The impact of rural-urban migration on under-two mortality in India

This paper examines the impact of rural-urban migration on under-two mortality in India, using data from the 1992/93 Indian National Family Health Survey. Multilevel logistic models are fitted for mortality in three age groups: neonatal, early post-neonatal, and late post-neonatal and toddler. Migration status was not a significant determinant of mortality in any of the three age groups. Further analysis shows that a relationship between migration status and mortality exists when socioeconomic and health utilization variables are omitted from the models. The relationship between migration and mortality is thus explained by differences in socioeconomic status and use of health services between rural-urban migrant and nonmigrant groups. The selectivity of rural-urban migrants on socioeconomic characteristics creates mortality differentials between rural-urban migrants and rural non-migrants. Problems faced by migrants in assimilating into urban societies create mortality differentials between rural-urban migrants and urban non-migrants. These results highlight the need to target migrants in the provision of health services, and demonstrate that rural areas continue to have the highest levels of infant-child mortality. Further research is needed to understand the health care needs of rural-urban migrants in order to inform the provision of appropriate health care.