Project-induced displacement, secondary stressors, and health.

摘要

It is estimated that 15 million migrants displaced by development projects every year in the world. However, research on health impacts of project-induced displacement is insufficient. The existing literature concerning the causal effect of migration on health is inconclusive due to the selective nature of migration and other methodological problems.;This study employs the stress process model as the major theoretical framework, components from Cernea's IRR model as well as Scudder and Colson's framework are also incorporated to examine the short-term health impact of the displacement resulting from China's Three Gorges Dam Project. I also explore whether the displacement's effect on health is mediated by three secondary stressors, i.e., deterioration in social integration, SES, and community resources. To address the methodological problems typical in migration studies, we use the natural experiment design to collect pre- and post-migration data from both migrants and non-migrants (the control group). The pre-migration survey interviewed 775 designated migrants and 555 non-migrants in 2003. We successfully traced 1070 subjects in post-migration survey conducted in 2006.;Using the difference model and the structural equation modeling procedures as analytical strategies, we found that the displacement heightened migrants' depression, and worsened their self-rated health. The displacement was also responsible for deterioration in social integration, socio-economic status, and community material resources. The observed effects of the displacement on migrants' health were mainly mediated by undesirable changes in social integration and income. This study suggests that social integration, a factor which has been overlooked in past studies, is at least as important as economic factors in affecting the health of the displaced. It also demonstrates the utility of the stress process model for studying mental and physical health of project-induced migrants in an Eastern culture setting.