Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, and Reproductive Health, 615 N. Wolfe Street, 21205 Baltimore MD United States.
Population and Preventive Medicine, Department of Family, Population and Preventive Medicine, Division of Evaluative Sciences, Division of Community Health, Program in Public Health, Stony Brook, NY 11794, United States.
Soc Sci Med. 2019 Aug;235:112389. doi: 10.1016/j.socscimed.2019.112389. Epub 2019 Jul 2.
A strong and consistent association between migration and health has been found in many settings, but the overwhelming focus of this research has been on adults. In addition, identifying the effect of migration on health largely remains an unresolved challenge, due in part to the inability to distinguish between the effect of migration on health and the selection of children of differing health status into migration streams. In this research we examine the relationship between internal migration and child health in Malawi. We use longitudinal panel data with pre- and post-migration health measures for children and their mothers, which permits us to measure both migration health selection and the effect of migration on health. We also examine if child health changes over time in post-migration destinations. We do not find evidence of migration health selection: children who move have similar pre-migration health status to non-migrant children. We find that the impact of migration on child health is mediated by mothers' characteristics. Before controlling for mothers' health status, we find a strong negative impact of migration on health, particularly for children moving to rural areas or cities, and children moving due to changes in mothers' marital status. After controlling for mothers' health status, however, the negative impact of migration on child health disappears. We also find that child health is worse with longer durations spent in post-migration residence, compared to children who don't move.
在许多情况下,移民与健康之间存在着强烈而一致的关联,但这项研究的重点压倒性地放在了成年人身上。此外,由于无法区分移民对健康的影响和不同健康状况的儿童选择移民流的影响,确定移民对健康的影响在很大程度上仍然是一个未解决的挑战。在这项研究中,我们考察了马拉维国内移民与儿童健康之间的关系。我们使用了具有儿童及其母亲迁移前后健康指标的纵向面板数据,这使我们能够衡量移民健康选择和移民对健康的影响。我们还研究了儿童在迁移目的地的健康是否随时间发生变化。我们没有发现移民健康选择的证据:迁移的儿童与非迁移儿童的迁移前健康状况相似。我们发现,母亲的特征中介了移民对儿童健康的影响。在没有控制母亲健康状况的情况下,我们发现迁移对健康有很强的负面影响,特别是对于迁移到农村或城市的儿童,以及由于母亲婚姻状况变化而迁移的儿童。然而,在控制了母亲的健康状况后,迁移对儿童健康的负面影响就消失了。我们还发现,与不迁移的儿童相比,在迁移后居住地停留时间较长的儿童健康状况更差。