Abstract
We investigate the impacts of rural-to-urban migration on the health of young adult migrants. A key methodological challenge involves the potentially confounding effects of selection on the relationship between migration and health. Our study addresses this challenge in two ways. To control for potential effects of prior health status on post-migration health outcomes, we employ a longitudinal approach. To control for static unobserved characteristics that can affect migration propensity as well as health outcomes, we use fixed-effects analyses. Data were collected in 2005 and 2007 for a cohort of young adults in rural Kanchanaburi province, western Thailand. The migrant sample includes individuals who subsequently moved to urban destinations where they were reinterviewed in 2007. Return migrants were interviewed in rural Kanchanaburi in both years but moved to an urban area and returned in the meantime. A rural comparison group comprises respondents who remained in the origin villages. An urban comparison sample includes longer-term residents of the urban destination communities. Physical and mental health measures are based on the SF-36 health survey. Findings support the “healthy migrant hypothesis.” Migrants are physically healthier than their nonmigrant counterparts both before and after moving to the city. We did not find an effect of migration on physical health. Rural-to-urban migrants who stayed at destination experienced a significant improvement in mental health status. Fixed-effects analyses indicate that rural-to-urban migration positively affects mental health. Return migrants do not fare as well as migrants who stayed at destination on both physical and mental health status—evidence of selective return migration.
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Notes
For a recent extensive review of the health consequences of international and internal migration for Southeast Asians, see VanLandingham and Fu (2012).
“Midnight Train to Georgia” is a 1973 number-one hit single by Gladys Knight & the Pips. The boyfriend of the song’s narrator is a musician who moved from his native Georgia to Los Angeles to become a “superstar, but he didn’t get far.” He decides to give up, and “go back to the life he once knew.”
Anglewicz et al. (2014) found a relationship between rural-to-urban migration and timing of sexual debut, using the same data from Thailand.
These individuals were identified as permanent rural-to-urban migrants (i.e., intending to stay indefinitely) by household members who remained in rural Kanchanaburi. During the follow-up survey in 2007, the fieldwork team inquired about the residence of all household members who were interviewed in 2005. Interviewees informed the survey team if a member of the household resided in a different location, such as the urban areas in this study. The sample of rural-to-urban migrants comprised individuals who were interviewed in Kanchanaburi in 2005 but were identified as rural-to-urban migrants in 2007 by the origin household.
Those who reported moving out of rural Kanchanaburi to an urban destination and staying there for at least one month before moving back to the origin household were classified as return migrants.
Defining a longer-term urban resident as someone who has lived in the urban area for at least five years allows us to (1) include within our urban reference group the vast numbers of young adults who have become quite familiar with urban life but weren’t necessarily born in the city; and (2) exclude temporary migrants who have either only recently arrived or frequently come and go. We think that five years is a reasonable cutoff point to make these distinctions because urban residence for that duration of time demonstrates a commitment to an urban orientation. Also, existing studies on residential mobility, including the U.S. decennial census, regularly employ five-year duration measures (Long 1988).
Analytical models for our logistic, fixed effects, and linear regression analyses described here are included in Online Resource 1.
In rural areas, young men often maintain their residence in their home village while working itinerantly nearby.
Those who scored lower than 1 standard deviation below the mean PCS score were only one-half as likely to move to the city and stay there as those with normal or high PCS scores (odds ratio = 0.494, p = .027). There was not a significant association between low PCS and subsequent rural-urban-rural migration for return migrants (odds ratio = 1.391, p = .205). Models controlled for the same sociodemographic characteristics as shown in Table 3.
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Acknowledgments
The authors gratefully acknowledge funding support from the Eunice Kennedy Shriver National Institute for Child and Human Development, National Institutes of Health (VanLandingham PI: R01 HD46527), and helpful comments from the anonymous reviewers.
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Nauman, E., VanLandingham, M., Anglewicz, P. et al. Rural-to-Urban Migration and Changes in Health Among Young Adults in Thailand. Demography 52, 233–257 (2015). https://doi.org/10.1007/s13524-014-0365-y
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DOI: https://doi.org/10.1007/s13524-014-0365-y