Rural-urban Migration and Overweight Status in Low- and Middle-income Countries: Evidence from Longitudinal Data in Indonesia

Abstract

With rapid urbanization and intensive rural-urban migration, being overweight has become an increasingly common source of health risks in low- and middle-income countries (LMICs). However, the impact of rural-urban migration on overweight status is understudied in the LMIC context. Previous studies primarily used cross-sectional data, failing to adjust for migration health selection. Furthermore, the potential gender pattern in the impact of rural-urban migration remained unclear, and the potential cumulative effect of the duration of urban residence among migrants was rarely examined with longitudinal data. Meanwhile, the mediating effects of health behavioral factors were poorly understood. Using data from the fourth and fifth waves of the Indonesia Family Life Survey (IFLS) and employing fixed-effects (FE) models (N=7267), this study provided new evidence on the impact of rural-urban migration on overweight status across time and gender. Findings suggest that rural-urban migration significantly and positively predicted being overweight, and the association was significantly stronger among women than men. The results also show that years lived in urban areas did not significantly predict overweight among migrants, and that mediating health-related behaviors did little to explain adverse weight outcomes of migrants. As the number of rural-urban migrants continues growing, LMIC governments should implement health interventions aiming for healthy weight status among migrant communities. Meanwhile, gender-specific programs targeting women should be considered. Future research should explore other potential mediators of the link between rural-urban migration and overweight.