BMJ Open
Volume 9, Issue 7, 2019

Do adult health outcomes in urban population reflect local health risk? A matched cohort analysis of migration effects in Ouagadougou, Burkina Faso (Article) (Open Access)

Bocquier P.* , Soura A.B. , Sanogo S. , Randall S.
  • a Centre de Recherche en Démographie, Université Catholique de Louvain, Louvain-la-Neuve, Belgium, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
  • b Institut Supérieur des Sciences de la Population, Université de Ouagadougou, Ouagadougou, Burkina Faso, Burkina Faso
  • c Institut Supérieur des Sciences de la Population, Université de Ouagadougou, Ouagadougou, Burkina Faso, Burkina Faso
  • d Department of Anthropology, University College of London, London, United Kingdom

Abstract

Background Selective migration may affect health indicators in both urban and rural areas. Sub-Saharan African urban areas show evidence of both negative and positive selection on health status at outmigration. Health outcomes as measured in urban populations may not reflect local health risks and access to health services. Methods Using the Ouagadougou Health and Demographic Surveillance System and a migrant follow-up survey, we measured differences in health between matched non-migrants and outmigrants. We applied Cox and competing risks models on migration and death. Results Controlling for premigration health status, migrants who moved out of Ouagadougou have higher mortality (HR 3.24, 95% CI 1.23 to 8.58) than non-migrants and migrants moving to other Ouagadougou areas. However, these effects vanish in the matched sample controlling for all interactions between death determinants. These and other results show little evidence that migration led to higher mortality or worse health. Conclusions Health outcomes as measured in Ouagadougou population do reflect local health risks and access to health services despite high migration intensity. However, neither the hypothesis of effect of health on migration nor the hypothesis of negative effect of migration on health or survival was confirmed. © 2019 Author(s).

Author Keywords

demography Public health

Index Keywords

male controlled study urban population female health status cell migration cohort analysis death mortality demography health hazard Article Burkina Faso follow up human adult migrant public health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85069758851&doi=10.1136%2fbmjopen-2019-029059&partnerID=40&md5=261a452fba3e22e3df7f7a073c0571e6
DOI: 10.1136/bmjopen-2019-029059
ISSN: 20446055
Original Language: English