4.7 Article

Internal migration, urban living, and non-communicable disease risk in South Africa

Journal

SOCIAL SCIENCE & MEDICINE
Volume 274, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2021.113785

Keywords

Internal migration; Urbanization; Non-communicable disease; Blood pressure; Hypertension prevalence; South Africa; Low and middle income countries; Gender

Funding

  1. Population Studies and Training Center at Brown University
  2. Eunice Kennedy Shriver National Institute of Child Health and Human Development [P2C HD041020, T32 HD007338]

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This paper contributes to migration-health scholarship by analyzing the effect of migration and urban living on non-communicable disease risk in South Africa using panel data. The study reveals gender differences in the migration-health relationship, with urban living associated with lower blood pressure in men but no urban health advantage in women, who are negatively affected by migration through increased blood pressure. Further research on gendered determinants of blood pressure may be crucial in understanding hypertension incidence in contexts like South Africa.
This paper offers theoretical and substantive contributions to migration-health scholarship by employing rich panel data with biomarkers to estimate the effect of migration and urban living on non-communicable disease risk in South Africa. Internal migration and urbanization continue to be pervasive demographic and socioeconomic phenomena that structure daily life in low? and middle? income countries (LMICs). Yet, how these processes affect illness and disease in low-resource settings is still not well understood. Five waves (2008?2017) of South Africa?s National Income Dynamics Study data and fixed-effects modeling are used to estimate the relationship between urban residence, migration, and health. Results indicate that the migration-health relationship differs by gender: urban living for men is associated with lower blood pressure. While urban residence appears to convey a health advantage when men reside in urban compared with rural places, there is no evidence of an urban health advantage among women. Migration does, however, negatively affect women?s health through higher blood pressure (BP). These findings highlight the need for further interrogation of the ways in which processes and health consequences of migration and urban living are structured by gender in LMICs. Given the importance of urbanization and the prevalence of migration in LMICs, the gendered determinants of blood pressure may be key to understanding rising hypertension incidence in contexts like South Africa.

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