PLoS Medicine
Volume 7, Issue 4, 2010

The effect of rural-to-urban migration on obesity and diabetes in india: A cross-sectional study (Article) (Open Access)

Ebrahim S.* , Kinra S. , Bowen L. , Andersen E. , Ben-Shlomo Y. , Lyngdoh T. , Ramakrishnan L. , Ahuja R.C. , Joshi P. , Das S.M. , Mohan M. , Smith G.D. , Prabhakaran D. , Srinath Reddy K.
  • a Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
  • b Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • c Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • d Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
  • e Department of Social Medicine, University of Bristol, Bristol, United Kingdom
  • f South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
  • g Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
  • h Department of Medicine, King George's Medical College and Institute of Clinical Epidemiology, Lucknow, India
  • i Department of Medicine, Government Medical College, Nagpur, India
  • j Department of Neurology, Krishna Institute of Medical Sciences, Hyderabad, India
  • k Department of Medicine, Dr. B R Ambedkar Medical College, Bangalore, India
  • l Department of Social Medicine, University of Bristol, Bristol, United Kingdom
  • m South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India, Centre for Chronic Disease Control, New Delhi, India, Public Health Foundation of India, New Delhi, India
  • n Public Health Foundation of India, New Delhi, India

Abstract

Background: Migration from rural areas of India contributes to urbanisation and may increase the risk of obesity and diabetes. We tested the hypotheses that rural-to-urban migrants have a higher prevalence of obesity and diabetes than rural nonmigrants, that migrants would have an intermediate prevalence of obesity and diabetes compared with life-long urban and rural dwellers, and that longer time since migration would be associated with a higher prevalence of obesity and of diabetes. Methods and Findings: The place of origin of people working in factories in north, central, and south India was identified. Migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by interview, examination, and fasting blood samples. Obesity, diabetes, and other cardiovascular risk factors were compared. A total of 6,510 participants (42% women) were recruited. Among urban, migrant, and rural men the age- and factory-adjusted percentages classified as obese (body mass index [BMI] >25 kg/m2) were 41.9% (95% confidence interval [CI] 39.1-44.7), 37.8% (95% CI 35.0-40.6), and 19.0% (95% CI 17.0-21.0), respectively, and as diabetic were 13.5% (95% CI 11.6-15.4), 14.3% (95% CI 12.2-16.4), and 6.2% (95% CI 5.0-7.4), respectively. Findings for women showed similar patterns. Rural men had lower blood pressure, lipids, and fasting blood glucose than urban and migrant men, whereas no differences were seen in women. Among migrant men, but not women, there was weak evidence for a lower prevalence of both diabetes and obesity among more recent (≤10 y) migrants. Conclusions: Migration into urban areas is associated with increases in obesity, which drive other risk factor changes. Migrants have adopted modes of life that put them at similar risk to the urban population. Gender differences in some risk factors by place of origin are unexpected and require further exploration. © 2010 Ebrahim et al.

Author Keywords

[No Keywords available]

Index Keywords

residential mobility urban population immigrant India blood pressure human sex difference middle aged diabetes mellitus rural population obesity controlled study Aged Cross-Sectional Studies interview lipid Young Adult lipid blood level cross-sectional study Humans Adolescent male urban rural difference female Socioeconomic Factors risk factor Risk Factors socioeconomics high risk population prevalence Article glucose blood level major clinical study adult migration age glucose body mass
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77951762127&doi=10.1371%2fjournal.pmed.1000268&partnerID=40&md5=88f1c95c91ff31f9af061646f98a75dc
DOI: 10.1371/journal.pmed.1000268
ISSN: 15491277
Cited by: 188
Original Language: English