Rural-urban migration and health: evidence from longitudinal data in Indonesia.

Previous studies on the impact of migration on health often face the difficulties of choosing the proper comparison group and addressing potential selection of migration. Using longitudinal data for 1997 and 2000 from Indonesia, this paper examines the effect of rural-urban migration on physical and psychological health, by (1) comparing the health of migrants with that of the appropriate group of comparison, people who remained in rural origins, and (2) studying health both prior to and after migration to adjust for possible selection bias. The research further explores various socioeconomic, psychosocial, and behavioral pathways mediating the migration effect. Results show that rural-urban labor migration increased the risk of psychological disorder as measured by depressive symptoms. This was largely a result of reduced social support due to family disruption, because the deleterious effect was particularly strong for migrants who moved alone and was negligible for migrants moving with family members. In contrast, migration had little impact on physical health in the medium term. This was largely attributed to the multiple offsetting influences of migration: migration improved economic status and living standards but led to increased work-related stressors and barriers to health utilization. In addition, despite earning higher income, migrants tend to underconsume and remit a large amount of earnings to original families, which hindered potential health gains from improved economic well-being. Copyright 2009 Elsevier Ltd. All rights reserved.