Parental migration and the mental health of those who stay behind to care for children in South-East Asia

Longitudinal associations between parental migration and children's psychological well-being in Southeast Asia: The roles of caregivers' mental health and caregiving quality

OBJECTIVE

This study investigates the longer-term effects of parental migration on the psychological well-being of children who stay behind in two major labor-sending countries in Southeast Asia, namely, Indonesia and the Philippines. Adopting the framework of the 'care triangle', we further examine how caregivers' mental health and caregiving quality moderate the associations between parental migration and children's psychological well-being.

METHODS

Using longitudinal data collected in 2008 and 2016/17, we assess children's psychological well-being during early childhood (aged 3-5 years) and again in adolescence (aged 11-13 years). We apply both fixed-effects and random-effects models, using the Hausman test to indicate the preferred model.

RESULTS

The findings indicate that there is no significant longer-term effect of parental migration on children's psychological well-being, but parental migration tends to show adverse effects on Filipino children's psychological well-being when they are cared for by a caregiver with poor mental health.

CONCLUSIONS

The two-country comparison demonstrates the complexities of understanding the gender-based influences of parental migration on children's psychological well-being. The findings also highlight the caregiver's role in maintaining frequent communications with migrant parents within the care triangle, which is crucial to children's well-being.

Long-term effects of left-behind experience on adult depression: Social trust as mediating factor

Background

Despite much attention paid to the mental health of left-behind children, there has not been sufficient research on whether and how left-behind experiences have long-term effects on adults among the general population. This paper aims to evaluate the long-term effects of left-behind experience on adult psychological depression.

Methods

By using the China Labor-force Dynamics Survey in 2018 (CLDS 2018), we assessed depression by the Center for Epidemiological Studies, Depression Scale (CES-D) and used a cut-off score of 20 for detecting depression (Yes = 1, No = 0). The Binomial logistic regression was used to compare the odds ratio across groups. We used the KHB method in the mediation analysis, to measure the indirect effect of social trust on the relationship between left-behind experience and depression.

Results

The rate of depression (χ2 = 17.94, p < 0.001) for the children who have left-behind experience (LBE) (10.87%) was higher than the children who have non-left-behind experience (N-LBE) (6.37%). The rate of social trust (χ2 = 27.51, p < 0.001) of LBE (65.70%) was lower than N-LBE (75.05%). Compared with the other three groups, left-behind experience occurred in preschool (OR = 2.07, p < 0.001, 95% CI = [1.45, 2.97]) was more likely to suffer from depression. The indirect effect of social trust (OR = 1.06, p < 0.01, 95% CI = [1.02, 1.10]) is significantly on the relationship between LBE and psychological depression, with the total effect (OR = 1.71, p < 0.001, 95% CI = [1.27, 2.31]) and direct effect (OR = 1.62, p < 0.01, 95% CI = [1.20, 2.18]) are both significantly. The proportion of indirect effect in the total effect is 10.69%.

Conclusion

The left-behind experience that occurred in childhood has a significantly negative effect on adult psychological depression, in which preschool left-behind experience played the most critical role. Social trust is the mediating factor associated with left-behind experience and psychological depression. To mitigate the long-term effects of the left-behind experience on psychological depression, parents need to be prudent about the decision-making of migration in the preschool stage of their children. and subsequent policies should strengthen social work targeting vulnerable youth groups especially those with left-behind experience at an early age in terms of their psychological depression.

Through our own eyes and voices: The experiences of those "left-behind" in rural, indigenous migrant-sending communities in western Guatemala

