We found that overall, migration and urbanization are linked to health changes, but less adversely than is often presumed, once other personal characteristics are controlled.

Over the duration of the study, a gradual rise in migration outward from the rural origin community, commonly to the large, dense and economically dynamic metropolis took place.  Migration is widespread in our study population, but it is also selective, underscoring the value of longitudinal studies (vs snapshots) for understanding the impact of migration and urbanization on development.

Other specific findings include:

• Younger, male and more educated, persons are more likely to initiate a migration. Migrants report more favorable psychosocial conditions than rural origin nonmigrants.
• Migration to urban areas is associated with higher blood pressure, but only among women.
• Migration is associated with more frequent consumption of both processed foods and fruits and vegetables
• During the COVID pandemic, levels of employment decreased, with return migration to the rural origin was associated with loss of employment
• Prevalence of chronic conditions (HIV-positive status and non-communicable disease diagnoses) increased over time, with most chronic health conditions at lower levels in migrants.
• Our investigation to date suggests that migration and subsequent urban residence was associated with both characteristics and circumstances that raise concerns for long-term health trajectories, e.g. dietary changes, and socioeconomic outcomes that point to more optimistic trajectories, e.g. more positive self-reported health, access to full-time employment.