Health and Migration Within and Across Borders: A Longitudinal Study of Mexican Internal Migrants and Return US Migrants
Health and migration are interrelated processes. This dissertation focuses on the case of Mexico to study the reciprocal relationship between migration and health by examining health selection among return US migrants and internal migrants and whether health trajectories change as a result of migration. This study was motivated by three research question. First, does the health of return US migrants improve or worsen as a result of migration, and does this change differ from that of non-migrants? Second, does internal migration produce different health trajectories relative to staying in the community of origin, and does it vary for men and women? Third, does internal migration shape the health disparities between the Mexican indigenous and non-indigenous populations? Using longitudinal data from the Mexican Family Life Survey, I estimated linear growth curves to assess migrants’ and non-migrants’ initial health status and changes in health over time. All analyses focused on overall health (measured by self-rated health) as the outcome of interest. Taken together, the findings from this dissertation provide evidence of the reciprocal relationship between health and migration, but also reveal that this relationship operates differently based on the destination and on the specific migrant population. Overall, I found similar patterns among return US migrants and indigenous internal migrants: both groups exhibited evidence of positive health selection relative to their non-migrant counterparts and both experienced a similar trend of health deterioration after migration. Internal migrants, on the other hand, were not significantly different from non-migrants in initial health or changes in health. The findings also underscore the reality that migrants are not a homogenous group. As an aggregate group, Mexican internal migrants were not positively selected on health and migration did not appear to have an independent effect on their health trajectories. However, this finding obscures the experiences of ethnic minorities. By disaggregating internal migrants and investigating the particular experiences of indigenous Mexicans, I uncovered significant health selection and evidence of health deterioration among a subset of internal migrants. Findings about the deterioration in the health of return migrants and indigenous migrants have implications for the Mexican health care system.