Melissa S Burroughs Pena1, Antonio Bernabé-Ortiz2, Rodrigo M Carrillo-Larco2, Juan F Sánchez3, Renato Quispe2, Timesh D Pillay4, Germán Málaga5, Robert H Gilman6, Liam Smeeth7, J Jaime Miranda5. 1. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Duke University Research Institute, Duke University, Durham, North Carolina, USA. 2. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru. 3. Department of Parasitology, U.S. Naval Medical Research Unit No.6 (NAMRU-6), Callao, Peru. 4. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Medical School, University College London, London, UK. 5. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. 6. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA Biomedical Research Unit, Asociación Benéfica PRISMA, Lima, Peru. 7. CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Abstract
OBJECTIVE: To compare all-cause and cause-specific mortality among 3 distinct groups: within-country, rural-to-urban migrants, and rural and urban dwellers in a longitudinal cohort in Peru. METHODS: The PERU MIGRANT Study, a longitudinal cohort study, used an age-stratified and sex-stratified random sample of urban dwellers in a shanty town community in the capital city of Peru, rural dwellers in the Andes, and migrants from the Andes to the shanty town community. Participants underwent a questionnaire and anthropomorphic measurements at a baseline evaluation in 2007-2008 and at a follow-up visit in 2012-2013. Mortality was determined by death certificate or family interview. RESULTS: Of the 989 participants evaluated at baseline, 928 (94%) were evaluated at follow-up (mean age 48 years; 53% female). The mean follow-up time was 5.1 years, totalling 4732.8 person-years. In a multivariable survival model, and relative to urban dwellers, migrant participants had lower all cause mortality (HR=0.30; 95% CI 0.12-0.78), and both the migrant (HR=0.07; 95% CI 0.01-0.41) and rural (HR=0.06; 95% CI 0.01-0.62) groups had lower cardiovascular mortality. CONCLUSIONS: Cardiovascular mortality of migrants remains similar to that of the rural group, suggesting that rural-to-urban migrants do not appear to catch up with urban mortality in spite of having a more urban cardiovascular risk factor profile. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: To compare all-cause and cause-specific mortality among 3 distinct groups: within-country, rural-to-urban migrants, and rural and urban dwellers in a longitudinal cohort in Peru. METHODS: The PERU MIGRANT Study, a longitudinal cohort study, used an age-stratified and sex-stratified random sample of urban dwellers in a shanty town community in the capital city of Peru, rural dwellers in the Andes, and migrants from the Andes to the shanty town community. Participants underwent a questionnaire and anthropomorphic measurements at a baseline evaluation in 2007-2008 and at a follow-up visit in 2012-2013. Mortality was determined by death certificate or family interview. RESULTS: Of the 989 participants evaluated at baseline, 928 (94%) were evaluated at follow-up (mean age 48 years; 53% female). The mean follow-up time was 5.1 years, totalling 4732.8 person-years. In a multivariable survival model, and relative to urban dwellers, migrant participants had lower all cause mortality (HR=0.30; 95% CI 0.12-0.78), and both the migrant (HR=0.07; 95% CI 0.01-0.41) and rural (HR=0.06; 95% CI 0.01-0.62) groups had lower cardiovascular mortality. CONCLUSIONS: Cardiovascular mortality of migrants remains similar to that of the rural group, suggesting that rural-to-urban migrants do not appear to catch up with urban mortality in spite of having a more urban cardiovascular risk factor profile. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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