Collinson Mark A, White Michael J, Bocquier Philippe, McGarvey Stephen T, Afolabi Sulaimon A, Clark Samuel J, Kahn Kathleen, Tollman Stephen M
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; INDEPTH Network, Accra, Ghana;
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Sociology, Population Studies and Training Center, Brown University, Providence, RI, USA.
Glob Health Action. 2014 May 15;7:23514. doi: 10.3402/gha.v7.23514. eCollection 2014.
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.
人口迁移和城市化是可持续发展与健康的核心要素，但关于特定人群时间趋势的数据却很匮乏。健康的男性和女性进行迁移，是因为就业和改善生活的机会在地理上分布不均。这种人口流动可能导致不健康的接触和环境，以及对原居家庭的收入回报产生影响。
本文旨在描述南非东北部农村地区临时迁移的模式、水平和趋势；2000年至2011年期间按死因分类的死亡率趋势；以及按广泛死因类别划分的临时迁移与死亡率之间的关联。
在一个连续的生存时间竞争风险模型中使用阿金库尔健康与人口监测系统的纵向数据。
在南非东北部农村地区，临时迁移（主要是为了工作目的而迁移且仍与农村家庭保持联系）在解释死亡率差异方面比年龄和性别更为重要，无论死因如何。在这种情况下，临时迁移与传染病死亡率之间不断变化的关系主要受到移民接触不健康状况减少的影响。该研究表明，临时迁移与非传染病死亡率之间不断变化的关系主要受到迁移时间延长带来的生计改善的影响。
由于临时迁移并非仅与传染病相关，无论针对何种健康风险，公共卫生政策都应考虑人口流动因素。有必要加强农村医疗保健系统，因为移民在需要医疗保健时往往会回到农村家庭。
