Cancer is a prevailing cause of mortality worldwide, imposing an immense economic burden on both individual patients and society at large. Existing studies tend to focus more on the disease burden rather than the economic burden of cancer, failing to fully understand the crucial financial impact on cancer patients. Using the data from Electronic Health Records (EHRs) in all hospitals in Shenzhen, we analyzed the direct costs of inpatients with cancer in Shenzhen. The database included 10,540,120 inpatient records during 2016–2022. Furthermore, cancer-related inpatient records were extracted using International Classification of Diseases, 10th Revision. Descriptive statistics were used to analyze demographic variables, the trends of cost-related information during hospitalization, and hospitalization information including length of stay (LOS), number of hospitalized patients, and hospital visits. Additionally, we categorized the hospitalization records into 25 subgroups based on the types of cancer to conduct a more detailed analysis of each subgroup. During 2016 to 2022, 10,540,120 hospitalization records were observed (43.8

The application of Large Language Models (LLMs) in healthcare prompts critical reflection on the impact of linguistic justice on health equity. Disparities in data availability across languages during the training and evaluation phases of LLMs result in significant performance variations. These disparities risk reinforcing existing inequities in healthcare access and outcomes. This study outlines strategies for integrating linguistic justice into LLM assessment frameworks, advancing health equity and global health.

Non-communicable chronic diseases pose a significant public health challenge worldwide. China has launched a nationwide standardized Chronic Disease Patient Management program to provide primary care for patients with hypertension and type 2 diabetes, but its effect on reducing risks of other chronic diseases remains unclear. Here we show, using linked health profiles and medical records from 26 million residents in Shenzhen, China, that program enrollment is associated with lower comorbidity risk among 701,759 patients with newly diagnosed hypertension and 320,179 patients with newly diagnosed type 2 diabetes between 2017 and 2023. Instrumental variable analyses indicate that enrollment reduces overall comorbidity risk by 9% and 14%, respectively. Participants show lower risks for more than 20 chronic diseases. Intervention-specific analyses reveal heterogeneous effects, with alcohol-use, medication-adherence, and psychological support interventions reducing risks of multiple chronic diseases in both patient groups, whereas smoking cessation intervention shows more complex risk patterns among patients with hypertension. These findings support standardized chronic disease management for reducing comorbidity risk and highlight the need for personalized follow-up.

RATIONALE AND OBJECTIVES:Diagnostic safety in radiology may be influenced by occupational conditions beyond the point of image interpretation. This study examined whether workload was associated with diagnostic safety-related events directly or through sequential effects on recovery impairment and psychological strain. MATERIALS AND METHODS: In a nationwide cross-sectional survey of 3729 radiology residents from 407 training institutions in mainland China, we evaluated structural pathways linking workload, recovery impairment, psychological strain, and recent self-reported diagnostic safety-related events. Workload, recovery impairment, and psychological strain were operationalized as standardized composite scores. Generalized structural equation modeling with a weighted least squares mean- and variance-adjusted estimator was used to estimate direct and indirect associations. RESULTS:Workload was positively associated with recovery impairment (β = 0.45, P < .001), and recovery impairment was strongly associated with psychological strain (β = 1.63, P < .001). Psychological strain was associated with 1-month diagnostic safety-related events (β = 0.39, P = .03), whereas direct paths from workload and recovery impairment to events were not statistically significant. The serial indirect pathway from workload through recovery impairment and psychological strain to safety-related events was statistically significant (P = .03). In the 3-month sensitivity analysis, estimates followed the same direction as the primary model but were smaller in magnitude and did not reach statistical significance. Findings were consistent across individual workload indicators and training stages. CONCLUSION:Among radiology residents in China, workload was associated with recent self-reported diagnostic safety-related events primarily through impaired recovery and psychological strain rather than through a direct workload effect. These findings support a recovery-strain framework for understanding diagnostic vulnerability during training and suggest that protecting restorative capacity may be relevant to diagnostic safety interventions.

