Dimensions of internal migration and their relationship to blood pressure in South Africa

Abstract
Hypertension prevalence is on the rise in low and middle income countries like South Africa, and migration and concomitant urbanization are often considered to be associated with this rise. However, relatively little is known about the relationship between blood pressure (BP) and internal migration - a highly prevalent population process in LMICs. This study employs data for a group of 194 adult men and women from an original pilot dataset drawn from the Agincourt Health and Demographic Surveillance System in northeast South Africa. Migrants in the sample are identified, tracked, and interviewed. The relationship between BP and migration distance and the number of months an individual spends away from his/her home village is estimated using robust OLS regression, controlling for a series of socioeconomic, health, and behavioral characteristics. This study finds migrants who move further distances and for longer durations to have significantly higher systolic and diastolic BP compared with shorter-term migrants and those who remain nearby or in their home village. These associations remain robust and statistically significant when adjusting for measures of socioeconomic conditions, as well as body mass index (BMI), and the number of meals consumed per day. Migration, both in terms of distance and time away, explains significant variation in BP among migrants in a typical South African context. This finding suggests the need for further studies of nutritional and psychosocial factors associated with geographic mobility that may be important factors for understanding rising hypertension in LMICs.
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Keywords
Migration and Social Mobility; Population Health; Demography
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