Internal migration is a salient dimension of adulthood in Haiti, particularly among women. Despite the high prevalence of migration in Haiti, it remains unknown whether Haitian women’s diverse patterns of migration influence their children’s health and survival. In this paper, we introduce the concept of lateral (i.e., rural-to-rural, urban-to-urban) versus nonlateral (i.e., rural-to-urban, urban-to-rural) migration to describe how some patterns of mothers’ internal migration may be associated with particularly high mortality among children. We use the 2006 Haitian Demographic and Health Survey to estimate a series of discrete-time hazard models among 7,409 rural children and 3,864 urban children. We find that compared with their peers with nonmigrant mothers, children born to lateral migrants generally experience lower mortality, whereas those born to nonlateral migrants generally experience higher mortality. Although there are important distinctions across Haiti’s rural and urban contexts, these associations remain net of socioeconomic factors, suggesting they are not entirely attributable to migrant selection. Considering the timing of maternal migration uncovers even more variation in the child health implications of maternal migration; however, the results counter the standard disruption and adaptation perspective. Although future work is needed to identify the processes underlying the differential risk of child mortality across lateral versus nonlateral migrants, the study demonstrates that looking beyond rural-to-urban migration and considering the timing of maternal migration can provide a fuller, more complex understanding of migration’s association with child health.
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The cross-sectional nature of the data prohibits us from accounting for change in household characteristics between the time of the survey and the child’s birth or, in the case of deceased children, death. We reduce the risk of misclassification by limiting the analyses to births that occurred in the 10 years before the survey. Furthermore, in ancillary analyses we further restrict the sample to births that occurred less than seven years before the survey and confirm that the results are consistent with those shown here.
We classify mothers’ origin community as “urban” if she migrated from a city or town and “rural” if she migrated from the countryside.
In supplemental models (results available upon request), we also categorize these children according to their mother’s destination residence and confirm that, because of the small percentage of cases, the classification of these children does not influence the results.
In both rural and urban Haiti, mortality is significantly higher in the first month of life and then drops throughout the remainder of the first five years. There is a nominal increase in mortality in later childhood in the rural sample, which likely is evidence of age heaping. As discussed in the methods section, our discrete-time modeling approach is ideal for handling the age heaping that is a common feature of retrospective mortality data.
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Smith-Greenaway, E., Thomas, K.J.A. Exploring Child Mortality Risks Associated with Diverse Patterns of Maternal Migration in Haiti. Popul Res Policy Rev 33, 873–895 (2014). https://doi.org/10.1007/s11113-014-9326-9
- Maternal migration
- Child mortality