title: Migration, urbanisation and mortality: 5-year longitudinal analysis of the PERU MIGRANT study.
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.
authors.affiliation: CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Duke University Research Institute, Duke University, Durham, North Carolina, USA.
authors.forename: Melissa S
authors.initials: MS
authors.lastname: Burroughs Pena
authors.affiliation: CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bernabé-Ortiz
authors.affiliation: CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Rodrigo M
authors.initials: RM
authors.lastname: Carrillo-Larco
authors.affiliation: Department of Parasitology, U.S. Naval Medical Research Unit No.6 (NAMRU-6), Callao, Peru.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Sánchez
authors.affiliation: CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Renato
authors.initials: R
authors.lastname: Quispe
authors.affiliation: CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru Medical School, University College London, London, UK.
authors.forename: Timesh D
authors.initials: TD
authors.lastname: Pillay
authors.affiliation: 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.
authors.forename: Germán
authors.initials: G
authors.lastname: Málaga
authors.affiliation: 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.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.affiliation: 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.
authors.forename: Liam
authors.initials: L
authors.lastname: Smeeth
authors.affiliation: 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.
authors.forename: J Jaime
authors.identifier: http://orcid.org/0000-0002-4738-5468
authors.initials: JJ
authors.lastname: Miranda
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D015897:Comorbidity; D003644:Death Certificates; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D014504:Urban Health / Q000706:statistics & numerical data*
keywords: EPIDEMIOLOGY; MIGRATION; MORTALITY