MHFUS is using both existing data and a new large-sample longitudinal survey of individuals to study the relationships among migration, urbanization, and health. The research team is conducting this study in South Africa, geographically focused on a population in the rural northeast that is highly migratory. This study will allow the team to examine and address social science and public health concerns connected to chronic health conditions and their treatment, livelihood changes that accompany migration, and connections between the origin community and the migrants.

The project is designed to help resolve confusion in the migration-urbanization-health nexus, with direct policy implications for South Africa and both substantive and methodological lessons for a broad array of scientific concerns in Low and Middle Income Countries (LMICs). A better understanding of the way in which these redistributive forces operate can help inform global health policy by 1) improving the understanding of how migration and urbanization impact population health, so as to better understand the trade-off between the salutary increases in socioeconomic circumstances associated with urbanization and the health risks that accompany that shift; 2) improving the understanding of population redistribution, so as to be better equipped to incorporate spatial demography into companion health investigations; (3) identifying circumstances where population mobility itself may compromise the treatment cascade – compromising the continuity necessary to deliver suitable health care for chronic conditions. In carrying out this major research project, the team will also help build scientific capacity in the region.

Planning for the new five-year observational study is well underway. Questionnaire development is in process with anticipated fieldwork in 2017. The MHFUS questionnaire will gather information on residential history, educational and occupational activities, health conditions and access to care, a variety of health behaviors, and selected biomarkers. The initial wave of the survey will interview young adults, both migrants and residents of the origin community, and subsequent waves will follow these individuals as they engage in temporary and circular migration or elect to remain in the origin. Results from the study will be aimed at shedding light on issues of how mobile individuals acquire and manage chronic diseases and access long-term care. A particularly novel and valuable feature of this research will be the opportunity to link the contemporary survey data to the long-standing demographic surveillance information for the individual and that person’s origin household and community. This approach is designed to give greater insight into the several intertwined demographic and health dynamics and shed a brighter light on the determinants of risk factors for key health outcomes. By gathering detailed information on health care access and treatment, the project can test whether barriers to care are posed by migration. The project will also inform the study of migration and urbanization more generally by helping understand the rate of adaptation of migrants in their new locales and determining the consequences of out-migration for rural sending communities.