Centre de recherche en démographie, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
School of Public Health, University of the Witwatersrand, Johannesburg, Republic of South Africa.
BMJ Open. 2019 Jul 11;9(7):e029059. doi: 10.1136/bmjopen-2019-029059.
Selective migration may affect health indicators in both urban and rural areas. Sub-Saharan African urban areas show evidence of both negative and positive selection on health status at outmigration. Health outcomes as measured in urban populations may not reflect local health risks and access to health services.
Using the Ouagadougou Health and Demographic Surveillance System and a migrant follow-up survey, we measured differences in health between matched non-migrants and outmigrants. We applied Cox and competing risks models on migration and death.
Controlling for premigration health status, migrants who moved out of Ouagadougou have higher mortality (HR 3.24, 95% CI 1.23 to 8.58) than non-migrants and migrants moving to other Ouagadougou areas. However, these effects vanish in the matched sample controlling for all interactions between death determinants. These and other results show little evidence that migration led to higher mortality or worse health.
Health outcomes as measured in Ouagadougou population do reflect local health risks and access to health services despite high migration intensity. However, neither the hypothesis of effect of health on migration nor the hypothesis of negative effect of migration on health or survival was confirmed.
选择性迁移可能会影响城市和农村地区的健康指标。撒哈拉以南非洲的城市地区在向外迁移时，健康状况呈现出负向和正向选择的证据。城市人口的健康结果衡量标准可能无法反映当地的健康风险和获得卫生服务的情况。
我们利用瓦加杜古健康和人口监测系统以及移民随访调查，衡量了匹配的非移民和移民之间的健康差异。我们将 Cox 和竞争风险模型应用于移民和死亡。
控制迁移前的健康状况，离开瓦加杜古的移民的死亡率高于非移民和移民迁往瓦加杜古其他地区的移民（HR 3.24，95%CI 1.23 至 8.58）。然而，在匹配样本中，控制所有死亡决定因素之间的相互作用后，这些影响就消失了。这些和其他结果表明，迁移并没有导致更高的死亡率或更差的健康状况。
尽管迁移强度很高，但在瓦加杜古人群中测量的健康结果确实反映了当地的健康风险和获得卫生服务的情况。然而，无论是健康对迁移的影响的假设，还是迁移对健康或生存的负面影响的假设，都没有得到证实。
