RESUMO
Background: To understand if migrants living in poverty in low and middle-income countries (LMICs) have mortality advantages over the non-migrant population, we investigated mortality risk patterns among internal and international migrants in Brazil over their life course. Methods: We linked socio-economic and mortality data from 1st January 2011 to 31st December 2018 in the 100 Million Brazilian Cohort and calculated all-cause and cause-specific age-standardised mortality rates according to individuals' migration status for men and women. Using Cox regression models, we estimated the age- and sex-adjusted mortality hazard ratios (HR) for internal migrants (i.e., Brazilian-born individuals living in a different Brazilian state than their birth) compared to Brazilian-born non-migrants; and for international migrants (i.e., people born in another country) compared to Brazilian-born individuals. Findings: The study followed up 45,051,476 individuals, of whom 6,057,814 were internal migrants, and 277,230 were international migrants. Internal migrants had similar all-cause mortality compared to Brazilian non-migrants (aHR = 0.99, 95% CI = 0.98-0.99), marginally higher mortality for ischaemic heart diseases (aHR = 1.04, 95% CI = 1.03-1.05) and higher for stroke (aHR = 1.11, 95% CI = 1.09-1.13). Compared to Brazilian-born individuals, international migrants had 18% lower all-cause mortality (aHR = 0.82, 95% CI = 0.80-0.84), with up to 50% lower mortality from interpersonal violence among men (aHR = 0.50, 95% CI = 0.40-0.64), but higher mortality from avoidable causes related to maternal health (aHR = 2.17, 95% CI = 1.17-4.05). Interpretation: Although internal migrants had similar all-cause mortality, international migrants had lower all-cause mortality compared to non-migrants. Further investigations using intersectional approaches are warranted to understand the marked variations by migration status, age, and sex for specific causes of death, such as elevated maternal mortality and male lower interpersonal violence-related mortality among international migrants. Funding: The Wellcome Trust.
RESUMO
Abstract Using 2015 data of the Colombia Demographic and Health Survey, we investigated the incidence of belonging to a household with an Internally Displaced Person (IDP) on the likelihood of grade retention by sex. Particularly, a bivariate logistic regression was used to identify the correlation between families with IDP and children's gender on the probability of repeating a school year. Boys' were negatively affected when they live in an IDP household. Also, boys had a higher like-lihood of repeating a grade. We need to know how to act upon the social determinants that create social gaps and disadvantages across IDP, but also, to align with Sustainable Development Goals to eliminate gender inequalities.
Resumen (analítico) Utilizando datos de 2015 de la Encuesta de Demografía y de Salud de Colombia investigamos la incidencia de pertenecer a un hogar con una persona desplazada forzada por el conflicto armado interno (IDP) sobre la probabilidad de repetición de grado por sexo. En particular, se utilizó una regresión logística bivariada para identificar la correlación entre familias con desplazados internos y el género de los niños en la probabilidad de repetir un año escolar. Los niños se vieron afectados negativamente cuando vivieron en un hogar desplazado forzado. Además, los varones tuvieron una mayor probabilidad de repetir una asignatura. Necesitamos saber cómo actuar sobre los determinantes sociales que crean brechas sociales y desventajas entre los desplazados internos, pero también para alinearnos con los objetivos de desarrollo sostenible en busca de eliminar las desigualdades de género.
Resumo (analítico) Utilizando dados de 2015 da Pesquisa Demográfica e de Saúde da Colômbia (DHS), investigamos a incidência de pertencer a uma família com uma Pessoa Deslocada Interna (IDP) sobre a probabilidade de retenção de notas por sexo. Particularmente, uma regressão logística bivariada foi usada para identificar a correlação entre famílias com PID e sexo das crianças sobre a probabilidade de repetir um ano escolar. Os meninos foram afetados negativamente quando vivem em uma casa de deslocados internos. Além disso, os meninos tinham maior probabilidade de repetir uma nota. Precisamos saber como agir de acordo com os determinantes sociais que criam lacunas e desvantagens sociais entre os deslocados internos, mas também alinhar com os ODS para eliminar as desigualdades de gênero.