Primary Submission Category: Migration
Elevated Blood Pressure Among Migrant Women in South Africa: Evidence from A Longitudinal Cohort Study
Authors: Chantel Pheiffer Stephen McGarvey Michael White Carren Ginsburg
Presenting Author: Chantel Pheiffer*
Demographic and health transitions have simultaneously resulted in urbanization and a rise in the non-communicable disease (NCD) burden in low- and middle-income countries (LMICs). Yet, we know relatively little about whether and how urbanization is contributing to the rise in NCDs in such contexts. This paper demonstrates that internal migration, responsible for much of urban growth in LMICs, may be contributing to NCD risk as assessed by elevated blood pressure (BP) in LMICs in gendered and geographically differentiated ways. We use data collected in 2018 (baseline) and in 2022 (follow-up) from the Migrant Health Follow-Up Study in this analysis. The Migrant Health Follow-Up Study is a cohort study of residents aged 18-40 at baseline who are members of households within the Agincourt Health and Socio-Demographic Surveillance System in rural northeast South Africa. We investigate the relationship between internal migration and elevated BP among 2,163 men and women in South Africa for whom we have valid BP and anthropometric measures. Using a fixed effects approach, and stratifying by sex, we find that a migration event results in elevated BP among women controlling for socioeconomic, demographic, health, and health behavior characteristics. We observe no parallel increase in BP with a migration event among men. Further, we find that the magnitude of the migration-BP relationship depends on the specific urban destination to which migrants move. These findings are robust and statistically significant for both systolic and diastolic blood pressure, and regardless of model specification. Our research shows that the intersection of race, gender, and migration status is creating a distinct health penalty for women in South Africa in terms of elevated blood pressure. These findings underscore the importance of investigating the social determinants of NCD risk in low-resource rapidly urbanizing settings.