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      Do migrants lives matter? A comparison of causes of death between African migrants from SADC countries and South Africans in the post-Apartheid era (2002-2015)

      research-article
      Lorena Núñez Carrasco , Abha Jaiswal , Jairo Arrow , Michel Kasongo Muteba , Bidhan Aryal
      International Journal of Migration, Health and Social Care
      Emerald Publishing
      Migrants, Mortality, natural causes of death, South Africans, Unnatural causes of death

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          Abstract

          Purpose

          Migrants historically and currently form an integral part of South Africa. Their importance and contribution to the country’s economy and development are undeniable. Yet, life for African migrants in South Africa is becoming increasingly difficult. An analysis of migrants mortality until now has not been conducted. The purpose of this paper is to compare the trends of the cause of death among South African Citizens (RSA) and African migrants from countries that form part of the South African Development Community (SADC), that make up nearly 70% of the migrants in the country.

          Design/methodology/approach

          Using Stats SA data of all registered deaths in South Africa (2002-2015), this paper compares all causes of death (COD) between RSA and SADC migrants. This paper studies the patterns in COD among these population groups for the years 2002 to 2015 in deaths due to infectious diseases and unnatural causes. Logistic regression was used to quantify the odds of dying due to infectious disease and unnatural causes for each population group. This paper included a calculation of the odds of dying due to assault, as a sub-group within unnatural deaths.

          Findings

          A total of 7,611,129 deaths were recorded for the local South African population and 88,114 for SADC migrants for the period under study (2002–2015). The burden of mortality for both infectious diseases and unnatural causes was higher for SADC migrants as compared to RSA. SADC migrants were 1.22 times more likely to die from infectious diseases than RSA (P < 0.001, 95% confidence interval (CI) (1.12, 1.23). Similarly, SADC migrants were 2.7 times more likely to die from unnatural causes than South Africans (P < 0.001, 95% CI (2.17, 2.23). The odds of dying from assault was the same as that of unnatural causes. Also, it was found that women were more likely to die from infectious diseases (OR = 1.11, P < 0.001, 95% CI (1.11, 1.11) compared to men, regardless of nationality.

          Research limitations/implications

          The bias resulting from migrants who return home to die due to illness, described in the literature as the salmon bias, is present in this paper. This paper, therefore, concludes death due to infectious diseases could be higher among migrants.

          Practical implications

          The heightened mortality among SADC migrants can be related to the impact of social determinants of health such as living and working conditions and barriers to access to health care. Moreover, the higher probability of death due to unnatural causes such as assaults constitute a proxy to estimate the impact of xenophobic violence observed in the country over the past decade. Policy interventions should focus on migrant health-care systems. Also, programmes to mitigate and curb xenophobic sentiments should be carried out to address the growing disparity of preventable unnatural causes of death.

          Originality/value

          This study offers the first quantification of mortality due to infectious diseases and unnatural causes among RSA and SADC migrants.

          Related collections

          Most cited references18

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          • Abstract: found
          • Article: not found
          Is Open Access

          Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease Study.

          The poor health of South Africans is known to be associated with a quadruple disease burden. In the second National Burden of Disease (NBD) study, we aimed to analyse cause of death data for 1997-2012 and develop national, population group, and provincial estimates of the levels and causes of mortality.
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            • Record: found
            • Abstract: found
            • Article: not found

            Returning home to die: circular labour migration and mortality in South Africa.

            To examine the hypothesis that circular labour migrants who become seriously ill while living away from home return to their rural homes to convalesce and possibly to die. Drawing on longitudinal data collected by the Agincourt health and demographic surveillance system in rural northeastern South Africa between 1995 and 2004, discrete time event history analysis is used to estimate the likelihood of dying for residents, short-term returning migrants, and long-term returning migrants controlling for sex, age, and historical period. The annual odds of dying for short-term returning migrants are generally 1.1 to 1.9 times (depending on period, sex, and age) higher than those of residents and long-term returning migrants, and these differences are generally highly statistically significant. Further supporting the hypothesis is the fact that the proportion of HIV/TB deaths among short-term returning migrants increases dramatically as time progresses, and short-term returning migrants account for an increasing proportion of all HIV/TB deaths. This evidence strongly suggests that increasing numbers of circular labour migrants of prime working age are becoming ill in the urban areas where they work and coming home to be cared for and eventually to die in the rural areas where their families live. This shifts the burden of caring for them in their terminal illness to their families and the rural healthcare system with significant consequences for the distribution and allocation of health care resources.
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              • Record: found
              • Abstract: found
              • Article: not found

              Good treatment outcomes among foreigners receiving antiretroviral therapy in Johannesburg, South Africa.

              Foreigners, including displaced persons, often have limited health-care access, especially to HIV services. Outcomes of antiretroviral therapy (ART) in South Africans and foreigners were compared at a Johannesburg non-governmental clinic. Records were reviewed of 1297 adults enrolled between April 2004 and March 2007 (568 self-identified foreigners, 431 South Africans citizens and 298 with unknown origin). Compared with citizens, foreigners had fewer hospital admissions (39%, 90/303 versus 51%, 126/244; P < 0.001), less missed appointments for ART initiation (20%, 39/200 versus 25%, 51/206; P < 0.001), faster median time to ART initiation (14 versus 21 days, P = 0.008), better retention in care (88%, 325/369 versus 69%, 155/226; P < 0.001) and lower mortality (2.5%, 14/568 versus 10%, 44/431; P < 0.001) after 426 person-years. In logistic regression, after controlling for baseline CD4 count and tuberculosis status, foreigners were 55% less likely to fail ART than citizens (95% CI = 0.23-0.87). These findings support United Nations High Commissioner for Refugees recommendations that ART should not be withheld from displaced persons.
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                Author and article information

                Contributors
                Journal
                IJMHSC
                10.1108/IJMHSC
                International Journal of Migration, Health and Social Care
                IJMHSC
                Emerald Publishing
                1747-9894
                1747-9894
                10 December 2020
                10 December 2020
                : 16
                : 4
                : 459-468
                Affiliations
                [1]Department of Sociology, University of the Witwatersrand , Johannesburg, South Africa
                [2]Research and Information System for Developing Countries (RIS), New Delhi, India
                [3]School of Public Health, University of the Witwatersrand , Johannesburg, South Africa
                [5]Faculty of Economics, South Asian University , New Delhi, India
                Author notes
                Lorena Núñez Carrasco can be contacted at: Lorena.Nunezcarrasco@wits.ac.za
                Article
                654404 IJMHSC-08-2020-0078.pdf IJMHSC-08-2020-0078
                10.1108/IJMHSC-08-2020-0078
                f8490b8f-ab62-4c68-84a6-c7f56d9215e2
                © Emerald Publishing Limited
                History
                : 08 August 2020
                : 13 September 2020
                : 13 September 2020
                Page count
                Figures: 5, Tables: 5, Equations: 0, References: 30, Pages: 1, Words: 4971
                Categories
                research-article, Research paper
                cat-HSC, Health & social care
                , Vulnerable groups
                , Inequalities & diverse/minority groups
                , Sociology
                , Race & ethnic studies
                , Minorities
                , Sociology
                , Race & ethnic studies
                , Multiculturalism
                , Sociology
                , Race & ethnic studies
                , Racial identity
                , Sociology
                , Work
                , economy & organizations
                , Labour movements
                Custom metadata
                M
                Web-ready article package
                Yes
                Yes
                JOURNAL
                included

                Unnatural causes of death,Migrants,South Africans,Mortality,natural causes of death

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