilization of public health services among older migrant population: a structural equation modeling analysis of multi-group chain mediating effect

Enhancing accessibility and equity in basic public health services for older migrants constitutes a pivotal objective within global healthcare systems. Previous research has elucidated the impact of social capital, as well as objective and subjective social integration, on the utilization of public health services. However, there exists a dearth of studies investigating the specific pathways linking these factors. The present study conducted an analysis of data obtained from the 2017 China Mobile Population Dynamic Monitoring Survey, which involved a sample of 5729 older migrants. Structural equation modelling was employed to examine our hypothesized model encompassing social capital, objective social integration, subjective social integration, and the utilization of public health services. Multi-group analysis was utilized to validate the moderating role of migrant reasons within the proposed model. The findings indicated a positive association between social capital and the utilization of public health services (β = 0.037, p < 0.05). Social capital was positively correlated with two mediating variables, objective (β = 0.216, p < 0.001) and subjective social integration (β = 0.095, p < 0.001). Objective social integration was positively correlated with subjective social integration (β = 0.144, p < 0.001). Both objective (β = 0.386, p < 0.001) and subjective social integration (β = 0.144, p < 0.001) exhibited a positive relationship with the utilization of public health services. Finally, the impact of social capital on the utilization of public health services varied depending on the reason for migration. Social capital was positively associated with the utilization of public health services. Objective and subjective social integration were crucial factors in this process. The impact of social capital on the utilization of public health services varied based on migration motivations. These insights are valuable for policies promoting equal access to public health services and overall well-being for older migrants in an aging society.