Rapid urbanization has produced disordered urban greenspace (UGS) development, closely tied to public health outcomes. Despite growing recognition of health policy's role in spatial planning, UGS remains weakly integrated into formal policymaking. Existing studies emphasize top-down influences, yet the role of institutionalized, demand-side Public Health Affairs (PHAs) in shaping UGS planning is underexplored. Using natural language processing (NLP), we classify 19,493 health-related suggestions submitted between 2011 and 2022. A geographic interaction matrix is constructed to assess their spatial distribution across provinces and years. These data integrated with remote sensing indicators and the Greenspace Equitable Development Index (GEDI), which captures both accessibility and diversity in urban greenspaces. Employing Fixed Effects (FE), Gaussian Mixture Modeling (GMM) and Multi-Scale Geographically Weighted Regression (MGWR), the findings show: (1) PHAs significantly affect UGS outcomes; GMM results indicate that a 1% rise in Two Session Suggestions (TSS) creases greenspace diversity by 0.362% with a three-year lag. (2) Social development-and health services-related TSS enhance greenspace accessibility and diversity, whereas law-and policy-related TSS show a delayed but significant positive effect on overall GEDI (beta = 0.016, p < 0.05). (3) The spatial influence of PHAs evolved from localized clusters in southern and western China in 2012 to an almost nationwide distribution by 2022. These results suggest that UGS development often emerges as an implicit outcome of broader PHAs, even without explicit targeting. Establishing a demand-side framework, this study demonstrates how participatory health affairs drive greenspace equity and health-responsive sustainability strategies within centralized urban governance contexts.

BackgroundCommunity health workers (CHWs) played an important role in community-based COVID-19 prevention and control while maintaining routine primary care. The pandemic created a stressful work context for CHWs and may also have been followed by perceived positive psychological changes. Although positive psychological changes have been studied among hospital-based healthcare workers, less is known about such changes among CHWs in China. This study assessed self-reported positive psychological changes and associated factors among Chinese CHWs after the COVID-19 pandemic.MethodsA mixed-methods study was conducted from April 29 to June 10, 2023, in Shenzhen, China. In the quantitative phase, cluster sampling was used to recruit CHWs from 51 community health centers. Participants completed an online survey on demographic characteristics, COVID-19-related exposure, rumination, coping strategies, perceived social support, and positive psychological changes. Moderate-to-high positive psychological changes were defined as a mean item score of ≥3 in at least one domain of the Chinese version of the Post-Traumatic Growth Inventory. Univariate and multivariable logistic regression analyses were performed. In the qualitative phase, purposive sampling was used to recruit CHWs for semi-structured interviews, and interview data were analyzed using interpretative phenomenological analysis.ResultsThe quantitative phase included 634 CHWs. The mean age was 35.7 years, and 76.0% were female. Overall, 58.8% reported moderate-to-high positive psychological change. After adjustment, moderate-to-high positive psychological change was associated with higher positive coping (AOR = 1.13, 95% CI: 1.08–1.18), deliberate rumination (AOR = 1.12, 95% CI: 1.06–1.18), and family support (AOR = 1.08, 95% CI: 1.02–1.14). Sensitivity analysis showed similar patterns, although some associations differed between the models. The qualitative phase included 12 CHWs from 6 community health centers. Interviews further suggested that coping strategies, cognitive processing, family support, and work-related support shaped their psychological adjustment.ConclusionMore than half of CHWs reported moderate-to-high positive psychological change after the COVID-19 pandemic. Workplace mental health programs for CHWs should address distress while supporting adaptive coping, reflective processing of difficult work experiences, and family-sensitive support. These measures may help protect CHWs’ mental health and improve primary care preparedness for future public health emergencies.

To investigate factors associated with quality of life (QoL) among women with urinary incontinence (UI) in a large, population-based sample. 9,974 women aged ≥ 20 years with UI from a national survey conducted between September 2019 and December 2021 using multistage, stratified, cluster sampling. UI severity was assessed using International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF), and QoL was evaluated using Incontinence Impact Questionnaire Short Form (IIQ-7). Women were categorized into good or poor QoL groups. Logistic regression was used to examine associations between potential risk factors and QoL, estimating odds ratios (ORs) and 95

Vaccination remains one of the most cost-effective methods for disease prevention. However, utilization of self-paid vaccines, including EV71, varicella, influenza, and DTaP-IPV-Hib in this study, remains insufficient among children under six in China. To investigate the determinants of willingness to vaccinate (WTV) for self-paid vaccines and assess cost-WTV heterogeneity, we conducted structured-questionnaire surveys with 2212 randomly selected households in Hangzhou, each with at least one child under six. Multiple regression analysis was used to identify the key determinants of WTV, and a mixed-effect model was employed to analyze the correlation between vaccine cost and WTV, further segmenting the data with unsupervised clustering techniques. Our findings highlighted impact of vaccination cost as a pivotal factor influencing the WTV for self-paid vaccines. We categorized the population into four groups based on their sensitivity to vaccine cost. Families with one child, children aged 1-3 y, highly-educated parents, and higher socioeconomic status consistently exhibited high WTV. Our analysis offers targeted strategies to enhance vaccine uptake and improve immunization coverage.

