ระยะเวลาดำเนินงาน: ธันวาคม 2545 – พฤศจิกายน 2546
หัวหน้าโครงการ: สุรีย์พร พันพึ่ง
นักวิจัย: อุมาภรณ์ ภัทรวาณิชย์, Philip Guest, Dr.Mark Vanlandingham, นิพนธ์ ดาราวุฒิมาประกรณ์, วรรณี หุตะแพทย์
1.Explore the various dimensions and determinants of health status change among young adults (age 15-29) resulting from migration from rural areas to urban areas
2. Explore the relationship between health status and subsequent decisions to migrate, i.e. migrant selectivity
A small but emerging literature on the effects of rural-to-urban migration on health has demonstrated great potential for this line of research. Critical shortcomings are that much of the existing research suggesting such impacts is based upon data that are cross-sectional, uni-dimensional, devoid of critical contextual factors, and confounded by selection biases. The current proposal addresses these shortcomings in a variety of ways. First, the proposed research will link with the extensive population database that has been established by Mahidol University through their demographic field station project in Kanchanaburi Province, Thailand, funded by the Wellcome Trust. This field station has collected over the past three years three waves of data at the individual, family, and contextual level that will employ critical baseline and contextual information for the proposed research on migration and health. Second, the proposed research will itself engage in three waves of data collection, some in conjunction with the field station project, to provide assessments of changes in health status over time among both migrants and non-migrants living in both sending and receiving areas. Third, the proposed research will employ a wide range of health assessment tools, including physical and self-reported measures. Fourth, the proposed research will examine not only the impact of rural-to-urban migration upon the health of migrants, but also the effect of health status on subsequent decisions to migrate, providing an important assessment of the impact of selection factors upon the migration/health relationship.
The specific aims of the proposed research are as follows:
- Provide a multidimensional assessment of young adult health for migrants and for non-migrants in sending areas (rural Kanchanaburi Province, Thailand), and receiving areas (Kanchanaburi and Bangkok metropolitan areas). This assessment will include a standard assessment of overall health (the SF-36); mental health (a Thai depression scale); social integration (the Social Relations Scale); access to care (special module); workplace injuries (special module); reproductive health (special module); several physical measures (BMI, waist-hip ratio, and blood pressure); and a qualitative module to assess special health problems related to migration.
- Provide an assessment of changes in various dimensions of heath status over time for both migrants and non-migrants.
- Provide an assessment of the degree to which differences between the health of migrants and non-migrants are due to migration processes per se; to contextual factors in both rural and urban environments; family-level factors related to affluence; and to a priori individual differences related both to decisions to migrate and to various dimensions of health status (selection factors).
The goals of the study relate directly to the goals of NICHD's program announcement, "Population movement: determinants and consequences" (PA 00-032): "Innovative, theory-driven research on migration is needed to improve modeling of selection effects …;" and "Further research is needed on migrant selectivity with respect to health, the relationship between health changes and migration, including the impact of migration on health and access to health services,…".