title: Climate-driven migration: an exploratory case study of Maasai health perceptions and help-seeking behaviors.
abstract: OBJECTIVE
  By 2050, over 250 million people will be displaced from their homes by climate change. This exploratory case study examines how climate-driven migration impacts the health perceptions and help-seeking behaviors of Maasai in Tanzania. Increasing frequency and intensity of drought is killing livestock, forcing Maasai to migrate from their rural homelands to urban centers in search of ways to support their families. Little existing research investigates how this migration changes the way migrants think about health and make healthcare decisions.
  
  
  METHODS
  This study used semi-structured qualitative interviews to explore migrant and non-migrant beliefs surrounding health and healthcare. Migrant and non-migrant participants were matched on demographic characteristics and location.
  
  
  RESULTS
  Migrants emphasized the importance of mental health in their overall health perceptions, whereas non-migrants emphasized physical health. Although non-migrants perceived more barriers to accessing healthcare, migrant and non-migrant help-seeking behaviors were similar in that they only sought help for physical health problems, and utilized hospitals as a last option.
  
  
  CONCLUSIONS
  These findings have implications for improving Maasai healthcare utilization, and for future research targeting other climate-driven migrant populations in the world.
authors.affiliation: Department of Environmental Health Sciences, Columbia University, New York, NY, USA. akh2148@cumc.columbia.edu.
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Heaney
authors.affiliation: Stanford Prevention Research Center, Stanford University, Palo Alto, CA, USA.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Winter
mesh_terms: D044383:Black People / Q000523:psychology*; D057231:Climate Change; D004641:Emigration and Immigration / Q000639:trends*; D004651:Employment / Q000191:economics; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D019982:Organizational Case Studies; D036301:Qualitative Research; D012424:Rural Population; D012959:Socioeconomic Factors; D013636:Tanzania; D014505:Urban Population
keywords: Climate change; Healthcare; Maasai; Mental health; Rural-to-urban migration; Tanzania