Background:Telemedicine has rapidly expanded; however, standardized, telemedicine-specific patient-reported experience measures tailored to outpatient workflows are limited in many settings. Objective:This study aimed to develop and psychometrically validate the Telemedicine Service Experience Questionnaire (TSEQ) for Chinese outpatients using telemedicine services. Methods:We conducted a web-based survey among outpatients who completed a telemedicine consultation at Peking Union Medical College Hospital between July 1, 2021, to August 31, 2021, and who had used telemedicine services, using an adapted Chinese Patient Experience Questionnaire that encompasses 15 questions across 4 dimensions, to investigate patients' telemedicine consultation experiences. Item generation was informed by a literature review, workflow mapping, and expert review. We evaluated the factor structure using exploratory factor analysis and confirmatory factor analysis on the full sample with cross-validation. Reliability was assessed using Cronbach α and item-total correlations. Results:In total, 3338 participants completed the survey (mean age 45.3, SD 17.8 y; n=2182, 65.4% female participants; n=1827, 54.8% with college education or above). The exploratory factor analysis of the final 14-item scale resulted in 4 factors. After scrutinizing the content, these factors were labeled "Service Efficiency," "Post-treatment," "Information Guidance," and "Humanistic Care," and they demonstrated good internal consistency (Cronbach α values of 0.876, 0.840, 0.962, and 0.876, respectively). Moreover, as the average variance extracted values were greater than 0.5 and the composite reliability values were greater than 0.7, the TSEQ scale has high convergent validity. Our findings suggest that the psychometric properties of the 14-item TSEQ are valid and reliable for assessing telemedicine service experience among Chinese outpatients. Conclusions:The TSEQ demonstrates a stable multidomain structure with satisfactory reliability and validity for evaluating outpatient telemedicine service experience in China. The instrument can support routine quality monitoring and guide targeted workflow improvements. Future studies should validate the TSEQ in multisite and postpandemic samples and examine measurement invariance across key subgroups.

Telemedicine has gained prominence in managing chronic diseases, particularly post-COVID-19. However, interventions often lack consistent categorization based on patient engagement levels, and evidence of efficacy remains heterogeneous. This review synthesized findings from systematic reviews to evaluate the benefits and challenges of telemedicine for chronic disease management. A systematic search of the Medline, EMBASE, and Web of Science databases was conducted to identify systematic reviews with meta-analyses published between January 2022 and December 2024. The Triple Aim framework was used to assess the impact of telemedicine on clinical outcomes, patient experience, and healthcare costs. A framework for digital patient engagement levels was developed to explore the relationship between engagement levels and intervention effectiveness. A total of 81 systematic reviews met the inclusion criteria. Among these, 31% focused on cardiovascular diseases, 30% on diabetes, 28% on cancer, 4% on chronic lung diseases, and 7% on general chronic conditions. Intervention levels were categorized as consultation (9%), involvement (42%), partnership/shared leadership (13%), or unspecified (36%). Clinical outcomes were reported in 61 reviews, patient-reported outcomes in 23, and economic impacts in only 4 reviews, indicating substantial research gaps. Telemedicine enhances patient care experiences and population health, demonstrating substantial benefits in managing diabetes, cancer, cardiovascular, and chronic lung diseases. It holds considerable potential for reducing healthcare costs. However, further research is needed to evaluate the feasibility and effectiveness of telemedicine across different engagement levels. Furthermore, standardized methodologies and improved tools are essential to advance telemedicine research and implementation.

