Young adults in South Africa often move in search of work or education, leading to temporary and circular migration patterns. These patterns have deep roots in the country's labour system and apartheid spatial planning. A recent study, the Migrant Health Follow-Up Study, has been following about 3,000 young adults aged 18 to 40 from the Agincourt sub-district in Bushbuckridge, Mpumalanga. The study aims to understand the impact of migration on health.
The study, conducted by a team of public health and social science researchers from the South African Medical Research Council/Wits Agincourt Unit at the University of the Witwatersrand and Brown University in the US, used home visits and telephone interviews over five rounds approximately one year apart. The research team gathered information on migration, education, employment, household characteristics, health and health service use. 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, but this relationship varied by the health outcome, and was shaped by both personal characteristics and circumstances in destinations. Migrants tended to be younger and more often were men, with higher levels of education and fewer chronic conditions. These findings are consistent with the well-known “healthy migrant hypothesis”: 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 sub-district.
The health effects of migration are mixed, not uniformly harmful. The prevalence of chronic conditions increased over the duration of the study among both migrants and non-migrants, but the increases were lower among migrants. However, living in urban areas can introduce particular health risks, such as consuming processed food more frequently and having a higher chance of abdominal obesity. Other risks were unevenly distributed, with migration to urban areas possibly increasing blood pressure, particularly among women.
The findings point to 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. This also means planning around the reality that many people's lives span more than one place. Internal migrants contribute to destination communities, and their integration can be improved by enhancing access to services and economic inclusion.
The study's results have policy implications for South Africa, suggesting that policies should focus on reducing the health risks that can accompany movement while recognising the opportunities migration can create. By understanding the complex relationships between migration, urbanisation and health, policymakers can develop targeted interventions to support the health and wellbeing of young adults who move for work and opportunity.
Key points
- Migration has a complex relationship with health outcomes, and its effects vary depending on personal characteristics and circumstances in destinations.
- The study highlights the need for continuity of healthcare as people move between places and for attention to urban conditions that shape diet, blood pressure and chronic disease risk.
- Policymakers should focus on reducing health risks associated with migration while recognising the opportunities it can create, and develop targeted interventions to support the health and wellbeing of young adults who move for work and opportunity.
