International Journal of Public Health

, Volume 61, Issue 6, pp 641–649 | Cite as

Climate-driven migration: an exploratory case study of Maasai health perceptions and help-seeking behaviors

  • Alexandra K. HeaneyEmail author
  • Sandra J. Winter
Original Article



By 2050, over 250 million people will be displaced from their homes by climate change. This exploratory case study examines how climate-driven migration impacts the health perceptions and help-seeking behaviors of Maasai in Tanzania. Increasing frequency and intensity of drought is killing livestock, forcing Maasai to migrate from their rural homelands to urban centers in search of ways to support their families. Little existing research investigates how this migration changes the way migrants think about health and make healthcare decisions.


This study used semi-structured qualitative interviews to explore migrant and non-migrant beliefs surrounding health and healthcare. Migrant and non-migrant participants were matched on demographic characteristics and location.


Migrants emphasized the importance of mental health in their overall health perceptions, whereas non-migrants emphasized physical health. Although non-migrants perceived more barriers to accessing healthcare, migrant and non-migrant help-seeking behaviors were similar in that they only sought help for physical health problems, and utilized hospitals as a last option.


These findings have implications for improving Maasai healthcare utilization, and for future research targeting other climate-driven migrant populations in the world.


Climate change Mental health Rural-to-urban migration Tanzania Healthcare Maasai 


Compliance with ethical standards

Ethics approval

The Stanford Institutional Review Board gave human subjects approval for this research in April, 2013 and informed oral consent was obtained from every participant.

Supplementary material

38_2015_759_MOESM1_ESM.pdf (52 kb)
Supplementary material 1 (PDF 53 kb)


  1. Andersen R (1995) Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 36:1–10CrossRefPubMedGoogle Scholar
  2. Bailis DS, Segall A, Chipperfield JG (2003) Two views of self-rated general health status. Soc Sci 56:203–217Google Scholar
  3. Bernard H, Ryan G (1998) Text analysis: qualitative and quantitative methods. In: Handbook of methods in cultural anthropology. Rowman & Littlefield, LondonGoogle Scholar
  4. Bhugra D (2004) Migration and mental health. Acta Psychiatr Scand 109:243–258CrossRefPubMedGoogle Scholar
  5. Biermann F, Boas I (2010) Preparing for a warmer world: towards a global governance system to protect climate refugees. Glob Environ Polit 10:60–88CrossRefGoogle Scholar
  6. Biswas-Diener R, Vittersø J, Diener E (2005) Most people are pretty happy, but there is cultural variation: the Inughuit, the Amish, and the Maasai. J Happiness Stud 6:205–226CrossRefGoogle Scholar
  7. Christakis N, Ware N, Kleinman A (1994) Illness behavior and the health transition in the developing world. In: Chan LC, Kleinman A, Ware N (eds) Health and social change in international perspective. Harvard University Press, Cambridge, pp 275–302Google Scholar
  8. Coast E (2002) Maasai socioeconomic conditions: a cross-border comparison. Hum Ecol 30:79–105CrossRefGoogle Scholar
  9. Confalonieri U, Menne B, Akhtar R et al (2007) Human health. In: Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change, Cambridge. Cambridge, UK, pp 391–431Google Scholar
  10. Cornally N, McCarthy G (2011) Help-seeking behaviour: a concept analysis. Int J Nurs Pract 17:280–288. doi: 10.1111/j.1440-172X.2011.01936.x CrossRefPubMedGoogle Scholar
  11. Corrigan P (2004) How stigma interferes with mental health care. Am Psychol 59:614–625CrossRefPubMedGoogle Scholar
  12. Friel S, Hancock T, Kjellstrom T, McGranahan G, Monge P, Roy J (2011) Urban health inequities and the added pressure of climate change: an action-oriented research agenda. J Urban Health 88(5):886–895. doi: 10.1007/s11524-011-9607-0 CrossRefPubMedPubMedCentralGoogle Scholar
  13. Gary F (2005) Stigma: barrier to mental health care among ethnic minorities. Issues Ment Health Nurs 26:979–999CrossRefPubMedGoogle Scholar
  14. Glaser B (1965) The constant comparative method of qualitative analysis. Soc Probl 12:436–445CrossRefGoogle Scholar
  15. Gollwitzer PM, Oettingen G (1998) The emergence and implementation of health goals. Psychol Health 13:687–715. doi: 10.1080/08870449808407424 CrossRefGoogle Scholar
  16. Jeacocke P (2010) Environmental refugees: a new concept for the current day?Google Scholar
  17. Jylhä M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 69:307–316. doi: 10.1016/j.socscimed.2009.05.013 CrossRefPubMedGoogle Scholar
  18. Kapborg I, Berterö C (2002) Using an interpreter in qualitative interviews: does it threaten validity? Nurs Inq 9:52–56CrossRefGoogle Scholar
  19. Kroeger A (1983) Anthropological and socio-medical health care research in developing countries. Soc Sci Med 17:147–161. doi: 10.1016/0277-9536(83)90248-4 CrossRefPubMedGoogle Scholar
  20. Leventhal H, Brissete I, Leventhal E (2003) The common sense model of self-regulation of health and illness. The self-regulation of health and illness behavior. Taylor & Francis Group, New York, pp 42–66Google Scholar
  21. McKay L, Macintyre S, Ellaway A (2003) Migration and health: a review of the international literature. Medical Research Council Social and Public Health Sciences Unit, University of Glasgow, GlasgowGoogle Scholar
  22. McLeman R, Hunter L (2010) Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change 1:450–461CrossRefPubMedPubMedCentralGoogle Scholar
  23. McMichael C, Barnett J, McMichael AJ (2012) An ill wind? Climate change, migration and health. Environ Health Perspect 120:646–654CrossRefPubMedPubMedCentralGoogle Scholar
  24. Miles M, Huberman A, Saldaña J (2013) Qualitative data analysis: a methods sourcebookGoogle Scholar
  25. National Bureau of Statistics (2012) Statistics for development. In: 2012 Census Publ. Accessed 19 Mar 2015
  26. Papadopoulos I, Lay M (2003) The impact of migration on health beliefs and behaviours: the case of Ethiopian refugees in the UK. Contemp Nurs 15:210–221CrossRefGoogle Scholar
  27. Riley E, Olengurumwa O, Olesangale T (2012) Urban pastoralists; a report on the demographics, standards of living, and employment conditions of migrant Maasai living in Dar es SalaamGoogle Scholar
  28. Sirri L, Fava GA, Sonino N (2013) The unifying concept of illness behavior. Psychother Psychosom 82:74–81. doi: 10.1159/000343508 CrossRefPubMedGoogle Scholar
  29. Tsai J (2007) Ideal affect: cultural causes and behavioral consequences. Perspect Psychol Sci 2:242–259CrossRefPubMedGoogle Scholar
  30. World Health Organization, World Meteorological Organization (2012) Health and climateGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2015

Authors and Affiliations

  1. 1.Department of Environmental Health SciencesColumbia UniversityNew YorkUSA
  2. 2.Stanford Prevention Research CenterStanford UniversityPalo AltoUSA

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