Rural-Urban Migrants in China: Mental Health Challenges and Denial of Rights

Jason Hung

Devised in 1950s, hukou is a residency registration system that controls internal rural-urban migration within China. Then in 1978 the Chinese Communist Party started a series of socioeconomic reforms, including the establishment of “special economic zones” in urban and coastal regions. Urbanization in coastal regions began to contribute to vast income disparity between urban and rural areas. For example, in 1983 rural incomes were 55% of urban incomes, but by 2005 they were just under a third of urban incomes. As a consequence, there has been an influx of rural-urban migration since 1978 as people relocate in an attempt to earn better incomes.

In 2003, the Chinese government reported that there were about 140 million internally displaced migrants, increasing to 147 million in 2005.1 In 2012, there were approximately 230 million citizens residing in a place other than their hometown, of whom 80% were rural-urban migrants. Although there is relative affluence in urban China, Chinese immigration policies discriminate against non-urban residents of the urban areas, and they are generally excluded from the socio-economic benefits available to urban residents. Most people in this “floating population” hold rural hukou which means that they are unable to enjoy the social rights available to citizens with urban hukou.

Rural-urban migrants cannot normally change their residency status from rural hukou to urban hokou. As a result they are not eligible to work in urban areas unless they have registered and paid for the “temporary residency registration”. Without that registration, rural-urban migrants are known as illegal migrants in urban China and this renders them socially invisible and unwelcome.

These rural-urban migrants suffer various human rights violations. For example, they endure overcrowded and unsanitary housing conditions. In a recently published paper by Li et al, a 21-year-old man described sleeping in an airless room with over 30 other labourers, and with no access to showers. Another young man who migrated to Beijing in 1999 highlighted the problems of employment exploitation: in a six-month period he earned only 500 Chinese yuan (about $62 US) with the rest of his income withheld by the employer.

Employment law protects urban workers. For example, Article 39 (1) of the Employment Law states employers may only dismiss their employees for failing to meet recruitment conditions during a probationary period. Article 41 of the Employment Contract Law requires employers to give 30 days notice in advance, or pay a one-month salary in lieu of notice, if an employee is dismissed. Employees are also legally entitled to 5-15 days of paid leave annually. In contrast, rural-urban migrants without a “temporary residency registration” are not protected by Employment Law or Employment Contract Law. When illegal migrants experience human rights violations, they have no legal recourse available to them.

Social rights impacts on mental health

The constant socioeconomic hardships and social rights failings experienced by rural-urban migrants result in socio-psychological concerns. Qun Shen et al. and Xiaoming Li et al. reported large numbers of young rural-urban migrants suffering from mental health disorders, including depression, anxiety, hostility, social isolation, and insomnia.2 Factors which affect the psychological well-being of rural-urban migrants include stigmatization, financial worries, heavy work load, family separation, expectation-reality discrepancy, and difficulty in coping on a daily basis.3 Rural-urban migrants, especially those with depression, are at increased risk of suicide. One of the most publicised cases involved the suicides and attempted suicides of 13 young rural-urban workers employed at the Foxconn factories in southern China in 2010.4

Despite the invisibility of rural-urban migrants because of their rural hukou, the ever-increasing numbers of rural-urban migrants residing in urban China has begun to draw public and government’s attention to their social, economic, and mental health crises. At the moment rural-urban migrants cannot access health care. Although the New Rural Cooperative Medican Scheme (NRCMS) was introduced in 2003 to cover health services for Chinese citizens with rural hukou, rural-urban migrants are unable to access health facilities once they leave rural areas.5 Nor can these migrants access the Medican Assistance Programme (MAP) and Urban Resident Basic Medical Insurance (URS), both of which were introduced in 2000s in order to cover health benefits for unemployed and poor urban residents.6

Awareness is growing of the mental and other health issues faced by the rural-urban migrants and of the failure of the government to address their social rights. This is putting pressure on the government to make the NRCMS transferable from rural residency to urban residency, or to extend MAP and URS to cover those unprivileged and socially vulnerable rural-urban migrants. Change is needed urgently to redress these human rights failings, and provide rural-urban migrants with access to equitable health care, income, and housing conditions.

Jason Hung is a research assistant at the Sociology Department, University of Warwick, UK, and a former visiting scholar at Department of Political Science, UCLA. Email address:


  1. Fang C, Dewen W. (2009), “Impacts of internal migration on economic growth and urban development in China”, The Social Science Research Council.
  2. Mou J, Cheng J, Griffiths SM et al. (2011), “Internal migration and depressive symptoms among migrant factory workers in Shenzhen, China”, Community Psychol, 39, pp. 212–30.
  3. Zhang J, Li X, Fang X et al. (2009), “Discrimination experience and quality of life among rural-to urban migrants in China: the mediation effect of expectation-reality discrepancy”, Qual Life Res, 18, pp. 291–300; Lin D, Li X, Wang B et al. (2011), “Discrimination, perceived social inequity, and mental health among rural-to-urban migrants in China”, Community Ment Health, 47, pp. 171–80; Gui Y, Berry JW, Zheng Y (2011), “Migrant worker acculturation in China”, Int J Intercult Rel, 36, pp. 598–610; Chen J. (2011), “Internal migration and health: re-examining the healthy migrant phenomenon in China”, Soc Sci Med, 72, pp. 1294–1301.
  4. Bhat MA (2012), “Rather TA. Socio-economic factors and mental health of young people in India and China: an elusive link with globalization”, Asian Social Work Policy Rev, 6, pp. 1–22.
  5. Qiu P, Yang Y, Zhang J et al. (2011), “Rural-to-urban migration and its implication for new cooperative medical scheme coverage and utilization in China”, BMC Public Health, 11, p. 520.
  6. Lin W, Liu GG, Chen G (2009), “The urban resident basic medical insurance: a landmark reform towards universal coverage in China”, Health Econ, 18, pp. 83–96; Hu S, Tang S, Liu Y et al. (2008), “Reform of how health care is paid for in China: challenges and opportunities” Lancet, 372, pp. 1846–53.