Migration and Health among

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youth

Research report
On
Effect of migration on health of
students and young adults

By:
group-5

Anindam Basu

Anjali Nanda

Akshay Soni
 Migration and Health among
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Jyotsana Khatri

Neha Gupta

Shilpa Jain

Under the guidance of Prof. Pawan

Kumar Taneja
Index

Chapter Name Page no.

Chapter 1 Introduction ……………………………………………………………………02

Chapter 2 Methodology ……………………………………………………………………15

Chapter 3 Results …………………………………………………………………………..20

Chapter 4 Discussions ……………………………………………………………………...33

References …………………………………………………………………………………..35
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Chapter – 1
Introduction
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Abstract:

Purpose: Migration is movement of people from one place to another. After the movement to a

new destination, people face 4 major kinds of changes which could lead to their health related

issues. This comprises of climate, food, water and socio – cultural changes. Delhi has been the

capital city of India, so people migrate to Delhi for Higher Education & Employment

opportunities. Therefore the above changes leads to Health related problems to the students and

work professionals would ultimately lead to affect the work of colleges and companies.

Design/ Methodology: The study has been conducted on mixed method research design. The data

has been collected from the students and work professionals with the help of Questionnaire. The

questionnaire had been designed by first having discussions with the people about the health

problems been faced by them. Snowball sampling method has been used. Then quantitative

analysis has been done to do the analysis.

Key Findings: During the study the sample of 150 students and work professionals migrating to

Delhi basically face Gastrointestinal Problems and Hair Loss Problems. Also the time of stay in

a destination place is more than the person get accumulate or gets adapted to the Climatic

Factors, Food, Water and Socio cultural factors. Also the study has lead us to understand that

what overall Health Issues that has been faced by the people migrating to Delhi.
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INTRODUCTION.

Migration is a process which involves physical movement of people from one place to another.

According to UN multilingual dictionary “Migration” is defined as a form of spatial mobility

between one Geographical unit to another, involving a permanent change of residence. But here

we are talking “Migration” as the process where there might not be a permanent change of

residence but for some reasons the person has migrated to other geographical area and is staying

in that area for minimum 3 months. The reasons for which the migration takes place from one

place to another are:

1) Migration for studies.

2) Migration for employment.

Migration involves two areas:

1) Place of origin: The place of area from which a move is made is the place of origin (i.e.

starting point). For migrants the place of origin may be: -

• An area of residence at the beginning of the migration interval. Or,

• An area of residence from which last move was made for the current

migration interval.

1) Place of destination: The area where the move terminates is the place of destination (i.e.

ending point).

Migration can be classified into two major types:

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1) Internal migration: It is a migration process occurring within the same country.

2) International Migration: It is a migration process occurring from outside the country.

Why Delhi & NCR? Delhi been the capital city of India and having more than 10 universities

and more than 100’s of colleges, the reason of migrating of the students for Higher Studies like

graduation and Post graduation leads to more of the migration from Rural areas to Delhi. Also

most of the MNC’s and other companies are having there setups in Delhi and NCR’s which also

leads to the more Migration of people to Delhi.

In recent years, a very high rate of internal migration has been witnessed in India. Employment,

by far, remains the biggest cause of migration in the country. Studies have found that the inter-

state movement is not very high and most people remain within the same state after migration.

However literate people constitute a vast majority of the migrants. Though considered by many

as a natural and, at times, a beneficial process, it has led to several problems in the Indian

scenario. Though the freedom to reside in any part of the country has been enshrined in the

Indian constitution as a fundamental right, experience has shown that it has only created friction

points within the society.

Several push and pull factors exist in the country which are responsible for the large-scale

migration. India has high levels of regional disparity in terms of population distribution and

development indicators. Most of the north Indian states are poor in infrastructure facilities and

are also highly populated. Hence a large number of people from states like Uttar Pradesh, Orissa

and Bihar migrate to other states in search of jobs. Low and variable agricultural production

coupled with lack of local employment opportunities are the biggest cause of movement of
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people outside the state. In states like Orissa, landlessness and marginalisation of the poor people

turns out to be the main cause of them moving to other more developed regions of the country in

the hope of a better livelihood.