Migration from Central America to the United States has become a strategy to escape economic poverty, exclusionary state policies and violence for people of Mayan descent. Under the principles Community Based Participatory Research, we explored the health concerns of Indigenous Mayans in rural migrant-sending communities of Guatemala using their own visual images and narratives through a Social Constructivist lens. Half of households in the study region have at least one member emigrated to the United States, making many "transnational families." Focus groups and photographs and narratives from 20 Photovoice participants, aged 16-65, revealed significant health challenges related to conditions of poverty. Drivers of immigration to the United States included lack of access to healthcare, lack of economic opportunity, and an inability to pay for children's education. Health implications of living in communities "left-behind" to immigration centered around changes in societal structure and values. Mental health challenges, sadness and loss were experienced by both children and adults left behind. An increase in substance use as a coping mechanism is described as increasingly common, and parental absence leaves aging grandparents raising children with less guidance and supervision. Lack of economic opportunity and parental supervision has left young adults vulnerable to the influence of cartel gangs that are well-established in this region. Findings from this study provide insight into challenges driving immigration, and the health impacts faced by rural, Indigenous communities left behind to international immigration. Results may inform research and interventions addressing disparities and strategies to cope with economic and health challenges.

The impact of living arrangements and intergenerational support on the health status of older people in China: are rural residents disadvantaged compared to urban residents?

Research to-date has examined the impact of intergenerational support in terms of isolated types of support, or at one point in time, failing to provide strong evidence of the complex effect of support on older persons’ wellbeing. Using the Harmonised China Health and Retirement Longitudinal Study (2011, 2013 and 2015), this paper investigates the impact of older people's living arrangements and intergenerational support provision/receipt on their physical and psychological wellbeing, focusing on rural–urban differences. The results show that receiving economic support from one's adult children was a stronger predictor for higher life satisfaction among rural residents compared to urban residents, while grandchild care provision was an important determinant for poor life satisfaction only for urban residents. Having weekly in-person and distant contact with one's adult children reduced the risk of depression in both rural and urban residents. Older women were more likely than men to receive support and to have contact with adult children, but also to report poor functional status and depression. The paper shows that it is important to improve the level of public economic transfers and public social care towards vulnerable older people in rural areas, and more emphasis should be placed on improving the psychological wellbeing of urban older residents, such as with the early diagnosis of depression.

Offspring's labor migration and its implications for elderly parents' emotional wellbeing in Indonesia

Population ageing and labor out-migration are increasingly challenging normative intergenerational support systems and familial welfare in parts of Asia. Extant studies look at how migration affects the material wellbeing of sending-households, but less is known about how migration shapes the emotional health of non-migrants as origin and destination conditions evolve. This study examines how labor migration among adult children shape the emotional health of elderly parents in Indonesia, and how observed implications are modified by alternative care arrangements and different migrant destinations. Using panel data from 2101 respondents age 50+ in the 2007 and 2014 Indonesia Family Life Survey, and individual-level fixed effects regressions, this study finds that offspring's migration is associated with increased parental depression, net of covariates. Depressive outcomes are abated if resulting care deficits are offset by co-residence or daily interactions with adult children, or if children move to economically lucrative international destinations; however, having a child in Malaysia - a destination characterized by high informal labor employment - increased parental depression. These findings draw attention to the non-economic implications of migration and the distress experienced specifically by parents who lack intergenerational support and who have concerns about child's wellbeing at destination.

Men's migration and women's mortality in rural Mozambique

Labor migration is widespread and growing across the world. As migration grows, the economic outcomes of migration increasingly diversify, and so do its consequences for the well-being and health of both migrants and non-migrating household members. A considerable body of scholarship has examined the effects of migration on the physical and mental health of 'left-behind' household members. The impact of migration on mortality, particularly of non-migrating marital partners, is less well understood. Addressing this gap, we use data from a longitudinal survey of married women conducted over twelve years in rural Mozambique to examine the association between men's labor out-migration and their non-migrating wives' mortality. The analyses detect no significant differences when comparing non-migrants' wives to migrants' wives in the aggregate but point to instructive variation among migrants' wives according to the economic success of migration, as measured by the effects of migration on the household's material well-being. Specifically, women married to less successful migrants had higher mortality risks over the project span than women married to more successful migrants, regardless of other individual and household-level factors. Importantly for this setting with high HIV prevalence, the advantage of wives of more successful migrants is significant for HIV/AIDS-unrelated deaths but not for HIV/AIDS-related deaths. We situate these findings within the cross-national scholarship on migration and health.

