Intergenerational support dynamics and the sandwich generation: analyzing the effect of family migration on health among the Chinese migrant workers.

Background: China's landscape of social mobility is shifting from individual to household-level migration. This highlights the increasingly crucial role of family-based relocation in the lives of migrant workers. Therefore, the impact of household migration on migrant workers' health has emerged as a central topic in scholarly discourse.

Methods: Grounded in the social vulnerability theory, the family stress theory and the life course theory, this study utilizes data from the 2017 China Migrants Dynamic Survey to rigorously examine the effect of family factors on migrant workers' health outcomes. Quantitative methods used in this study include propensity score matching, heterogeneity tests, total effect analysis, robustness checks, mediation modeling, and endogeneity test.

Results: This study demonstrates that household migration intensifies health vulnerabilities among migrant workers through the interplay of intersecting structural forces. Analyses from the life course perspective reveal that cumulative socioeconomic precarity and family obligations amplify health risks, with nuclear family units facing heightened stressors arising from dual financial and cultural pressures. Empirical evidence identifies a paradoxical mechanism whereby collectivist norms and survival imperatives drive individuals to prioritize intergenerational welfare over personal health. These findings highlight how the health trajectories of migrant workers become embedded in systemic vulnerabilities, where migration patterns intersect with institutional exclusion to transform family strategies into chronic health burdens across life stages.

Conclusions: By adopting an integrated analytical framework that accounts for structural, familial, and individual-level factors, the study contributes to a more comprehensive understanding of the multifactorial influences on migrant workers' health outcomes. The findings underscore the need to shift public service policies from a sole focus on individual workers to addressing the holistic needs of migrant households. Such a transition is critical for mitigating the health burdens associated with household migration and ensuring that policy interventions align with the complex realities of family-centered migration strategies in contemporary China.