Three Essays On Internal Migration And Risk Factors For Non-Communicable Diseases (ncds) In Low- And Middle-Income Countries (lmics)

Abstract

Low- and middle-income countries (LMICs) have been experiencing extensive internal migration, which is closely associated with the increasing prevalence of risk factors for non-communicable diseases (NCDs). In this dissertation, I study the impact of internal migration on main NCD risk factors across three diverse LMIC contexts: China, Indonesia, and Malawi. In Chapter 1, I introduce the background, motivation, and research goals of this dissertation. In Chapter 2, I use data from the 2011 China Health and Retirement Longitudinal Study (CHARLS) to examine the associations between rural-urban migration and three main NCD risk factors, hypertension, obesity, and abdominal obesity, among older adults aged 45 or above. I find that rural-urban migrants have significantly higher chances of getting all three risk factors than rural non-migrants, suggesting a negative impact of rural-urban migration on health outcomes. Meanwhile, the number of years lived in cities significantly predicts being hypertensive, implying a “years since migration (YSM)” effect. In addition, health-related behaviors examined play a very limited role in mediating the association between migration and health. In Chapter 3, using data from the fourth and fifth waves of the Indonesia Family Life Survey (IFLS), I study the impact of rural-urban migration on overweight status in Indonesia. I find that rural-urban migration is significantly associated with being overweight, and the association is significantly stronger among women than men, demonstrating a gender disparity in health. Moreover, the number of years lived in cities does not predict overweight status, and health behavioral factors still explain little of the association between migration and health. In Chapter 4, I use data from the 2008 and 2019 waves of the Malawi Longitudinal Study of Families and Health (MLSFH) to investigate the impact of internal migration, not only rural-urban but also rural-rural, on weight status in Malawi. I find that rural-urban and rural-rural migration are both significantly associated with increased Body Mass Index (BMI) and that rural-rural migration significantly predicts being overweight. Meanwhile, the impact of rural-rural migration is significantly stronger among women than men, showing a gendered impact of migration on health. In Chapter 5, I summarize findings from the three main chapters and discuss their implications for policymaking and future research