Maharashtra, Gujarat, the south Indian states and other states in northern parts of the country like

Haryana, Punjab and Delhi have become attractive destinations for the migrant population.

Rapid urbanisation and industrialisation of these areas have generated more employment

opportunities and also created better infrastructure.

India, the 2nd largest country as far as population is concerned and having a GDP of over 8%

(IMF and World Bank Report 2010) the large part of youngsters especially students are

migrating basically from underdeveloped or rural areas to urban areas in search of Higher studies

i.e. Graduation and Post Graduation courses. Delhi being the capital city of India and having

more than 10 universities and 100’s of colleges & institutes, the migration rate becomes higher

for the students to migrate to Delhi. And also as the companies are having their offices in Delhi,

the people tend to migrate to Delhi for better job perspective.

Literature Review: Basically why do the people migrate from one part of the country to another

part of the country? It’s because of the fact that there are push and pull factors which leads to

people to migrate.

1) Push Factors: The factors which push the people to migrate from the point of origin to

different places. These could be Natural Calamity, Unemployment etc.

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2) Pull Factors: Those factors which pull the migrants towards it. This factors could be

Employment, Higher Studies etc.

People have started permanent movement from one place to another and this type of movement

started around 2 decades ago and therefore is very difficult to know about the migrated people

from any of the data sources (Chatterjee, 2007). The only source of the migration can only be get

from the census but they don’t ask the question about the Migration from the people of India.

According to the Census Data which has data from 1991 -2001 is

1) Uttar Pradesh has been the largest provider of Migrants to Delhi – NCR having 40.05%.

2) The total number of Migrants 2222041 in the period of 10 years.

Source: http://indiacurrentaffairs.org/survey-on-migration-rate-to-delhi/ which is a secondary

data taken up from the Census of India.

Delhi’s first human development report (HDR), which has recently been completed after two

years of research with the help of United Nations Development Programme, shows that the

national capital is urban magnet. The population of Delhi has been increasing at a rate that is

more than one-and-half times the national average because of migration from neighbouring

states.

According to the report, it has been increasing at an annual rate of 4.27%, compared to the all-

India average of 2.75%. Mumbai, in contrast, has been growing slower than the country as a

whole with an annual growth rate of 2.65%.

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Surprisingly, the maximum number of migrants are from Uttar Pradesh, Haryana and not Bihar.

Bihar occupies the third slot. The other states from where people migrate to Delhi include

Rajasthan, Punjab, West Bengal, Madhya Pradesh and north eastern states. The report attributes

the migration to better employment opportunities in Delhi — a fact that is reflected in economic

factors like growth of enterprises and health care in Delhi. According to statistics in human

development report, the number of enterprises in Delhi have grown at an annual rate of 1.36% in

the last one decade.

In 2005, according to the report, the number had grown to 7.54 lakh. The total number of

persons engaged in these enterprises has increased from 35 lakh in 1998 to 41 lakh in 2005. The

report also shows Delhi as an urban paradox. While it is a magnet of sorts for most people and

has one of the highest gross state domestic product (GSDP), demographic indices paint a sorry

picture. The state has a poor sex ratio of 821 females per 1,000 males as compared to the all-

India average of 933.

The scenario is just a shade better for the 0-6 years age group. As compared to an all-India

ratio of 927 females, Delhi has a sex ratio of 865 per 1,000 males in the age group.

Migration and Health: There are basically four types of Migration that takes place:

1) Rural – Urban Migration

2) Urban – Urban Migration

3) Rural – Rural Migration

4) Urban – Rural Migration.

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Due to this the reasons basically the people face health related issues after they have migrated

from one place to another. The health related issues are totally dependent on the following

criteria of specific socio demographic structure which comprises of age, sex, level of their

education, attainment, occupation and income. These factors determine the context in which

migration has taken place. By this way their heath related risks are predetermined by certain

factors at the destination areas.

Internal migration by place of birth has increased at a very rapid rate from 1991 to 2001 (Census

of India 2001 Report). It has increased from 838.5 million to 1,028 million between the two

census periods. This has lead to alarming situation for the urban places basically because most of

the migrants are working in the informal manufacturing industries, working as casual labourers,

rickshaw pullers and hawkers (Dev, 2000).

