The Effect of Internal Migration on Changes in Blood Pressure among Women in South Africa

Chantel Pheiffer, University of Massachusetts at Boston
Stephen McGarvey, Brown University
Carren Ginsburg, University of the Witwatersrand, Johannesburg
Michael J. White, Brown University

Eighty-five percent of the world’s 15 million premature non-communicable disease (NCD)-related deaths occur in low and middle-income countries (LMICs) each year, with elevated blood pressure (BP) constituting the leading metabolic risk factor for NCDs. Our understanding of the social and behavioral correlates and predictors of elevated BP remains limited, however. In this study we investigate whether migration and urbanization affect NCD risk as assessed by elevated BP. We use data collected in 2018 (baseline) and in 2022 (follow-up) from the Migrant Health Follow-Up Study, a longitudinal cohort study of residents aged 18-40 at baseline who are members of households within the Agincourt Health and Socio-Demographic Surveillance System in rural northeast South Africa. The sample consists of 2,163 men and women for whom we have valid BP and anthropometric measures. Using a fixed effects approach, and stratifying by sex, we find that a migration results in elevated BP among women controlling for socioeconomic, demographic, health, and health behavior characteristics. We also find that the magnitude of the migration-BP relationship depends on the urban destination to which female migrants move. Our research shows that the intersection of gender, and migration status is creating a distinct health penalty for women in South Africa.

Keywords: Internal Migration and Urbanization, Health and Morbidity, Gender Dynamics, Longitudinal studies

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