287 Internal migration and child nutrition in Brazil: a longitudinal study of over 5 million children

Abstract PTH 2: Determinants of Health Disease and Interventions 2, B307 (FCSH), September 3, 2025, 15:45 - 16:39 Background Migration can serve as an adaptation to poor living circumstances but may also deepen health inequalities. Aims We assessed whether internal migration in Brazil affects children’s nutritional status. Methods This longitudinal study used Brazil’s routine collected socioeconomic, birth and nutritional monitoring linked data. Children aged 0 to 59 months, born from January 1, 2008 to December 31, 2015, and followed up until December 31, 2017. Internal migrants were defined as children whose State of residence at birth differed from the State of residence for nutritional monitoring. Odds ratio (OR) using binomial and multinomial regression was used to estimate the association migration and nutritional status. We also assessed if the association varied with differences in the municipal Human Development Index (HDI) of birth and monitoring and age. The nutritional status of the children was classified as stunting (L/HAZ < -2); wasting (WHZ z-score < -2); overweight risk (WHZ z-score >1 and ≤ 2); and obesity (WHZ z-score >2 z-score). Results Migrant children exhibited a lower chance of stunting (OR 0.95; 95% CI 0.94–0.96) and being at a chance for overweight (OR 0.93; 95% CI 0.92–0.94) and obesity (OR 0.92; 95% CI 0.91–0.93), but they faced a higher chance of wasting (OR 1.09; 95% CI 1.07–1.11). Children who migrated to lower HDI municipalities had an increased chance of wasting (OR 1.21; 95% CI 1.18–1.24) compared to non-migrants. Younger migrant children (0–23 months) were at higher risk of overweight (OR 1.05; 95% CI 1.03–1.07) and obesity (OR 1.10; 95% CI 1.08–1.13), while older migrant children showed a lower risk. Conclusions Internal migration in Brazil contributes to better nutritional outcomes for children overall. However, migration to municipalities with lower human development and migration involving younger children are associated with disproportionately worse nutritional outcomes.