There are number of factors that are believed to effect the health of the migrants as a whole

(International Organization for Migration,2005). These include 2 major factors i.e. Indirect

Impact Factors & Direct Impact Factors.

The direct impact factors includes such as the natural environment at the place of origin and

place of destination. The other factors consist of lifestyle factors (habits of eating junk food,

chewing tobacco, smoking and drinking alcohol). This also includes socio – economic situation

like the living and the working conditions of the individuals. These factors would either support

or hamper the chance of succession for each of the individual or for migrant community as a

whole (Grondin, 2004). Not only this the main effect of migration is been seen in the migrant
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workers which are there in the lower income and while they are exposed to other occupational

hazards and unsafe working conditions (Pascale 2003).

The main focus of the study of Migration in India has been to see the other lifestyle diseases that

are occurring in urban part of India. The obesity prevalence in India in Urban people has

increased from 5% in 1984 to 15 % in 2004 (Ramachandran, 2002).

Other than this the main studies conducted on the youth undergoing internal migration were for

mortality rate (Islam M. et al., 2005), exposure to disease (Zheng et al, 2005) and risks of

contracting HIV and sexually transmitted infections (Yang X. et al, 2005). Basically the work on

the health status of youth has been done but mainly the communicable and lifestyle diseases

were of the main focus. Basically an adult joins any institute for higher studies and Migrates

from rural to urban area. This led us to think to propose this kind of study to work on the health

related issue generally been faced by the young adults after they have joined the college and

gone to different places for work. The survey on “Migration and Health” which has been

conducted by the Institute of Social Studies (ISS) in the year 1997 reveals that “2/3 rd of the

migrants said that their health has become worsen after their migration”.

The process of migration introduces threats to psychosocial health and well being in a number of

ways. The decision to move, for example, is often replete with fear of the unknown, anxiety

about those being left behind, and a sense of impending loss. Some observers have termed it a

type of cultural death that seriously affects the well being of migrants and their capacity to settle

elsewhere, especially where there are additional obstacles of language, culture as well as policies

and practices designed to make migration unattractive.

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Anxiety and homesickness are frequent problems that easily become chronic when not treated or

resolved, and can present serious implications for overall psychosocial well being, including

depression and psychosomatic functional disorders such as stress-related ulcers, migraines and

disabling back pain (Carballo, Divino and Zeric 1998). Together with the challenge of

resettling in new societies and cultures and doing so under difficult conditions, these problems

often lead to a heavy reliance on alcohol and tobacco.

There is a relationship between psychosocial and physical well being of the migrants’ coming to

the different environment (Carballo et al, 2004). It is always confounded by the cultural

differences in the thinking of the people. As all people do, migrants carry with them the Health

with them whenever they are migrating either internally or internationally. Therefore the more is

the time spending in one particular area, the more adaptability to the conditions of the people

towards the conditions.

Geographical and climate settings

The National Capital Territory of Delhi sprawls over 1483 sq km (148,300 ha) between latitudes

28o 24'17'and 28o28'52' North and South West. The Gangetic Plain and the Aravalli Ridge

converge at Delhi, giving mixed geological character with alluvial plains as well as quartzite

bedrock. The climatic regime of Delhi falls under the semi arid type, as influenced by the

considerable distance of the city from the sea and prevalence of continental winds during major

portion of the year. It is characterized by extreme dry conditions associated with hot summers

and cold winters. It also experiences heavy rains primarily during monsoon. The temperature

ranges between 18.7 o C (mean minimum) and 40.3 o C (mean maximum). The normal annual
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average rainfall is 714.6mm. As a result of its extreme climatic variations, almost three fourths

of the year(nine months) is not conductive for living out doors or in temporary shelters due to

heat, cold, rains and disease vectors.

Presently, it has become an alternative, central place for international trade as well as seat of

power. The increase in Delhi's population from 4.1 million in 1911 to14.37 in 2000 is the highest

in the world. Major increase during the master plan period has been in last two decades from 5.2

million to 13.4 million.