OBJECTIVES:This study studied how health-related behaviours moderated or mediated the potential negative impacts of workload on well-being of healthcare providers, and examined their dynamic and heterogeneous effects on primary care physicians and residents. STUDY DESIGN:Cross-sectional study. METHODS:The study population was junior healthcare providers, who enrolled in a standardised primary care training track in China. A total of 14,315 surveys were distributed between December 2021 and February 2022, resulting in 9,208 valid responses from 17 provinces. The outcome variable was well-being, which was measured on a scale ranging from 1 to 5. The main explanatory variable was weekly working hours. Health-related behaviours included drinking, smoking, and exercising. OLS regression was used for moderation and mediation analyses. RESULTS:Healthcare providers reported an average of 50.86 working hours weekly, with a mean well-being score of 3.3. The proportions of providers who drinking alcohol, smoking, and exercising were 45 %, 6.9 %, and 63 %, respectively. Moderation analysis revealed that drinking had positive moderating effects in mitigating the adverse impact of workload on well-being, but these diminished as drinking frequency increased. Exercising also had positive moderating effects, with greater magnitudes. Smoking showed no moderating effect. Only exercising functioned as a mediator. CONCLUSIONS:Regular exercising and low frequency of drinking both positively moderated the negative effects of workload on well-being, with exercise showing a stronger effect. Heavy workloads limited providers' time for exercise, which further reduced their well-being. Smoking should be avoided, as it showed no beneficial effects on well-being.

Background Global warming is intensifying, exacerbating associated health issues. Heat-related illness, a critical risk during heatwaves, significantly impacts public health, yet its long-term health effects remain poorly understood. We established a cohort to investigate these health impact and explore the mitigative role of heatwave warnings. Methods Our cohort study enrolled 9,658,745 participants free of cardiovascular disease (CVD) at baseline from 1332 hospitals and 922 primary care centres in Shenzhen, China. The cohort was observed and followed up from January 1, 2017, to July 31, 2023. We utilized Cox proportional hazards model to analyse CVD incidence among participants who had heat-related illness versus those who did not, and further assessed causal relationship using instrumental variable approach. We employed stratified logistic regression to explore the protective effects of heatwave warning policies. Findings Among 9,658,745 participants followed up to 6 years, 238,278 (2.47%) developed CVD. People who developed CVD were generally older, male, with a higher degree of education, and with more hospital admissions before baseline. Heat-related illness was associated with CVD, with a hazard ratio of CVD 2.526 (95% CI = 2.301-2.773) among patients with heat-related illness compared with those without heat-related illness, and instrumental variable approach analysis suggested causation. Issuing heatwave warnings reduced hospital admissions for heat- related illness (OR [95% CI] = 0.902 [0.832-0.977]) and future CVD risk (OR [95% CI] = 0.964 [0.946-0.982]). The mitigative role of heatwave warnings suggested delayed effect, with mitigative effect at greatest magnitude one to two days after issuance for heat-related illness admission and three to four days for CVD. Interpretation Our study suggested that heat-related illness has significant long-term impacts on future CVD incidence, which can be mitigated by heatwave warnings.

Background: During the COVID-19 lockdown, it was difficult for residency training programs to conduct on-site, hands-on training. Distance learning, as an alternative to in-person training, could serve as a viable option during this challenging period, but few studies have assessed its role. Objective: This study aims to investigate the impact of distance learning during the lockdown on residents' self-assessed competency development and to explore the moderating effect of poor mental health on the associations. It is hypothesized that radiology residents who were trained through distance learning during the lockdown were more likely to report higher self-assessed competency compared to those who did not receive organized, formal training. Methods: A cross-sectional survey was conducted in 2021 among all of the radiology residents in 407 radiology residency programs across 31 provinces of China. To estimate the long-term outcomes of radiology residents' training after the initial COVID-19 outbreak, this study measured 6 core competencies developed by the US Accreditation Council for Graduate Medical Education reported by radiology residents. Multiple linear regression and moderating effect analysis were conducted to examine the associations between distance learning, mental health status, and self-assessed competencies. Mental health status moderated the association between distance learning and self-assessed competency of radiology residents. Results: A total of 2381 radiology residents (29.7% of the 8,008 nationwide) met the inclusion criteria and were included in the analysis. Among them, 71.4% (n=1699) received distance learning during the COVID-19 lockdown, and 73.2% (n=1742) reported mental health struggles ranging in severity from slight to extremely severe. Radiology residents who were trained through distance learning (beta=0.35, 90% CI 0.24-0.45) were more likely to report higher self-assessed competencies. This was particularly true for the competency of "interpersonal and communication skills" (beta=0.55, 90% CI 0.39-0.70). Whereas, the competency of "patient care and technical skills" (beta=0.14, 90% CI 0.01-0.26) benefited the least from distance learning. Poor mental health significantly moderated the relationship between distance learning and competency (beta=-0.15, 90% CI-0.27 to-0.02). Conclusions: Distance learning, a means of promoting enabling environments during the COVID-19 lockdown, serves its purpose and helps generally improve residents' self-assessed competencies, though different competency domains benefit unequally. The impact of mental health status calls for special attention so that distance learning can fulfill its potential.

