Effects of Social Capital and Migration on Health Outcomes among Residents of Slums in Delhi, India Pubblico
Mayne, Robert Patrick (2012)
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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