Variable Definition: The main focus of our study had been to see what are the changes that a

person especially youth are facing after they are migrating to Delhi. Therefore we defined some

of the variables in our study:

1) Independent Variable: Change variable – The cause that is supposed to be responsible for

bringing about change(s) in a phenomena or situation. Here in our study we have

considered variables like Climatic Change, Food, Water and Socio – Cultural changes as

Independent variables which directly or indirectly lead to the changes in the health of the

migrants.

2) Dependent Variable: Outcome Variables – The outcome of the change(s) brought about

by the introduction of an independent variable. Here the Health of the Migrants are the

dependent variables.

Objectives of the Study: The main objectives of our study has been:

1) To study “the health related issues being faced by the people after migration to Delhi.”
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2) To study health status of migrants in Delhi.

3) To determine the ‘’knowledge, attitude, practice of youth on health matters.’’

4) To make ‘’pragmatic recommendations to improve health status of young adults

undergoing migration.

Research Questions: In order to analyze the effect on health of the youth after migration to

Delhi, the following research questions has been formulated:

1) How many health issues are most common in the youth after migration?

2) Do the Migrants have any kind of bad habits like smoking and alcohol consumption after

Migration?

3) Do the time interval of stay of migrants affecting the overall health of the individuals?

4) What are the main factors are contributing the health of the migrants?

5) What is the overall effect of the Health on the migrants after migration?

Rationale/ Importance: After having consulting all the literature we have come to know that

there is a very significance importance of this kind of study. As the focus of our study is on the

young population those who are coming to Delhi for Studies or Employment purposes and their

health related issues. As according to the Ministry of Human Resource Development 2008 Delhi

been the capital city of India and having more than 10 universities and 100’s of colleges. Every

MNC’s have their offices in Delhi – NCR region. The Delhi has been away from the peninsular

part of India experiences all the four kinds of weather. Also the food and water is totally

different from the other parts of the country. Therefore this study would lead the:
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1) Students and Professionals to know about the health issues that they might face so that

they take precautionary measures. If they come prepare with themselves that how much

problem they might face in the near future. Also there is always a saying “Precaution is

better than cure”.

2) Colleges, universities and companies to help their students and employers by providing

medicines for the basic health problems. As the colleges and companies would know

what are the main problems that the people would face in the near future, they would be

ready with all the necessary medicines and also they would help them to cater the

problems better.

3) Migrants’ health can be improved by taking a number of initiatives such as reduction of

structural and cultural barriers.

4) Disease prevention interventions which would take into consideration the migrants

conditions and barriers and possibility for healthy behavior

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Chapter – 2
methodology
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Methodology

The researcher will employ mixed method research design.

– A combination of quantitative and qualitative data will be used for collection and
analysis.
– Presentation of facts will be done through words (qualitative) and statistical results
will be represented with numbers.(quantitative)
– Weaknesses of both methods overcome
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1) Data collection –

 From primary as well as secondary sources.

i) Primary sources –

Questionnaires
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It will include questions on personal data, duration of stay in Delhi, health issues faced after
migration (in this flu, viral and typhoid will be included as these are experienced as a result of
migration), Perception of migrants about the causative factors for the health issues faced after
migration and the overall effect of migration on health .

Interviews –
Unstructured Interviews will be used as a method of interviews where questions can be
changed or adapted to meet the respondent's intelligence, understanding or belief.
they will be used to pursue in depth information about the topic.

Focus group discussion –

A focus group as a form of qualitative research will be used in which a group of people will be
asked about their perceptions, opinions, beliefs and attitudes. Questions will be asked in an
interactive group setting where participants are free to talk with other group members

• ii.) Secondary sources – literatures and journals

1) Sampling

Due to the unavailability of specific data regarding the number of students who have migrated to
Delhi and the employees working in MNC’s ;the method of sampling used will be quota
sampling under which sample is selected from a chosen location and a person will be asked if he
is a migrant staying in delhi for a period of more than three months.

a) Sample size = 150 respondents

b) Age group = 15-30

c) Accessible population - The accessible population is a subset of the target population

that reflects specific characteristics with respect to age, gender, diagnosis, etc., and
who are accessible for study

It consisted of –
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 migrant students in Delhi who have resided for a time span of three months or more
 employees working in MNC ’s in Delhi and NCR region

a) Tool for data collection - self prepared questionnaire consisting of 13 questions.

b) Sampling method

Snow ball sampling –

the existing study subjects will be asked to recruit future subjects from among their
acquaintances. As the sample builds up, enough data will be gathered to be useful for research

Method:

1). The researcher will Draft up a participation program

2). The stakeholders will be approached and asked for contacts.

