a Social Work Department , Taylor University , Upland , IN , USA.
b Department of Global Community Health and Behavioral Sciences , Tulane University School of Public Health and Tropical Medicine , New Orleans , LA , USA.
Glob Public Health. 2018 Oct;13(10):1520-1532. doi: 10.1080/17441692.2017.1414281. Epub 2017 Dec 15.
The connection between migration and health has long been established, but relatively little is known about this relationship for older persons, particularly in sub-Saharan Africa (SSA). In this paper, we examine migration selection with regards to health status among older individuals in Malawi, by testing whether older migrants differ from non-migrants in health status before migration. To do so, we use data from the Malawi Longitudinal Study of Families and Health, a longitudinal panel dataset that includes a relatively large number of individuals at older ages. We focus on three measures: mental health, physical health, and HIV status. We find that the relationship between migration and health selection differs by gender. Older women who are HIV-positive are nearly 10 times more likely to migrate compared to their HIV-negative counterparts. For men, those with better mental health are less likely to migrate in the future. These results suggest that, although research in some settings shows that migrants have better health before moving, some older migrants have worse health than their non-migrant peers, and may, therefore, add to the already-heavy burden on rural health centres in Africa.
迁移与健康之间的关系早已确立,但对于老年人,特别是撒哈拉以南非洲(SSA)的老年人来说,人们对此知之甚少。在本文中,我们通过检验在迁移之前,老年移民与非移民在健康状况上是否存在差异,来研究马拉维老年个体的迁移选择与健康状况之间的关系。为此,我们使用了来自马拉维家庭与健康纵向研究的数据,这是一个包含大量老年个体的纵向面板数据集。我们关注三个方面:心理健康、身体健康和 HIV 状况。我们发现,迁移与健康选择之间的关系因性别而异。与 HIV 阴性的同龄人相比,HIV 阳性的老年女性移民的可能性要高出近 10 倍。对于男性来说,心理健康状况较好的人未来迁移的可能性较小。这些结果表明,尽管在某些情况下研究表明移民在迁移前的健康状况更好,但一些老年移民的健康状况比他们的非移民同龄人更差,因此可能会给非洲农村卫生中心带来已经很重的负担。