Ginsburg Carren, Myroniuk Tyler W, Pheiffer Chantel F, Moffett Bianca D, White Michael J
Medical Research Council/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 Public Health, University of Missouri, Columbia, Missouri, USA.
SSM Ment Health. 2024 Dec;6. doi: 10.1016/j.ssmmh.2024.100330. Epub 2024 Jun 17.
Investigations of migration effects on mental health conditions, including depression are sparse in low- and middle-income countries (LMIC), yet mental health may play a role in a decision to migrate, and migration in turn can impact on mental health outcomes.
This paper uses two waves of data from the Migrant Health Follow-Up Study, a young adult cohort of 3092 internal migrants and residents of the Agincourt study site in rural northeast South Africa to explore the relationship between internal migration and depressive symptoms, as measured on the Centre for Epidemiological Studies Depression (CES-D) scale. We employ logistic regression analysis to investigate selectivity of migrants are in relation to depressive symptoms, and we fit generalised linear -models to analyse depressive symptoms (CES-D scores) as a function of migration status and sociodemographic and health characteristics, accounting for temporal sequence.
Although we observe systematically low reporting of depressive symptoms, average CES-D scores are lower among migrants (comprising approximately 53% of the cohort) compared to Agincourt residents at both survey timepoints. We do not find evidence of a selection effect in relation to mental health among those newly migrating between Wave 2 and 3 (n=1393). In analyses of the CES-D score outcome, the significant influence of migration status on depressive symptoms is reduced with the inclusion of controls in the models. Consistent employment and higher levels of education are associated with lower CES-D scores, while diagnosis of a chronic condition is associated with higher scores.
The relationship between migration and depressive symptoms is influenced by factors preceding a migration and destination-place characteristics and experiences. Further examination of the role of migration at different stages of the process, along with continuing attention to psychosocial measurement considerations for LMIC subpopulations, can improve our understanding of these complex interrelationships and contribute to evidence.
在低收入和中等收入国家（LMIC），关于移民对心理健康状况（包括抑郁症）影响的研究很少，然而心理健康可能在移民决策中起作用，反过来移民也会影响心理健康结果。
本文使用了移民健康随访研究的两波数据，该研究是一个由3092名南非东北部农村阿金库尔研究地点的年轻成年内部移民和居民组成的队列，以探讨内部移民与抑郁症状之间的关系，抑郁症状通过流行病学研究中心抑郁量表（CES-D）进行测量。我们采用逻辑回归分析来研究移民与抑郁症状相关的选择性，并且我们拟合广义线性模型来分析抑郁症状（CES-D分数）作为移民状态、社会人口统计学和健康特征的函数，同时考虑时间顺序。
尽管我们系统地观察到抑郁症状的报告率较低，但在两个调查时间点，与阿金库尔居民相比，移民（约占队列的53%）中的平均CES-D分数更低。在第2波和第3波之间新移民的人群（n = 1393）中，我们没有发现与心理健康相关的选择效应的证据。在CES-D分数结果的分析中，随着模型中纳入控制变量，移民状态对抑郁症状的显著影响有所降低。持续就业和较高的教育水平与较低的CES-D分数相关，而慢性病诊断与较高的分数相关。
移民与抑郁症状之间的关系受到移民前因素、目的地特征和经历的影响。进一步研究移民在这一过程不同阶段的作用，同时持续关注低收入和中等收入国家亚人群的社会心理测量考量，能够增进我们对这些复杂相互关系的理解，并为相关证据提供支持。