Social support, well-being and involvement of fathers in transnational families in the Philippines

This study investigated left-behind Filipino fathers and their involvement as child caregivers. It hypothesized that social support and well-being predict paternal involvement, with well-being as the mediator. Results showed that familial and peer support predicted involvement, with well-being as mediator. Spousal support did not predict involvement or well-being. Findings highlight the importance of familial and peer support to left-behind fathers. Interactions between significant predictors of involvement present novel pathways to childcare. The non-significant role of spousal support is discussed in the context of transnational migration. Several interventions involving families and peers are suggested.

To Europe or Not to Europe? Migration and Public Support for Joining the European Union in the Western Balkans

For decades, countries aspiring to join the European Union (EU) have been linked to it through migration. Yet little is known about how migration affects individual support for joining the EU in prospective member states. We explore the relationship between migration and support for EU accession in the Western Balkans. Using data from the Gallup Balkan Monitor survey, we find that prospective and return migrants, as well as people with relatives abroad, are more likely to vote favorably in a hypothetical EU referendum. At the same time, only people with relatives abroad are more likely to consider EU membership a good thing. Our results suggest that migration affects attitudes toward joining the EU principally through instrumental/utilitarian motives, with channels related to information and cosmopolitanism playing only a minor role. Overall, we show that migration fosters support for joining the EU in migrants’ origin countries and that joining such a supranational institution is likely to foster political and institutional development of migrants’ origin countries.

Depressive symptoms among mothers with young children-the role of family migration and social networks in Mexico

BACKGROUND

Women who remain in migratory sending communities as their family members migrate internationally are at risk for depression. Limited research examines the association between the number of absent household members and a woman's mental health.

AIMS

This study examines the association between residing in a migrant household and depressive symptoms for women in Mexico while accounting for social networks and social support.

METHODS

Logistic regression analysis was employed using the Social Networks and Health Information Survey (SNHIS) (n = 320), a random household survey conducted in a medium-sized municipality in Guanajuato, Mexico.

RESULTS

Multivariate results suggest that residing in a household with two or more migrants was associated with increased odds of depressive symptoms, while having immediate kin in the community reduced the odds of depressive symptoms. Social relationships in the community and social support were associated with reduced odds of depressive symptoms. Their inclusion in the models reduced the significance of but did not significantly mediate the association between residing in a household with multiple migrants and depressive symptoms.

CONCLUSIONS

Services aimed at improving women's health should target women who reside in households with multiple migrants and focus on reducing the stress and mental health impacts associated with these relationships.

The association between parental migration and early childhood nutrition of left-behind children in rural China

BACKGROUND

More than one-third of children under 3 years old are left behind at home due to parental migration in rural China, and we know very little about early childhood nutrition of left-behind children (LBC) because of the dearth of research. This study examined the association between parental migration and early childhood nutrition of LBC in rural China.

METHODS

We used repeated cross-sectional data of rural children aged 6-35 months who participated in two surveys in six counties of northern and southern China in 2013 and 2016 respectively. The length, weight, and hemoglobin concentration were measured by trained health-care workers blinded to parental migration status. Stunting, underweight, wasting, and anemia were identified with the standards recommended by WHO. Generalized linear regressions and multivariate logistic regressions were employed to explore the association between parental migration and these nutritional outcomes at each time point.

RESULTS

Two thousand three hundred thirty-six and 2210 children aged 6-35 months were enrolled in 2013 and 2016, respectively. The results show a reduction of the risks of stunting, underweight, and wasting from 2013 (16.4, 8.5, and 3.5%, respectively) to 2016 (12.1, 4.0, and 1.5%, respectively) but highlight a constantly and alarmingly high risk of anemia among these children (44.8% in 2013 and 43.8% in 2016). Children with migrant fathers performed as well as or better than those with non-migrants on these indicators. Children with migrant parents performed slightly worse in 2013, but equal or slightly superior in 2016 on these indicators compared with children with non-migrants and migrant fathers. Children aged 6-17 months with migrant parents had a significantly lower risk of anemia than those living with their mothers or with both parents (43.1% vs. 63.6% and 61.5 in 2013, and 42.5 vs. 60.1 and 66.2% in 2016), even after controlling for children's sociodemographic characteristics.