3). Contacts will be gained and asked to participate.

4). Continue the snowballing with contacts to gain more stakeholders if necessary.

Advantages

Snowball sampling has a lot of advantages as oppose to other sampling methods. It is possible
for the surveyors to include people in the survey that they would not have known. It is also very
good for locating people of a specific population if they are difficult to locate.

Disadvantages

Snowball sampling is inexact, and can produce varied and inaccurate results.. Identifying the
appropriate person to conduct the sampling, as well as locating the correct targets is a time
consuming process which renders the benefits only slightly outweighing the costs. Another
disadvantage of snowball sampling is the lack of definite knowledge as to whether or not the
sample is an accurate reading of the target population. By targeting only a few select people, it is
not always indicative of the actual trends within the result group.

RESEARCH DESIGN
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Data has been obtained through the use of self-administrated questionnaires that included
questions on personal data ,duration of stay in Delhi, health issues faced after migration (in this
flu, viral and typhoid will be included as these are experienced as a result of
migration),Perception of migrants about the causative factors for the health issues faced after
migration and the overall effect of migration on health.

Data will be analyzed using pie charts, bar graphs and line graphs.
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Chapter – 3
results
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Results
Overall Profile of Respondents
 No. of Respondents : 150

 According to Gender.

 Males – 94

 Females – 56.

 According to Age Group :

 15-19: 8

 20-24: 102

 25-29: 28

 30 & above: 12.

 Nationality :

 Indian : 130

 Others : 20

 Reason of Migration :

 Education : 102

 Work : 44

 Others : 4

 Both (Work and Education) : 2

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 Duration of Stay:

 0-3 months: 1

 3 – 6 months : 52

 6- 12 months : 14

 1-2 years : 40

 2 years & above : 43

 Out of 150(sample size) we have 94 males and 56 females. The age range of the
sample is from 15 years to 30 years (i.e. 15-19, 20-24, 25-29, 30+). Both national
and international migrants are counted the study( Indians- 130, international
migrants- 20). Next the migrants are divided on the basis of the duration of stay in
delhi i.e. 0-3 months, 3 – 6 months, 6- 12 months, 1-2 years, 2 years & above.

 Reasons of migration- there are many reasons of migration, such as, education,
work/ employment, marriage, migration for prosperity, due to natural calamities
and due to political reasons. But the main factor accounted in are study is
education and employment.

 Health problems covered in this study:

1. Respiratory problems
2. Gastrointestinal problems(GI)
3. Skin problems
4. Hair loss
5. Stress related problems
6. Weight loss/ gain
7. Viral
8. Changes in sleeping pattern
9. Typhoid
10. Flu(any kind)
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Problems Sometimes/ Once Always Never

1. Respiratory Problems. 36 = 24% 10 = 6.66% 104 = 69.33%

2. Gastrointestinal (Stomach) 105 = 70% 15 = 10% 30 = 20%

Problems.

3. Skin Problems. 45 = 30% 32 = 21.33% 73 = 48.66%

4. Hair Loss Problems. 65 = 43.33% 67 = 44.66% 18 = 12%

5. Stress Related Problems. 49 = 32.66% 20 = 13.33% 81 = 54%

6. Weight Loss/ Gain. 76 = 50.66% 39 = 26% 34 = 22.66%

7. Viral 87 = 58% 11 = 7.3% 52 = 34.66%

8. Changes in sleeping pattern. 27 = 18% 31 = 20.66% 92 = 61.33%

9. Typhoid 36 = 24% 5 = 3.33% 109 = 72.66%

10. Flu (Any Kind) 59 = 39.33% 2 = 1.33% 89 = 59.33%

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Findings

According to above table, it is stated, that the most common problem is Gastrointestinal problem
among the migrants, which directly corresponds to the quality of food and water (the two main
factors quoted by the migrants, which contributes majorly to the health problems. The 2nd most
common problem is Hair Loss. The two most common factors leading to health issues after
migration are: Food (56% Agrees), and Water(55% Agrees). 56% of the total agrees that food is
the factor leading to health related issues after migration and 55% agrees with water. And the
uncommon problem encountered is the respiratory disorders.
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Comparative analysis between males and females

