Abstract
The objective of this study is to assess whether adult children’s migration is associated with overall well-being of left-behind elderly parents in Nepal. A cross-sectional house-to-house survey was conducted among 260 community-dwelling elderly residents of Krishnapur municipality, Nepal. Binary logistic regression was used to identify whether migration of adult children was associated with elderly parent’s self-reported chronic diseases, depressive symptoms, perceived loneliness and social support. More than half of the study household (51.2%) had at least one adult migrant child. Compared to participants without a migrant child, participants with a migrant child had higher odds of self-reported chronic diseases (OR = 1.79, 95%CI: 0.91–3.54), presence of depressive symptoms (OR = 1.07, 95%CI: 0.64–1.77), and self-perceived loneliness (OR = 1.23, 95%CI: 1.06–1.42) but except for loneliness, the odds ratio for other indicators of well-being were not statistically significant. Although the literature posits an inverse relationship between adult children’s migration and the overall well-being of the elderly parents, in our study, adult children’s migration was not associated with inverse health outcomes among study participants. However, from a policy perspective, it should be understood that these observations may be transient since the family structure of Nepalese society is rapidly changing.
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References
Global health and aging. National Institute on Aging, World Health Organization. 2011:1–32. Available at: http://www.who. int/ageing/publications/global_health.pdf.
Senior citizen Act. In Nepal Law Commission website. 2006. Available at: https://www.ilo.org/dyn/natlex/docs/ELECTRONIC/87505/99802/F775759502/NPL87505.pdf.
Central Bureau of Statistics National Population and Housing Census. Kathmandu. National Planning Commission Secretariat, Central Bureau of Statistics, Government of Nepal; 2001.
Central Bureau of Statistics. National Population and Housing Census. Kathmandu: National Planning Commission Secretariat, Central Bureau of Statistics, Government of Nepal; 2011.
Federal Interagency Forum on Aging-Related Statistics. Older Americans 2012: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics, Washington, DC: U.S. Government Printing Office. June 2012.
Theeke LA. Predictors of loneliness in U.S. adults over age sixty-five. Arch Psychiatr Nurs 2009;23;387–96.
Gupta AA, Lall AK, Das A, Saurav A, Nandan A, Shah D, et al. Health and socioeconomic status of the elderly people living in hilly areas of Pakhribas, Kosi Zone, Nepal. Indian J Commun Med 2016;273–9.
Khattri JB, Nepal MK. Study of depression among geriatric population in Nepal. Nepal Medical College J 2006;220–3.
Bisht PDPS, Pathak PDRS, Subedi DG, Shakya MDV, Gautam MKM. Health and Social Care Needs Assessment of Elderly: The Context of Piloting Service Developments and Care of Elderly in Pharping, Kathmandu, Nepal. Kathmandu, Nepal: Tribhuvan University, Ageing Nepal, and United Nations Population Fund; 2012.
Central Intelligence Agency. The World Fact Book: Net Migration Rate. Available at: [https://www.cia.gov/library/publications/the-world-factbook/fields/2112.html]
KC. Internal migration in Nepal. Population Monograph Nepal 2003;2;121–68.
Labour Migration for Employment. Kathmandu: Ministry of Labour and Employment; 2016. Available at —asia/—ro-bang-kok/—ilo-kathmandu/documents/publication/wcms_500311.pdf
Nepal Population Report 2011. Population Division, Minstry of Health and Population, Government of Nepal; Kathmandu, Nepal. 2011. Available at: http://danangtimes.vn/Portals/0/Docs/423145033-Nepal%20Population%20Report%202011.pdf.
Carballo M, Divino JJ, Zeric D. Migration and health in the European Union. Trop Med Int Health 1998;3;936–44.
Demurger S. 2015. Migration and families left behind. In: HAL.
Hadi A. Overseas migration and the well-being of those left behind in rural communities of Bangladesh. Asia Pac Popul J 1999;14;43–58.
Waidler J, Vanore M, Gassmann F, Siegel M. Migration and the Multi-Dimensional Well-Being of Elderly Persons in Georgia. J Popul Ageing 2017;1–22.
Scheffel J, Zhang Y. To What Extent does Rural Migration Affect the Elderly “Left-behind?” Ningbo China. School of Economics, The University of Nottingham; 2011.
Adhikari R, Jampaklay A, Chamratrithirong A. Impact of children’s migration on health and health care-seeking behavior of elderly left behind. BMC Public Health 2011;11;143
Bohme M, Persian R, Stohr T. Alone but Better Off? Adult Child Migration and Health of Elderly Parents in Moldova. Kiel Instaitute for the World economy; 2013.
Antman FM. How Does Adult Child Migration Affect the Health of Elderly Parents Left Behind? Evidence from Mexico Colorado. Department of Economics, University of Colorado at Boulder; 2010.
Adhikari S. Health, Nutrition and Care for Senior Citizens of Nepal in Twenty First Century. J Health Allied Sci 2013;73–5.
