Urbanization and internal migration as risk factors for non-communicable diseases in Thailand


Angkurawaranon, C; (2015) Urbanization and internal migration as risk factors for non-communicable diseases in Thailand. PhD thesis, London School of Hygiene & Tropical Medicine. DOI: 10.17037/PUBS.02267958

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Abstract

Urbanization, which is driven mainly by the expansion of cities and urban migration, is considered one of the key drivers of non-communicable diseases (NCDs) in developing countries. This research aims to investigate the patterns and associations between different levels of urban exposures and NCD risk factors, NCD morbidity and NCD mortality in Thailand, to better understand the mechanisms underlying the link between urbanization and NCD in Thailand. Using several study designs and analytical techniques, the research described in this thesis found that the process of migration and living in an urban environment were associated with lower social trust and higher levels of emotional problems. Urban environments were also associated with behavioural and physiological risk factors for NCDs, including smoking, heavy alcohol consumption, inadequate physical activity, inadequate fruit/vegetable consumption, high BMI, and high blood pressure. Both early life urban exposure and accumulation of urban exposure throughout life potentially play a role in these increases in behavioural and physiological risk factors for NCDs. Early life urban exposure was also found to be associated with an increased risk of developing obesity in adulthood. Increased psychosocial, behavioural and physiological risk factors associated with living in an urban environment may not translate directly into increased prevalence of biological risk factors for NCDs (such as high cholesterol), the development of NCDs, or into NCD-related mortality. It is likely that biological risk factors for NCDs, as well as NCD incidence and mortality are more amendable to change from the positive influences of urbanization through higher socioeconomic status and potential access to better health care.

Item Type: Thesis
Thesis Type: Doctoral
Thesis Name: PhD
Contributors: Nitsch, D (Thesis advisor);
Additional Information: uk.bl.ethos.664495
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Funders: Faculty of Medicine Development Scholarship, Chiang Mai University, Thailand
Copyright Holders: Chaisiri Angkurawaranon
URI: http://researchonline.lshtm.ac.uk/id/eprint/2267958

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