CONCLUSIONS

Parental migration may be not detrimental and even beneficial to early childhood nutrition of LBC in rural China. Continued nutritional support is needed for all rural children, especially interventions for preventing micronutrient deficiency. Programs for LBC are recommended to continue to focus on nutrition but pay more attention to other important health issues.

The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study

Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey was carried out in the Nawalparasi district. Study areas were purposively chosen; however, participants were randomly selected. Nepali versions of the 12-item General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), and Connor-Davidson Resilience Scale (CD-RISC) were used. Mental ill-health risk was prevalent in 3.1% of the participants as determined by GHQ. BDI identified mild or moderate depression in 6.5% of the participants with no one having severe depression. In bivariate analysis, a high frequency of communication with the husband was associated with lower mental ill-health risk and depression, as well as increasing resilience. Reduced return intervals of husbands and a high frequency of remittance were also associated with a low GHQ score. In a multiple regression model, adjusting for potential confounding variables, participants who communicated with their husbands at least once a day had a greater mean CD-RISC score (i.e., high resilience against mental ill-health risk) compared to those who did so at least once a week; a mean difference of 3.6 (95% CI 0.4 to 6.9), P = 0.03. To conclude, a low mental ill-health risk was found in the female spouses of migrants.

Migration and absent fathers: Impacts on the mental health of left-behind family members in Thailand

This paper examines whether children and main caregivers of overseas migrant fathers have fewer or more mental health symptoms compared to those of non-migrant fathers. The sample includes 997 households from the 2008 Child Health and Migrant Parents in South-East Asia project. The mental health measurements are the Strengths and Difficulties Questionnaire and the Self-Reporting Questionnaire. Compared to children of non-migrant fathers, those of migrant fathers are more likely to demonstrate conduct problems and hyperactivity/inattention. Factors which appear to impact a caregiver's mental health include the physical health status of children, caregiver's education level and household economic status. To reduce the risk of mental health problems on left-behind children, our findings imply the importance of encouraging and educating left-behind families to monitor the children's psychological well-being, especially those in father-migrant families.

Do remittances alleviate negative impacts of disaster on mental health? A case of the 2015 Nepal earthquake

This paper contributes to two strands of literature: disaster literature on post-disaster mental health and economics literature on migration. Remittances are a sizable source of income in many developing countries. Evidence suggests, however, that when adults migrate in order to support their families via remittances, family members left behind often experience poorer physical and mental health. We study the effects of remittances on the mental health of victims of a disaster, the earthquake (EQ) that hit Nepal in 2015. We used three waves of data from 335 individuals in 6 villages in Western Nepal in which emigration is prevalent. The first wave of the survey was conducted one year before the 2015 EQ. In the third wave, which was conducted one year after the EQ, the respondents aged 15 and older were assessed for post-traumatic stress disorder (PTSD) and depressive symptoms. PTSD symptoms were evaluated by the 17-item Checklist Civilian (PCL-C), and depressive symptoms were measured by the 20-question Epidemiologic Studies Depression Scales (CESD) questionnaire. In order to avoid capturing the impacts of remittances for daily expenses and reduce possible endogeneity in the remittance variables, we measured the change in remittances following the EQ. After controlling for pre-disaster body-mass index and asset holdings, we found that the increase in remittances sent to HHs reduced psychological distress measured by the PTSD and depression severity scores. The remittance variables, however, did not alleviate mental disorder as defined by the international-standard cutoff points of PCL-C and CES-D.

Are left-behind families of migrant workers at increased risk of attempted suicide? - a cohort study of 178,000+ individuals in Sri Lanka

BACKGROUND

There are an estimated 258 million international migrants worldwide. In Asia low-skilled workers often emigrate on a temporary basis (2-3 years) without their families. There is significant concern over the mental health and wellbeing of left-behind families in this region. No previous study has examined whether the risk of suicidal behaviour is elevated in left-behind family members.

