The effect on cardiovascular risk factors of migration from rural to urban areas in Peru: PERU MIGRANT Study.
The effect on cardiovascular risk factors of migration from rural to urban areas in Peru: PERU MIGRANT Study.
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DOI：
10.1186/1471-2261-9-23
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发表时间：
2009-06-08
影响因子：
2.1
通讯作者：
Smeeth L
中科院分区：
文献类型：
--
作者：
Miranda JJ;Gilman RH;García HH;Smeeth L
秘鲁从1970年代开始出现大规模移徙，原因是需要逃离出于政治动机的暴力和与工作有关的原因。大多数移民人口，主要是来自山区的安第斯农民，往往在首都的某些地区集中定居，他们的农村环境与城市环境相差无几。由于移徙的主要驱动力不是通常的经济和与工作有关的原因，移徙者不同于非移徙者的选择效应在秘鲁可能不那么突出。因此，秘鲁的情况为检验移徙的影响提供了一个独特的机会。秘鲁移民（PERU的农村到城市移民）研究旨在调查农村到城市的移民和非移民群体在特定CVD风险因素方面的差异程度。为此，选择了三个群体：农村，即一直生活在农村环境中的人;农村-城市，即从农村迁移到城市地区的人;城市，即一直生活在城市环境中的人。入组时的总体缓解率为73.2%，完成研究时的总体缓解率为61.6%。在拒绝参加研究的282/323人（87.3%）中获得了拒绝表。在农村和移民群体中，拒绝没有性别差异，但在城市群体中，70%的拒绝是男性。就年龄而言，在所有研究组中，最年长的年龄组（>60岁）中观察到大多数拒绝。最终达到的总样本量为目标样本量的98.9%（989/1000）。其中52.8%（522/989）为女性。农村、移民和城市研究组的最终规模分别为201人、589人和199人。移徙者第一次移徙的平均年龄和在城市环境中生活的年数分别为14.4岁（IQR 10-17）和32岁（IQR 25-39）。本文介绍了秘鲁移民的研究设计与移民研究的偏见和混淆的可能性的批判性分析，并减少这些问题的策略。还讨论了秘鲁的移徙案例对移徙和健康领域的潜在好处。
Mass-migration observed in Peru from the 1970s occurred because of the need to escape from politically motivated violence and work related reasons. The majority of the migrant population, mostly Andean peasants from the mountainous areas, tends to settle in clusters in certain parts of the capital and their rural environment could not be more different than the urban one. Because the key driver for migration was not the usual economic and work-related reasons, the selection effects whereby migrants differ from non-migrants are likely to be less prominent in Peru. Thus the Peruvian context offers a unique opportunity to test the effects of migration. The PERU MIGRANT (PEru's Rural to Urban MIGRANTs) study was designed to investigate the magnitude of differences between rural-to-urban migrant and non-migrant groups in specific CVD risk factors. For this, three groups were selected: Rural, people who have always have lived in a rural environment; Rural-urban, people who migrated from rural to urban areas; and, Urban, people who have always lived in a urban environment. Overall response rate at enrolment was 73.2% and overall response rate at completion of the study was 61.6%. A rejection form was obtained in 282/323 people who refused to take part in the study (87.3%). Refusals did not differ by sex in rural and migrant groups, but 70% of refusals in the urban group were males. In terms of age, most refusals were observed in the oldest age-group (>60 years old) in all study groups. The final total sample size achieved was 98.9% of the target sample size (989/1000). Of these, 52.8% (522/989) were females. Final size of the rural, migrant and urban study groups were 201, 589 and 199 urban people, respectively. Migrant's average age at first migration and years lived in an urban environment were 14.4 years (IQR 10–17) and 32 years (IQR 25–39), respectively. This paper describes the PERU MIGRANT study design together with a critical analysis of the potential for bias and confounding in migrant studies, and strategies for reducing these problems. A discussion of the potential advantages provided by the case of migration in Peru to the field of migration and health is also presented.
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