Lifecourse Urbanization, Social Demography, and Health Outcomes among a National Cohort of 71,516 Adults in Thailand

We examine the influence of urbanization on household structure, social networks, and health in Thailand. We compare lifetime urban or rural dwellers and those who were rural as children and urban as adults. Data derived from a large national cohort of 71,516 Sukhothai Thammathirat Open University adult students participating in an on-going longitudinal study of the health-risk transition in Thailand. The rural-urban group, one-third of cohort households, was significantly different from other groups (e.g., smaller households). The rural-rural and the urban-urban groups often were the two extremes. Urbanization, after adjusting for covariates, was a risk factor for poor overall health and depression. Urbanization is a mediator of the health-risk transition underway in Thailand. Health programs and policies directed at transitional health outcomes should focus on the health risks of the urbanizing population, in particular smoking, drinking, low social trust, and poor psychological health.