METHODS

Cohort study using baseline data from a large randomised controlled trial in Sri Lanka (n = 178,730 participants; 8% households had a current temporary foreign migrant) and prospective hospital presentations of suicide attempts. Using multilevel Poisson regression models, we compared the risk of attempted suicide in households with left-behind and non-left-behind family members. We also investigated whether the sex of the migrant or the age/sex of the household member left behind altered any associations.

RESULTS

The risk of an attempted suicide was elevated in female migrant households (IRR 1.60 95% CI 1.38, 1.85), but not male migrant households (IRR 1.01 95% CI 0.76,1.36)) with strong evidence that risk differed for female vs. male migrant households (p-value = 0.005). We found no evidence that the age or sex of the left-behind household member altered the association observed.

CONCLUSIONS

This analysis suggests that members of households with a temporary female foreign migrant are at an increased risk of attempted suicide, but these findings must be interpreted with caution. The increased risk of suicidal behaviour in these households may be due to factors that were present before the migration and persist post-migration (e.g. household violence, poverty).

Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis

BACKGROUND

Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs).

METHODS

For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871.

FINDINGS

Our search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27-1·82]; SMD 0·16 [0·10-0·21]), anxiety (RR 1·85 [1·36-2·53]; SMD 0·18 [0·11-0·26]), suicidal ideation (RR 1·70 [1·28-2·26]), conduct disorder (SMD 0·16 [0·04-0·28]), substance use (RR 1·24 [1·00-1·52]), wasting (RR 1·13 [1·02-1·24]) and stunting (RR 1·12 [1·00-1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains.

INTERPRETATION

Parental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people.

FUNDING

Wellcome Trust.

The social and economic impact of international female migration on left-behind parents in East Java, Indonesia

The objective of this article is to examine the impact of international female labor migration on left-behind parents by taking into consideration the daughters' marital status. Data were taken from in-depth interviews with 37 left-behind parents of migrant women in East Java Province. The study showed that left-behind parents had limited access to the remittances sent by married daughters, except when they carried out childcare responsibilities. Parents of unmarried daughters had some access to remittances, but this varied according to the economic conditions of the family. Left-behind parents were concerned about the safety of their daughters overseas, the marriage prospects of unmarried daughters, the stability of their daughters' marriages and the welfare of left-behind grandchildren. Because the migration of married and unmarried daughters has diverse impacts on left-behind parents, this should be considered in programs that aim to mitigate potential negative impacts of women's migration.

Engaged parenting, gender, and children's time use in transnational families: An assessment spanning three global regions

Global circuits of migration regularly separate parents from children. How families navigate this separation has changed markedly. The sharp decline in the cost of international communication makes possible new forms of transnational parenting. In many contexts, migrants are now actively engaged parents, involved in decisions, knowledgeable of children's schooling, employment, and activities, and in some cases, even conversant face-to-face with children via videoconferencing. These practices, however, are not universal. We use data from surveys in three countries to document the frequency and variability of intensive, engaged transnational parenting in the diverse global regions of Asia, Africa, and the Americas. We then ask whether the organisation of children's lives-specifically, time allocated to school homework, leisure, and household chores-varies by the degree to which migrant parents stay connected to sending homes. The gender of the migrant parent, stay-behind caregiver, and the gender of the child emerge as explanatory factors for engaged parenting and children's time use. However, and unexpectedly, in the Philippines, migrant mothers are less likely to practice engaged parenting. In sending households, girls in two of the three countries spend more time doing household chores than boys, but parental migration does not mitigate this difference. Although we find some evidence of more traditional gender practices, we also find exceptions that suggest potentially fruitful avenues for future research.

Emigration, remittances, and the subjective well-being of those staying behind

We offer the first global perspective on the well-being consequences of emigration for those staying behind using several subjective well-being measures (evaluations of best possible life, positive affect, stress, and depression). Using the Gallup World Poll data for 114 countries during 2009-2011, we find that having family members abroad is associated with greater evaluative well-being and positive affect, and receiving remittances is linked with further increases in evaluative well-being, especially in poorer contexts-both across and within countries. We also document that having household members abroad is linked with increased stress and depression, which are not offset by remittances. The out-migration of family members appears less traumatic in countries where migration is more common, indicating that people in such contexts might be able to cope better with separation. Overall, subjective well-being measures, which reflect both material and non-material aspects of life, furnish additional insights and a well-rounded picture of the consequences of emigration on migrant family members staying behind relative to standard outcomes employed in the literature, such as the left-behind's consumption, income, or labor market outcomes.

