Migration and the epidemiological transition: insights from the Agincourt sub-district of northeast South Africa.
Migration and the epidemiological transition: insights from the Agincourt sub-district of northeast South Africa.
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DOI：
10.3402/gha.v7.23514
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发表时间：
2014
影响因子：
2.6
通讯作者：
Tollman SM
中科院分区：
文献类型：
--
作者：
Collinson MA;White MJ;Bocquier P;McGarvey ST;Afolabi SA;Clark SJ;Kahn K;Tollman SM
移徙和城市化是可持续发展和健康的核心，但关于确定人口的时间趋势的数据很少。健康的男性和女性之所以迁移，是因为就业和改善生活的机会在地理上分布不均。这种干扰可能会导致不健康的风险敞口和环境，并给原籍家庭带来收入回报。这份文件的目的是说明南非东北部农村地区临时移徙的模式、水平和趋势；2000-2011年期间按死因类别分列的死亡率趋势；以及按主要死因类别分列的临时移徙和死亡率之间的关系。纵向，阿金库尔健康和人口监测系统的数据被用于一个连续的、生存时间、竞争风险的模型中。在南非东北部的农村，临时移民是指移民主要为了工作目的而搬迁，并与农村家庭保持联系，在解释死亡率的差异方面，无论是什么原因，临时移民比年龄和性别更重要。在这种情况下，临时移徙与传染病死亡率之间不断变化的关系主要受到移徙者暴露在不健康条件下的减少的影响。这项研究表明，临时移徙与非传染性疾病死亡率之间不断变化的关系主要受长期移徙所带来的生计利益增加的影响。由于临时移徙不只与传染病有关，公共卫生政策应考虑到人口流动，而不考虑目标健康风险。有必要加强农村卫生保健系统，因为流动人口往往在需要卫生保健时回到农村家庭。
Migration and urbanization are central to sustainable development and health, but data on temporal trends in defined populations are scarce. Healthy men and women migrate because opportunities for employment and betterment are not equally distributed geographically. The disruption can result in unhealthy exposures and environments and income returns for the origin household. The objectives of the paper are to describe the patterns, levels, and trends of temporary migration in rural northeast South Africa; the mortality trends by cause category over the period 2000–2011; and the associations between temporary migration and mortality by broad cause of death categories. Longitudinal, Agincourt Health and Demographic Surveillance System data are used in a continuous, survival time, competing-risk model. In rural, northeast South Africa, temporary migration, which involves migrants relocating mainly for work purposes and remaining linked to the rural household, is more important than age and sex in explaining variations in mortality, whatever the cause. In this setting, the changing relationship between temporary migration and communicable disease mortality is primarily affected by reduced exposure of the migrant to unhealthy conditions. The study suggests that the changing relationship between temporary migration and non-communicable disease mortality is mainly affected by increased livelihood benefits of longer duration migration. Since temporary migration is not associated with communicable diseases only, public health policies should account for population mobility whatever the targeted health risk. There is a need to strengthen the rural health care system, because migrants tend to return to the rural households when they need health care.