 After analyzing both the graphs, and comparing the analysis, we state that hair loss
problem is most common health problem in females, whereas gastrointestinal and hair
loss problems are more common in males. Also, it is seen that health related issues are
more common in males than females.
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Comparative analysis between migrants who have stayed more than 6months
in delhi and less than 6 months in Delhi.

The above two graphs are made on the basis of duration of stay of migrants in Delhi, i.e. less
than 6months and more than 6months. After analyzing and comparing the above two graphs, we
state that more is the duration of stay at migrant place, the more is the adaptability of the migrant
towards climate, food, water and socio-cultural factors of that place. The health issues in the
migrants are more common when they are new to the migrant place.

Relation of sports an health:

Migrants who play sports daily

Migrants who don’t play sports

The line graph shown, states the importance of correlation between health and sports. After
analyzing the data, it was found that the students who use to play outdoor games on a daily basis
have less health problems than those who don’t play games.

Positive vs Negative
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This graph, made on the basis of the response of migrants, states that 107 migrants out of
150(71%) agrees that they have a negative impact of migration on health. Whereas only 7
migrants out 150(6%) agrees that they have a positive impact on migration. And rest of them
were neutral.

Habits and health

According to this graph, there is a change in pattern of smoking, alcohol/ hard drinks, and
tobacco chewing habit, before and after migration. We found that most of the migrants increased
alcohol consumption after migration. And we also found a decrease in consumption of tobacco
chewing and smoking after migration ( but, since the sample is not a true sample so we cannot
generalize this statement). So it can be concluded that there is an increase in health problems
after migration because of increase in alcohol consumption.

Knowledge and attitude of migrants:

After data analysis, we found that still only 51.33% migrants prefer to go to the physician first
after they fall ill. And 23.33% migrants said that they prefer self medication first rather than
consulting physician and 25.33% migrants prefer consulting their parents, friends and relatives
initially.

This shows their attitude towards health, and their reluctancy and ignorance towards health
problems, which sometimes, leads to further worsening of the condition.
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Chapter – 4
Discussions
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Recommendation:
To the college authority-

The college authority can conduct biannual surveys(once in 6months) on the students residing in
hostels and college campus to assess their health status and major health issues. Also they can
assess which are the major factors contributing to their health problems, then steps can be taken
to eliminate those.

Also regular health check-up’s can be done and immunization program should be implemented
(for e.g. vaccination against hepatitis B), as a preventive measure.

Next, the college authority can appoint a physician on a regular basis and a psychologist/
counselor on a weekly basis to counter the stress related problems of students. Also, outdoor
sports should be made a part of curriculum.

To the students-

Get at least eight hours of sleep a night. Avoid skipping meals. When a meal is skipped, the
subsequent hunger may cause one to overeat. Eat breakfast, which helps concentration and
increases the likelihood of consuming calcium, folic acid, and vitamin C. These nutrients are
often low in the diet of college students. Exercise regularly. Physical activity helps burn off
calories, helps manage stress, and promotes mental and physical stamina.

Limitations:
 The sampling of Migrant People is been done by Snow Ball Sampling. Might not be the
true sample of the total population.

 The number of problems might be less as all communicable diseases is not been taken.

 The migrants are the students and work professionals from age group 15 – 30. Different
age group faces different kind of Health Problems.

 Time constraints and Resource constraints.

Future scope of the research:

The study which has been conducted by us has some above said limitations which can be
overcome by having the above resources like time and Human resources. The future is there as
the median age of India is 26 years and the younger generation in the next decade would join to
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the working age group. The study can be improvised by taking two groups of control i.e. non
migrants and case group i.e. migrants. Also this can act as a pilot for future to study the above as
well as other communicable and non communicable disease pattern.

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13)NCAS, 2004, Migration in India, Advocacy Internet, Vol: 6, Issue No 03, May-June.
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youth