Abstract
BackgroundUrban populations usually have higher levels of cardiovascular risk factors than rural populations in developing countries. However, association between cardiovascular risk factors and duration of urban dwelling, particularly for early stages of urban migrations, has not yet been adequately studied. We examined cardiovascular risks in relation to timing of urbanization in Thailand, paying attention to recent internal migrants.MethodsOur study base was a large national cohort (n = 87 151) of distance-learning Thai open university students recruited in 2005 and followed up in 2009. After exclusion of longitudinal dropouts and reverse migrants, 51 936 remained for analyses. The information collected included historical residence, urban migration and its lifecycle timing, self-reported doctor-diagnosed diseases, and socio-demographic and personal attributes that could influence health. To relate cardiovascular outcomes (prevalence and incidence of hypertension and hyperlipidaemia) and life-course urbanization status (ie at age 12, 4 years ago [2005] and at present [2009]), we applied logistic regression. Included in the models were 10 other covariates that could confound the urbanization effect.ResultsRecent migration (arriving within four years) among young cohort members (born after 1980) was associated with higher risk of hypertension (OR 1.80 for prevalence and 1.68 for four-year incidence). Higher hyperlipidaemia prevalence (and incidence) was associated with any urban dwelling. Recent migrants quickly developed hyperlipidaemia, particularly the youngest (born after 1980) and oldest participants (born before 1960).ConclusionsIncreased cardiovascular risks appear among rural-urban migrants within four years after they arrive. Given the scale of continuing urbanization, interventions are needed to support and educate recent migrants in Thai cities.
Highlights
Urban populations have higher prevalence of cardiovascular risks than rural populations in some developing countries.[1,2,3] Two recent cross-sectional studies explored the association between duration of urban dwelling and cardiovascular risk factors in India.[4,5] Both studies suggested that rural-urban migrants have higher prevalence of obesity than rural dwellers.In addition, body fat was found to increase rapidly after moving to an urban environment, while prevalence of other cardiovascular risk factors increased more gradually
We focus on hypertension and hyperlipidaemia and use data from a large community-based nationwide Thai Cohort Study (TCS) to investigate two important urbanization hypotheses related to the health-risk transition
We evaluated the impact of dropouts by comparing the baseline (2005) status for the analysed group to the unanalysed group for all the explanatory variables included in the models
Summary
Urban populations have higher prevalence of cardiovascular risks than rural populations in some developing countries.[1,2,3] Two recent cross-sectional studies explored the association between duration of urban dwelling and cardiovascular risk factors in India.[4,5] Both studies suggested that rural-urban migrants have higher prevalence of obesity than rural dwellers.In addition, body fat was found to increase rapidly after moving to an urban environment, while prevalence of other cardiovascular risk factors increased more gradually. Research on the relationship between timing of urban migration and cardiovascular risk factors (eg, hypertension and hyperlipidaemia) is still limited, especially in developing countries, the worldwide setting of massive urban migration. Urban populations usually have higher levels of cardiovascular risk factors than rural populations in developing countries. Association between cardiovascular risk factors and duration of urban dwelling, for early stages of urban migrations, has not yet been adequately studied. To relate cardiovascular outcomes (prevalence and incidence of hypertension and hyperlipidaemia) and life-course urbanization status (ie at age 12, 4 years ago [2005] and at present [2009]), we applied logistic regression. Results: Recent migration (arriving within four years) among young cohort members (born after 1980) was associated with higher risk of hypertension (OR 1.80 for prevalence and 1.68 for four-year incidence). Higher hyperlipidaemia prevalence (and incidence) was associated with any urban dwelling. Given the scale of continuing urbanization, interventions are needed to support and educate recent migrants in Thai cities
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