Returning Home to Die: Circular Labor Migration and Mortality in Northeast South Africa

Samuel J. Clark, University of Washington
Mark Collinson, University of the Witwatersrand
Kathleen Kahn, University of the Witwatersrand
Kyle Drullinger, University of Colorado at Boulder
Stephen Tollman, University of the Witwatersrand

The aim is to examine the hypothesis that circular labor migrants who become seriously ill while living away from home return to their rural homes to convalesce and possibly to die. Using data collected by the Agincourt demographic and health surveillance system in rural northeast South Africa, event history analysis is used to estimate the likelihood of dying for residents, recently returned migrants and long-term returned migrants. The annual odds of dying for recently returned migrants are 1.1 to 1.9 times higher than for all other migrant types, and the proportion of HIV/TB deaths among recently returned migrants increases with time. This suggests that increasing numbers of circular labor migrants of working age are becoming ill in urban areas where they work and are coming home to be cared for and eventually to die in the rural areas where their families live.