Migration, urbanization and the health transition in Peru

In 2011, construction of the Interoceanic Highway to connect the Pacific and Atlantic Oceans was completed. The highway pierces Peru and Brazil’s Amazon regions, and specifically, Peru’s Amazonian province of Madre de Dios (MDD), an emerging economic region undergoing dramatic population growth and environmental change, fueled by urbanization, gold mining, logging, castaña extraction, and ecotourism. Highway construction has increased connectivity and mobility among residents, but two highly vulnerable populations are emerging: one characterized as long-term residents mired in moderate-to-low poverty; and one characterized as newly established migrants who are naïve to potential local threats. High risk/high reward labor opportunities that are spatially diverse, combined with complex family structure make both populations highly mobile and at risk to both chronic and infectious disease. Here, we report results from a population-based study in 2011-12 of residents in MDD, to compare health outcomes (hypertension, overweight/obese, anemia, malnutrition, malaria and dengue) as a function of household vulnerability, resilience, and migration. Data are the most comprehensive ever collected in MDD and results are expected to identify strategies toward sustainable development in countries undergoing rapid transitions.