Do migrants lives matter? A comparison of causes of death between African migrants from SADC countries and South Africans in the post-Apartheid era (2002-2015)
Authors: Núñez Carrasco Lorena , Jaiswal Abha , Arrow Jairo , Muteba Michel Kasongo , Aryal Bidhan 
Published: October 2020

Purpose
Migrants historically and currently form an integral part of South Africa. Their importance and contribution to the country’s economy and development are undeniable. Yet, life for African migrants in South Africa is becoming increasingly difficult. An analysis of migrants mortality until now has not been conducted. The purpose of this paper is to compare the trends of the cause of death among South African Citizens (RSA) and African migrants from countries that form part of the South African Development Community (SADC), that make up nearly 70% of the migrants in the country.

Design/methodology/approach
Using Stats SA data of all registered deaths in South Africa (2002-2015), this paper compares all causes of death (COD) between RSA and SADC migrants. This paper studies the patterns in COD among these population groups for the years 2002 to 2015 in deaths due to infectious diseases and unnatural causes. Logistic regression was used to quantify the odds of dying due to infectious disease and unnatural causes for each population group. This paper included a calculation of the odds of dying due to assault, as a sub-group within unnatural deaths.

Findings
A total of 7,611,129 deaths were recorded for the local South African population and 88,114 for SADC migrants for the period under study (2002–2015). The burden of mortality for both infectious diseases and unnatural causes was higher for SADC migrants as compared to RSA. SADC migrants were 1.22 times more likely to die from infectious diseases than RSA (P < 0.001, 95% confidence interval (CI) (1.12, 1.23). Similarly, SADC migrants were 2.7 times more likely to die from unnatural causes than South Africans (P < 0.001, 95% CI (2.17, 2.23). The odds of dying from assault was the same as that of unnatural causes. Also, it was found that women were more likely to die from infectious diseases (OR = 1.11, P < 0.001, 95% CI (1.11, 1.11) compared to men, regardless of nationality.

Research limitations/implications
The bias resulting from migrants who return home to die due to illness, described in the literature as the salmon bias, is present in this paper. This paper, therefore, concludes death due to infectious diseases could be higher among migrants.

Practical implications
The heightened mortality among SADC migrants can be related to the impact of social determinants of health such as living and working conditions and barriers to access to health care. Moreover, the higher probability of death due to unnatural causes such as assaults constitute a proxy to estimate the impact of xenophobic violence observed in the country over the past decade. Policy interventions should focus on migrant health-care systems. Also, programmes to mitigate and curb xenophobic sentiments should be carried out to address the growing disparity of preventable unnatural causes of death.

Originality/value
This study offers the first quantification of mortality due to infectious diseases and unnatural causes among RSA and SADC migrants.