Abstract
This study aims to quantify changes in outdoor (ambient) air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality. Data on ambient fine particulate matter (PM2.5) was obtained from the National Aeronautics and Space Administration (NASA). Census data was used to calculate rates of within-country migration at the district level. We calculated differences in PM2.5 exposure between “current” (2016–2017) and “origin” (2012) districts for each migration patterns. Using an exposure-response relationship for PM2.5 extracted from a meta-analysis, and mortality rates from the Peruvian Ministry of Health, we quantified premature mortality attributable to each migration pattern. Changes in outdoor PM2.5 exposure were observed between 2012 and 2016 with highest levels of PM2.5 in the Department of Lima. A strong spatial autocorrelation of outdoor PM2.5 values (Moran’s I = 0.847, p-value=0.001) was observed. In Greater Lima, rural-to-urban and urban-to-urban migrants experienced 10-fold increases in outdoor PM2.5 exposure in comparison with non-migrants. Changes in outdoor PM2.5 exposure due to migration drove 185 (95% CI: 2.7, 360) premature deaths related to air pollution, with rural-urban producing the highest risk of mortality from exposure to higher levels of ambient air pollution. Our results demonstrate that the rural-urban and urban-urban migrant groups have higher rates of air pollution-related deaths.
Highlights
This study aims to quantify changes in outdoor air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality
The district-level migration rate showed a scattered spatial pattern, most migrants arrived to Greater Lima (Province of Lima) (Fig. 3 - left), which is the city with the lowest out-migration in the country (Fig. 3 - right)
The 43 districts that make up Greater Lima received two-fold the migrant population (1,242,834 migrants) than small cities that make up 1,633 districts (581,738 migrants)
Summary
This study aims to quantify changes in outdoor (ambient) air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality. Social vulnerability from economic instability, social isolation, poor access to healthcare services, increased exposure to infectious diseases, and traumatic events related to the migration itself have been known to affect migrants’ health[9,10,11,12,13,14] In addition to these stressors, migrants are exposed to new environments, which may have further impacts. With major increases in urbanization and migration to urban centers worldwide, which have higher levels of air pollution and other environmental exposures, the potential health implications of these changes and burden of migrant populations merits attention[23]. The study of health exposures among migrants needs to further characterize the different profiles of within country migrants, as recently exemplified in the case of obesity[24]
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