Regmi RR. 1993. Socio-Economic and Cultural Aspects of Ageing in Nepal.
Geriatric Center Nepal. Status Report on Elderly People (60+) in Nepal on Health. Kathmandu Nutrition and Social Status Focusing on Research Needs; 2010.
Shrestha L. Geriatric Health in Nepal: Concerns and Experience. Nepal Medical College J 2012;144–8.
Sharma JR, Sharma S. Enumerating Migration in Nepal. Working Paper I. Kathmandu: Centre for the Study of Labour and Mobility; 2011.
Gill GJ, Hoebink P. Seasonal labour migration in rural Nepal: a preliminary overview. Citeseer. 2003.
Ghimire S, Baral BK, Callahan K. Nutritional assessment of community-dwelling older adults in rural Nepal. PLoS One 2017;12;e0172052.
World Health Organization. WHO definition of health. Geneva: World Health Organization; 2003.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16;606–13.
Lowe B, Unutzer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care 2004;42;1194–1201.
Blackwell T, Mcdermott A. Test Review: Patient Health Questionnaire 9 (PHQ-9). Rehabilitation Counseling Bulletin, 2014 2014;57;246–8.
Kohrt BA, Luitel NP, Acharya P, Jordans MJ. Detection of depression in low resource settings: validation of the Patient Health Questionnaire (PHQ-9) and cultural concepts of distress in Nepal. BMC Psychiatry 2016;16;58.
Field A. Discovering statistics using SPSS; Sage publications; 2009.
Depression: percent of clinically significant depression patients who attain a 5 point or greater reduction in Patient Health Questionnaire (PHQ) score within 6 months after their New Episode PHQ. Agency for Healthcare Research and Quality.
Gierveld JDJ, Tilburg T V. A 6-item scale for overall, emotional, and social loneliness: confirmatory tests on survey data. Res Aging 2006;28;582–98.
Parkerson Jr G, Broadhead W, Tse C. Validation of the Duke Social Support and Stress Scale. Family Med 1991;23;357–60.
De Jong Gierveld J, Van Tilburg T. The De Jong Gierveld short scales for emotional and social loneliness: tested on data from 7 countries in the UN generations and gender surveys. Eur J Ageing 2010;7;121–30.
Bennett L, Dahal DR, Govindasamy P. Caste ethnic and regional identity in Nepal: Further analysis of the 2006 Nepal Demographic and Health Survey. 2008.
Dahal D, Gurung Y, Acharya B, Hemchuri K, Swarnakar D, 2002. Situational analysis of dalits in Nepal. National Dalit Strategy Report: Part 2002, 1.
Gibson J, McKenzie D, Stillman S. The impacts of international migration on remaining household members: omnibus results from a migration lottery program. Rev Econ Stat 2011;93; 1297–318.
Abas MA, Punpuing S, Jirapramukpitak T, Guest P, Tangchonlatip K, Leese M, Prince M. Rural-urban migration and depression in ageing family members left behind. British J Psychiatry 2009;195;54–60.
Davin D. Internal migration in contemporary China: London: MacMillan Press Ltd; 1998.
Böhme MH, Persian R, Stöhr T. Alone but better off? Adult child migration and health of elderly parents in Moldova. J Health Econ 2015;39;211–27.
Cong Z, Silverstein M. Intergenerational Support and Depression Among Elders in Rural China: Do Daughters-In-Law Matter? J Marriage Family 2008;70;599–612.
Antman FM. Elderly Care and Intrafamily Resource Allocation when Children Migrate. J Hum Resour 2012;47;331–63.
Stohr T. Intra-family migration decisions and elderly left behind Kiel Working Paper. 2013.
Constant AF, Zimmermann KF. International handbook on the economics of migration: Edward Elgar Publishing; 2013.
Weeks DG, Michela JL, Peplau LA, Bragg ME. Relation between loneliness and depression: a structural equation analysis. J Pers Soc Psychol 1980;39;1238–44.
Weiss RS. Loneliness: The experience of emotional and social isolation, Cambridge, Mass: MIT Press; 1973.
Mushtaq R, Shoib S, Shah T, Mushtaq S. Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. J Clin Diagn Res 2014;8;WE01–WE4.
Khanal S, Gautam KM. Prevalence and Management of Health Conditions in Older People’s Homes: A Case Study in Kathmandu. J British Soc Gerontol; 2011.
He W, Muenchrath MN, Kowal PR. Shades of gray: a cross-country study of health and well-being of the older populations in SAGE countries, 2007–2010: US Department of Commerce. US Census Bureau: Economics and Statistics Administration; 2012.
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Ghimire, S., Singh, D.R., Nath, D. et al. Adult Children’s Migration and Well-being of Left Behind Nepalese Elderly Parents. J Epidemiol Glob Health 8, 154–161 (2018). https://doi.org/10.2991/j.jegh.2018.07.004
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DOI: https://doi.org/10.2991/j.jegh.2018.07.004