Effects of Social Capital and Migration on Health Outcomes among Residents of Slums in Delhi, India Open Access

Mayne, Robert Patrick (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/s1784m24p?locale=en
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Abstract

The growth of cities in the global south, driven in part by unprecedented levels
of migration from rural areas to urban centers, has emerged as a major area of
public health concern. Additionally, previous research has shown that social
capital and residential segregation in urban areas may have significant impacts
on a wide variety of infectious and non-infectious health outcomes. The present
research seeks to measure the effect of both social capital and residential
segregation on febrile illness among rural-to-urban migrants living in slums in
Delhi. Data analyzed were collected as part of the Delhi Life of the Urban Poor
(DUP)/Delhi Voters Project (DVP) from 2009 until 2011. Two multilevel mixed-
effects logistic models were fitted, one for adult and one for child outcomes.
These models examined the effects of household migration, household social
capital, and slum-level measures of residential segregation (in terms of language,
state of origin and religion) on the odds of reporting more than two incidents of
febrile illness in the past year. For adults, being born outside of Delhi was a
significant predictor of higher incidence of illness among those with lower levels
of social capital (OR = 2.58, 95% CI: 1.11 - 6.01), while there was no significant
effect among those with higher levels of social capital. Among children, there
was no similar effect of place of birth on health outcomes, though a household
history of more frequent moves was a significant predictor of higher incidence of
illness (for one additional move, OR = 1.15, 95% CI: 1.001 - 1.31). Neighborhood
diversity was only significantly associated with illness among children, with
greater linguistic homogeneity predicting higher incidence of illness (OR = 1.01,
95%CI: 1.00 - 1.02). This study echoes previous findings that rural-urban
migration may place migrant populations at special risk for adverse health
outcomes, but finds that these effects, and thus programs designed to address
them, differ between adult and child populations.

Table of Contents

INTRODUCTION 1
REVIEW OF THE LITERATURE 4
URBANIZATION AND HEALTH 4
MIGRATION AND HEALTH 8
SLUMS AND HEALTH 10
STUDY AIMS AND OBJECTIVES 14
METHODS 17
STUDY DESIGN AND CONTEXT 17
CONCEPTUAL FRAMEWORK 18
STUDY POPULATION AND SAMPLING STRATEGY 20
STUDY MEASURES 22
ANALYSIS 27
RESULTS 28
DISCUSSION 39
BIBLIOGRAPHY 48
APPENDIX 1: SURVEY QUESTIONS 62
APPENDIX 2: MODEL VARIABLES 67

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