Psychiatric morbidity and its correlates among informal caregivers of older adults

OBJECTIVE

This present study estimated the psychiatric morbidity among informal caregivers of older adults and investigated its association with their socio-demographic factors and older adult's health status, including dementia, depression and physical health conditions.

METHODS

Data from a national cross-sectional survey were used. For each participating older adult, an informal caregiver who 'knew the older adult best' and was aware of their health condition, was also interviewed to collect information on the older adults' care needs, and behavioral and psychological symptoms of dementia (BPSD). Data from 693 pairs was used. Informal caregivers were administered the Self Reporting Questionnaire (SRQ)-20 and psychiatric morbidity was defined as those with a total SRQ score of ≥8. Measures included informal caregivers' socio-demographic characteristics, assessment of dementia and depression in the older adults and self-report on their lifetime and current physical conditions. The association of socio-demographic characteristics, health conditions, care assistance and BPSD was investigated using backward stepwise logistic regression analysis where psychiatric morbidity (total SRQ score<or ≥8) was used as a dependent variable and all other variables served as independent covariates.

RESULTS

Among informal caregivers, 8.8% exhibited psychiatric morbidity. Higher proportions of spousal caregivers and caregivers of older adults having more care needs and BPSD exhibited psychiatric morbidity. After adjusting for all covariates, caregivers' marital status, and the presence of BPSD and dementia in the older adults were identified as the strongest correlates of caregivers' psychiatric morbidity. The prevalence of psychiatric morbidity was 10%, 13.9% and 12.7% respectively in these groups. Married caregivers had higher odds of psychiatric morbidity (OR 2.50, 95% CI: 1.13-5.52). In addition, caregivers of older adults' with any BPSD (OR 5.87, 95% CI: 2.60-13.24) and dementia (OR 2.28, 95% CI: 1.23-4.20) were also associated with higher odds of psychiatric morbidity.

CONCLUSION

Informal caregivers' marital status and presence of any BPSD and dementia in the older adults in their care were identified as the strongest correlates of caregivers' psychiatric morbidity. Clinicians should be cognizant of the risk in this group of caregivers and assess and intervene to alleviate caregivers' psychological problems.

[Migrations in Latin American countries. Characteristics of the pediatric population]

INTRODUCTION

Migration is a growing phenomenon among Latin American countries (LAC) as well as others; however, scarce information is available studying its impact on paediatric groups and its association with socioeconomic variables.

OBJECTIVE

To study the association among socioeconomic variables and the immigration rate of paediatric population in LAC.

MATERIAL AND METHODS

Official rates of migration of LAC were obtained from: International Organization for Migration, Pan American Health Organization, and United Nations Development Programme. Demographic and socioeconomic information was also obtained for: gross domestic product (GDP), human development index (HDI), Gini coefficient of inequality (GC), alphabetization rate for adults (AA), net migration rate (NMR), and immigration of children<15 years (IM15). Description, linear correlations and analysis of differences between groups of countries were assessed.

RESULTS

The NMR was positive for Costa Rica, Panama, Venezuela, Chile and Argentina. No association among NMR and GDP, HDI, GC, AA was found. A correlation of IM15 was found with: GC (r=0.668, P=.01), with GDP (r=-0.720; P=.01), AA (r=-0.755; P=.01) and with HDI (r=-0.799; P=.01). Rate of IM15 was lower in LA countries with advanced/medium development (GDP>median) vs those with low development (Fisher, P<.0001).

CONCLUSIONS

There is a direct inverse association between GDP per capita, HDI, AA and GC and the proportion of each country IN15. We did not observe an association between NMR and HDI, AA, and GC. The health impact of these migrations should be analysed.