The aim is to provide updated assessments of the impact of migration from rural to urban areas on health, particularly on the risk factors associated with cardiovascular diseases, and to determine the magnitude of the differences in the cardiovascular risk factor profiles among groups of migrant versus non-migrant participants.
PERU MIGRANT is a longitudinal study among three sectors of the population: the first sector selected was the rural population, defined here as the population born in Ayacucho who have always lived in a rural environment; the second sector studied was the population born in Ayacucho who have migrated from rural areas to urban areas and currently live in Lima; the third group included in the study was the urban population, composed of individuals who were born in Lima and have always lived in urban areas up until the present day.
The hypothesis was that the risk for cardiovascular diseases increases in the population who migrated from rural to urban areas of Peru. Particular emphasis was placed on understanding the magnitude and trend of the differences in risk factor profiles for cardiovascular diseases.
The study was carried out among a sample of the population from 2007 to 2008. Initially, population censuses were created or updated in the area in order to identify the migrant and non-migrant inhabitants potentially eligible for the study. The next step was to randomly select participants and invite them to take part in the study. Those who accepted were invited to answer questionnaires and complete a clinical evaluation during which they were weighed, measured and had their blood pressure taken. In addition, blood-based biomarker assessment tests were carried out in order to identify lipid profiles, metabolic profiles (glycaemia, hemoglobin, insulin), and inflammatory profiles (fibrinogen and C-reactive protein).
After completing the fieldwork, a total of 989 participants completed the study, contributing with cardiovascular information.
The impact of rural-urban migration on cardiovascular risk factor profiles is not uniform across the different migration status, and it is also influenced by the age at which migration occurs. Variations were observed in the levels of some cardiovascular risk factors across the study groups. This observation indicates that urbanization is prejudicial to cardiovascular health. However, the degree of its harmful effect is not equally distributed.
The reduction of risk factors of chronic diseases in populations who have migrated within low and middle income countries from rural to urban areas represents one of the main challenges for public health in the 21st century.
These results challenge the predominant opinion that the cardiovascular risk factor profile in migrant populations is similar to the one in urban populations.
This study is one of the few ones that have contributed information regarding the rural Andean population in Peru to global estimates as part of the Global Burden of Metabolic Risk Factors of Chronic Diseases.
Jaime Miranda Montero
Lima and Ayacucho, Peru
Lima and Ayacucho, Peru
Wellcome Trust (estudio basal) wellcome.ac.uk
Universidad Peruana Cayetano Heredia (seguimiento) www.upch.edu.pe
2004 – 2009 (baseline study), 2013 – 2014 (first monitoring)
Jaime Miranda, MD, MSc, PhD, FFPH, Antonio Bernabé – Ortíz, MD, MPH.
Contributors: Liam Smeeth, MBChB, FRCGP, FFPH, MSc, PhD, (London School of Hygiene and Tropical Medicine, Inglaterra), Robert H. Gilman, MD, (Johns Hopkins University, Estados Unidos).