The COVID-19 pandemic has significantly disrupted urban mobility patterns, particularly in public transportation systems. Capturing the immediate behavioral responses of populations to such disruptive events is crucial for understanding their true impact and informing rapid public health interventions. This study investigates the pandemic's immediate impact on subway ridership in Beijing, utilizing a three-stage analytical framework that integrates machine learning, causal inference methods, and model interpretability. By conducting a multi-year comparative analysis of multiple indicators across the same period in years before and during the COVID-19 wave, we examined how various demographic, land use, network, and weather-related factors influenced subway ridership. The average treatment effect revealed a significant reduction of approximately 10,000 daily passengers per station after the COVID-19 outbreak in Xinfadi, Beijing, in June 2020. Spatiotemporal variations in the effects of key factors, such as betweenness centrality, housing prices, and the presence of restaurants and enterprises, were observed before and during the pandemic. Placebo tests were designed to confirm the robustness of our estimates. Our findings highlight the need for adaptive urban planning and evidence-based public health strategies to enhance urban resilience against future pandemics. In the face of the ongoing threat of emerging infectious diseases, this framework serves as a ready-to-deploy tool for rapid pandemic response in urban system management, offering data-driven guidance on safe and flexible transit operations.

OBJECTIVES:To alleviate the shortage of qualified physicians in rural areas, since 2010, the Chinese government has launched a National Compulsory Service Programme (NCSP) to enrol medical students for future work in township health centres (THCs) as general practitioners (GPs). The educational background of NCSP GPs is the best at THCs. This study aims to evaluate whether NCSP GPs have contributed to improving the quality of patient care at THCs and in what way. DESIGN:This is an explanatory sequential mixed methods study. SETTING:NCSP GPs are assigned to THCs in the rural areas of central and western China, where assistant physicians are permitted to practice independently as licensed physicians. The contribution of NCSP GPs was defined as the extent to which they were perceived to improve the quality of care at THCs. Job performance was defined as the aggregated value to the organisation of discrete behaviour episodes that an individual performs. PARTICIPANTS:For the quantitative component, nine provinces were selected by using a stratified random sampling method based on NCSP admission numbers. A total of 2815 THC leaders completed the survey (response rate, 32%). For the qualitative component, 33 NCSP GPs were recruited for semi-structured interviews through purposive and snowball sampling method. OUTCOME MEASURES:The contribution of NCSP GPs to improvements in the quality of care at THCs was assessed as a key outcome measure. RESULTS:68% of THC leaders reported that NCSP GPs contributed considerably to improving the quality of care. The contribution of NCSP GPs was significantly and positively associated with the performance of NCSP GPs themselves (β=0.789, 95% CI 0.724 ~ 0.854) and THC remoteness (β=0.144, 95% CI 0.067 ~ 0.222), but negatively associated with the percentage of licensed physicians at the THC (β=-0.340, 95% CI -0.483 ~ -0.197) and with the turnover of NCSP GPs (β=-0.119, 95% CI -0.221 ~ -0.016). The percentage of licensed physicians has a mediating role between THC remoteness and the contribution of NCSP GPs. Interviews revealed that NCSP GPs contributed to the THC as individual clinicians, and a majority also contributed by influencing others or participating in THC management, such as by improving diagnosis and treatment performance of others, standardising patient care, teaching and training and implementing safety processes. CONCLUSIONS:NCSP GPs have a positive impact on the quality of care at THCs. In addition to working as individual competent physicians, they can contribute to the THCs in many ways. Adjustments in NCSP curriculum design, more supportive measures and better allocation processes are recommended to maximise this programme's potential.

