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Migration, urbanisation and mortality: 5-year longitudinal analysis of the PERU MIGRANT study
  1. Melissa S Burroughs Pena1,2,
  2. Antonio Bernabé-Ortiz1,
  3. Rodrigo M Carrillo-Larco1,
  4. Juan F Sánchez3,
  5. Renato Quispe1,
  6. Timesh D Pillay1,4,
  7. Germán Málaga1,5,
  8. Robert H Gilman1,6,7,
  9. Liam Smeeth1,8,
  10. J Jaime Miranda1,5
  1. 1CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
  2. 2Duke University Research Institute, Duke University, Durham, North Carolina, USA
  3. 3Department of Parasitology, U.S. Naval Medical Research Unit No.6 (NAMRU-6), Callao, Peru
  4. 4Medical School, University College London, London, UK
  5. 5Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
  6. 6Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  7. 7Biomedical Research Unit, Asociación Benéfica PRISMA, Lima, Peru
  8. 8Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to J Jaime Miranda, CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendariz 497, 2nd Floor, Miraflores, Lima 18, Peru; jaime.miranda{at}upch.pe

Abstract

Objective To compare all-cause and cause-specific mortality among 3 distinct groups: within-country, rural-to-urban migrants, and rural and urban dwellers in a longitudinal cohort in Peru.

Methods The PERU MIGRANT Study, a longitudinal cohort study, used an age-stratified and sex-stratified random sample of urban dwellers in a shanty town community in the capital city of Peru, rural dwellers in the Andes, and migrants from the Andes to the shanty town community. Participants underwent a questionnaire and anthropomorphic measurements at a baseline evaluation in 2007–2008 and at a follow-up visit in 2012–2013. Mortality was determined by death certificate or family interview.

Results Of the 989 participants evaluated at baseline, 928 (94%) were evaluated at follow-up (mean age 48 years; 53% female). The mean follow-up time was 5.1 years, totalling 4732.8 person-years. In a multivariable survival model, and relative to urban dwellers, migrant participants had lower all cause mortality (HR=0.30; 95% CI 0.12−0.78), and both the migrant (HR=0.07; 95% CI 0.01−0.41) and rural (HR=0.06; 95% CI 0.01−0.62) groups had lower cardiovascular mortality.

Conclusions Cardiovascular mortality of migrants remains similar to that of the rural group, suggesting that rural-to-urban migrants do not appear to catch up with urban mortality in spite of having a more urban cardiovascular risk factor profile.

  • EPIDEMIOLOGY
  • MIGRATION
  • MORTALITY

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