Determinants of receipt of health education on non-communicable diseases through communities or workplaces among China’s rural-to-urban migrant population: a national repeated cross-sectional study

BACKGROUND: Health education plays a critical role in promoting preventive behaviours, improving disease awareness, and supporting non-communicable diseases (NCDs) prevention and management. This study aimed to examine the receipt, forms and determinants of NCD health education among rural-to-urban migrants in China. METHODS: Data were obtained from the 2014-2018 China Migrants Dynamic Survey. A repeated cross-sectional analysis was conducted among 665,218 rural-to-urban migrants. The dependent variable was whether participants had received health education on NCD prevention through their community or workplace in the past year. Independent variables included demographic and socioeconomic characteristics, migration-related factors, health record establishment, and family doctor contracting. Descriptive statistics were used to assess receipt and forms of health education. Chi-squared tests were used to compare the characteristics of participants who did and did not receive NCD health education. Multivariable binary logistic regression models were further used to identify factors independently associated with receipt of NCD health education. RESULTS: The proportion of migrants receiving NCD health education ranged from 15 to 30% between 2014 and 2018. Most education was delivered through printed or audiovisual materials (>80%), and face-to-face consultations declined from 43.7% in 2014 to 22.5% in 2018 (P < 0.001). Middle-aged and older migrants (aged >45 years; aOR 2.473, 95% CI: 2.184-2.801), those with education beyond junior high school (aOR 1.313, 95% CI: 1.236-1.394) and longer migration duration (aOR 1.126, 95% CI: 1.076-1.178) were more likely to receive health education. Higher per capita monthly household income (aOR 1.048, 95% CI: 1.003-1.094), established local health records (aOR 1.948, 95% CI: 1.885-2.013) and family doctor contracts (aOR 1.716, 95% CI: 1.643-1.792) were also positively associated. In contrast, female migrants (aOR 0.916, 95% CI: 0.890-0.942), migrants moving to East or North China (aOR 0.918, 95% CI: 0.865-0.975; aOR 0.916, 95% CI: 0.860-0.976) and those migrating with family members (aOR 0.957, 95% CI: 0.924-0.992) were less likely to receive health education. CONCLUSIONS: Receipt of NCD health education among rural-to-urban migrants remains limited, with reliance on passive information channels. Expanding community- and workplace-based programs, and strengthening family doctor services may help improve access to health education.