BACKGROUND:Urinary incontinence (UI) is commonly linked to pregnancy and obstetric factors, but the association between fetal birthweight and maternal UI remains contentious. This study investigates the association between fetal birthweight and maternal UI and its subtypes in Chinese primiparas. METHODS:Cross-sectional data from 54,346 women aged 20 years and above were obtained from the 2019-2021 National Urinary Incontinence Survey. Restricted cubic spline (RCS) regression analysis and threshold effect analysis were used to explore the association between fetal birthweight and urinary incontinence and its subtypes. RESULTS:Among 19,365 primiparas, the prevalence of UI was 14.5%. Adjusted analyses revealed that each 1.0 kg increase in birthweight correlated with a 32% (95% CI: 1.21-1.44) increased risk of UI. Categorical analysis indicated that women in the highest birthweight tertile (3.4-6.0 kg) faced a higher risk of UI compared to those in the lowest tertile (0.5-3.0 kg) (adjusted OR, 1.42; 95% CI: 1.28-1.57). RCS regression highlighted non-linear associations between birthweight and the risk of any type of UI, urgency UI (UUI), and mixed UI (MUI), with a significant turning point at 3.9 kg for overall UI risk. Subgroup analyses revealed interactions between birthweight tertiles and modifiable risk factors like physical activity, as well as clinical risk factors like hypertension. CONCLUSIONS:These findings underscore the independent association between fetal birthweight and UI in Chinese primiparas, emphasizing the importance of considering various factors when assessing this relationship. A non-linear association exists between birthweight and any type of UI, UUI, and MUI, respectively. This study offers novel insights into the potential classification strategies for fetal birthweight and call for future research to validate and comprehend the clinical implications.

Migrant workers make up a great proportion of total Chinese population and face more obstacles than citizens in getting access to essential healthcare services. To achieve Universal Health Coverage (UHC) and close the equity gap in health, it’s crucial to promote equitable access to healthcare services. Migration range has been proved to be associated with migration health. However, few studies have investigated how migration range influenced access to healthcare services. The roles of health records in China align with UHC objectives, which make it an effective indicator for evaluating the accessibility to healthcare services. This study aimed to explore the association between migration range and establishing health records. It is unclear whether the association varies across different levels of social integration. This study also aimed at exploring the moderating role of social integration in the association between migration range and establishing health records. We used national data from China Migrants Dynamic Survey. Logistic regression was applied to examine the association between migration range, social integration and establishing health records. The effect modification by patterns in social integration was also investigated by logistic regression. Our results revealed that migrant workers with long-distance migration were less likely to establish health records (OR 0.85 [95%CI 0.84-0.87]). They were also less likely to achieve good social integration (own a property in the destination city OR 0.40 [95%CI 0.37-0.42]). Notably, the association between migration range and establishing health records was modified by certain dimensions of social integration. This study concluded that the association between migration range and establishing health records was modified by different levels of social integration. More attention should be given to migrant workers with long-distance migration who experienced poor social integration, to improve their utilization of healthcare services in the destination city, thereby closing equity gap in health.

To describe the prevalence and subtypes of musculoskeletal disorders (MSDs) in Chinese radiologists, and to examine gender differences in the association between lifestyle patterns and MSDs. The study included 3666 radiology residents from 31 provinces in China. Latent class analysis (LCA) was used to classify clusters based on four lifestyle behaviors. Multivariate logistic regression was used to examine the associations between MSDs and clusters of lifestyle behaviors. Among 3666 radiology residents, the mean age was 27.3 years (SD = 2.6), and 58.0

Health coverage equality is key to equal healthcare access. In China, the Urban Employee Basic Medical Insurance (UEBMI) is a compulsory health coverage for people employed in urban areas and provides the best access to healthcare. Having the UEBMI is thus crucial for rural-to-urban migrant workers, the lack thereof indicates not only informal employment, but also unequal healthcare access, particularly for their vulnerable subgroups. This study aims to explore factors that contribute to UEBMI coverage gaps between gender and ethnicity migrant worker subgroups. The findings provide insights on targeted social policies to reduce inequalities in the most vulnerable subgroups. Using the population-based, nationally representative data from the China Migrant Dynamics Survey from 2009 to 2018, we assessed the UEBMI coverage rate status gaps in China’s migrant worker gender and ethnic subgroups. Socioeconomic determinants were education level, household income and occupation. Using probit regression models, we applied the Oaxaca-Blinder decomposition method to examine the extent to which gender and ethnicity disparities could be explained by socioeconomic gradients in UEBMI coverage rate status. One million, one hundred ninety-nine thousand, and thirteen participants were included in our study, 46.9