A recent study by The Conversation has shed light on the health impacts of urban migration in South Africa. The research, conducted by Carren Ginsburg, Chantel Pheiffer, Mark A Collinson, and Michael White, found that migration can improve livelihoods without uniformly harming health. The study tracked thousands of local residents in the Agincourt research zone in Mpumalanga province, providing a detailed look at how circular migration between rural homes and urban centers reshapes health outcomes over time.
The study, which began in 2018, followed approximately 3,000 young adults aged 18 to 40 from the Agincourt subdistrict in Bushbuckridge, Mpumalanga. The research team gathered information on migration, education, employment, household characteristics, health, and health service use through home visits and telephone interviews. Health measures included general health, chronic conditions, diet, depression risk, and resilience. The study found that migration was widespread and associated with changes in health, which were shaped by personal characteristics and destination conditions.
The study revealed that migrants differed from those who stayed behind in several important ways. Migrants tended to be younger, and the majority were men. They also had higher levels of education and fewer chronic conditions, and appeared to be more resilient. These findings are consistent with the "healthy migrant hypothesis," which suggests that people who migrate are often healthier than their non-migrant counterparts at the point when they move.
Migration and employment are closely linked, with migrants more likely to report being employed than those who remained at home. On average, about two-thirds of migrants were working in destinations, while more than half of those who remained at home were unemployed and looking for work. The relationship became particularly visible during the Covid-19 pandemic, when job losses resulted in some people returning to the Agincourt subdistrict.
The health effects of migration are mixed, with the prevalence of chronic conditions increasing over the duration of the study among both migrants and non-migrants. However, the increases were lower among migrants, suggesting that some of the health advantage seen at the time of migration persisted. At the same time, living in urban areas can introduce particular health risks, such as consuming processed food more frequently and having a higher chance of abdominal obesity.
The study's findings suggest that policies should focus on reducing the health risks that can accompany movement while recognizing the opportunities migration can create. The results encourage policy and planning that improves migrants' integration in destinations by improving access to services and economic inclusion. The study's authors emphasize the need for attention to continuity of healthcare as people move between places, as well as to the urban conditions that shape diet, blood pressure, and longer-term chronic disease risk.
The study's insights can help address how migration and livelihood changes may affect chronic health conditions and their treatment, with policy implications for South Africa. Gauteng, South Africa's economic engine, was the most common destination for migrants, with a substantial share of moves also taking place within Mpumalanga. The study's findings point to the need for planning around the reality that many people's lives span more than one place.
Key points
- Migration has mixed effects on health in South Africa, with urban diets and obesity risks highlighting the need for mobile healthcare planning.
- The study suggests that policies should focus on reducing health risks associated with migration while recognizing the opportunities it can create.
- The research emphasizes the need for continuity of healthcare as people move between places, as well as attention to urban conditions that shape diet, blood pressure, and chronic disease risk.
