TY - JOUR
T1 - Rural and urban migration to Europe in relation to cardiovascular disease risk: does it matter where you migrate from?
AU - Jansen, E. S.
AU - Agyemang, C.
AU - Boateng, D.
AU - Danquah, I.
AU - Beune, E.
AU - Smeeth, L.
AU - Klipstein-Grobusch, K.
AU - Stronks, K.
AU - Meeks, K. A. C.
N1 - Funding Information: The RODAM study was supported by the European Commission under the Framework Programme (Grant number: 278901 ). K.A.C.M. is supported by the Intramural Research Program of the National Institutes of Health in the Center for Research on Genomics and Global Health (CRGGH). The CRGGH is supported by the National Human Genome Research Institute , the National Institute of Diabetes and Digestive and Kidney Diseases , the Center for Information Technology and the Office of the Director at the National Institutes of Health ( 1ZIAHG200362 ). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Publisher Copyright: © 2021
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Objectives: To assess whether the environmental context (i.e. rural vs urban) in which individuals in low- and middle-income countries have resided most of their lives is associated with estimated cardiovascular disease (CVD) risk after migration to a high-income country. Study design: Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study were used including 1699 Ghanaian participants aged 40–79 years who had migrated to Europe from Ghana (1549 of urban origin, 150 of rural origin). Methods: Ten-year CVD risk was estimated using the Pooled Cohort Equation, with estimates ≥7.5% defining elevated CVD risk. Comparisons between urban and rural origin migrant groups were made using proportions and adjusted odds ratios (ORs). Results: The proportion of migrants with an elevated CVD-risk score was substantially higher among rural migrants than among urban migrants (45% vs. 37%, OR = 1.44, 95% confidence interval [CI]:1.03–2.02), which persisted after adjustment for education level, site of residence in Europe (London, Amsterdam or Berlin), length of stay in Europe, physical activity, energy intake and alcohol consumption (OR = 1.67, 95% CI: 1.05–2.67). Conclusion: Our findings indicate that migrants who spent most of their lives in a rural setting before migration to Europe may have a higher CVD risk than those of urban origins. Further work is needed to confirm these findings in other migrant populations and to unravel the mechanisms driving the differential CVD risk between urban and rural migrants.
AB - Objectives: To assess whether the environmental context (i.e. rural vs urban) in which individuals in low- and middle-income countries have resided most of their lives is associated with estimated cardiovascular disease (CVD) risk after migration to a high-income country. Study design: Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study were used including 1699 Ghanaian participants aged 40–79 years who had migrated to Europe from Ghana (1549 of urban origin, 150 of rural origin). Methods: Ten-year CVD risk was estimated using the Pooled Cohort Equation, with estimates ≥7.5% defining elevated CVD risk. Comparisons between urban and rural origin migrant groups were made using proportions and adjusted odds ratios (ORs). Results: The proportion of migrants with an elevated CVD-risk score was substantially higher among rural migrants than among urban migrants (45% vs. 37%, OR = 1.44, 95% confidence interval [CI]:1.03–2.02), which persisted after adjustment for education level, site of residence in Europe (London, Amsterdam or Berlin), length of stay in Europe, physical activity, energy intake and alcohol consumption (OR = 1.67, 95% CI: 1.05–2.67). Conclusion: Our findings indicate that migrants who spent most of their lives in a rural setting before migration to Europe may have a higher CVD risk than those of urban origins. Further work is needed to confirm these findings in other migrant populations and to unravel the mechanisms driving the differential CVD risk between urban and rural migrants.
KW - Africans
KW - Cardiovascular risk
KW - Migrants
KW - RODAM study
UR - http://www.scopus.com/inward/record.url?scp=85109009091&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.puhe.2021.06.001
DO - https://doi.org/10.1016/j.puhe.2021.06.001
M3 - Article
C2 - 34233244
SN - 0033-3506
VL - 196
SP - 172
EP - 178
JO - Public Health
JF - Public Health
ER -