title: Timing of urbanisation and cardiovascular risks in Thailand: evidence from 51 936 members of the thai cohort study, 2005-2009.
abstract: BACKGROUND
  Urban populations usually have higher levels of cardiovascular risk factors than rural populations in developing countries. However, association between cardiovascular risk factors and duration of urban dwelling, particularly for early stages of urban migrations, has not yet been adequately studied. We examined cardiovascular risks in relation to timing of urbanization in Thailand, paying attention to recent internal migrants.
  
  
  METHODS
  Our study base was a large national cohort (n = 87 151) of distance-learning Thai open university students recruited in 2005 and followed up in 2009. After exclusion of longitudinal dropouts and reverse migrants, 51 936 remained for analyses. The information collected included historical residence, urban migration and its lifecycle timing, self-reported doctor-diagnosed diseases, and socio-demographic and personal attributes that could influence health. To relate cardiovascular outcomes (prevalence and incidence of hypertension and hyperlipidaemia) and life-course urbanization status (ie at age 12, 4 years ago [2005] and at present [2009]), we applied logistic regression. Included in the models were 10 other covariates that could confound the urbanization effect.
  
  
  RESULTS
  Recent migration (arriving within four years) among young cohort members (born after 1980) was associated with higher risk of hypertension (OR 1.80 for prevalence and 1.68 for four-year incidence). Higher hyperlipidaemia prevalence (and incidence) was associated with any urban dwelling. Recent migrants quickly developed hyperlipidaemia, particularly the youngest (born after 1980) and oldest participants (born before 1960).
  
  
  CONCLUSIONS
  Increased cardiovascular risks appear among rural-urban migrants within four years after they arrive. Given the scale of continuing urbanization, interventions are needed to support and educate recent migrants in Thai cities.
authors.affiliation: National Centre for Epidemiology and Population Health, ANU College of Medicine, Biology and Environment, the Australian National University.
authors.forename: Jiaying
authors.initials: J
authors.lastname: Zhao
authors.forename: Sam-Ang
authors.initials: SA
authors.lastname: Seubsman
authors.forename: Adrian
authors.initials: A
authors.lastname: Sleigh
authors.forename: The
authors.initials: T
authors.lastname: Thai Cohort Study Team
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D014507:Urbanization