The general and mental health of movers to more- and less-disadvantaged socio-economic and physical environments within the UK

Exploring residential relocation- differences between newcomers and settled residents in health, travel behaviour and neighbourhood perceptions

This study explores whether people who have recently moved to an area differ from longer-term residents in their health, travel behaviour, and perceptions of the environment. Using a large, representative sample from the UKHLS, Newcomers demonstrate significantly lower mental and physical health, reduced car commuting, and a higher likelihood of liking their neighbourhood. Area deprivation, urbanicity, household income, and age emerge as influential moderators with i.e. Newcomers in affluent areas experiencing lower physical health than Settled Residents, and rural Newcomers expressing less neighbourhood satisfaction. Our findings highlight that Newcomers' perceptions of their environment diverge and environmental influences vary among population segments, potentially impacting related health behaviours such as active travel. Furthermore, residential relocation introduces Newcomers with distinct characteristics into areas, affecting the context in which potential population health interventions aiming to influence health behaviours operate. This necessitates a deeper understanding of what influences reactions to the environment as well as ongoing adaptation of environmental interventions to respond to changing contexts within the same location over time.

Work-related internal migration and changes in mental and physical health: A longitudinal study using German data

Work-related internal migration can be associated with various labor market benefits such as improved career opportunities. However, benefits can be offset by specific burdens (relocation stress) which, in turn, can lead to adverse health outcomes. These burdens include organizing the move, difficulties in maintaining social relationships, homesickness or feelings of displacement. However, there is a particular lack of longitudinal studies which deploy advanced methods to examine how internal migration affects shifts in health-related quality of life (HRQOL) over time. Also, there has been little research into whether the consequences of relocations differ by socio-economic position. In order to address these gaps, we apply fixed effects (FE) panel regression models to representative data from the German Socio-Economic Panel (SOEP). We use the SF-12 Health Survey items to capture the subjective assessment of overall mental and physical well-being. Overall, we find an increase in physical HRQOL after the relocation event. Mental HRQOL tends to decrease before the event and then increases afterwards, on average, but there seems to be very little lasting change. Subgroup analyses, however, reveal differential trajectories by educational level, i.e. a clear educational health gradient around migration. While physical and mental HRQOL increases among movers with high educational attainment, individuals with lower levels of education show decreases in both health dimensions upon moving.

Longitudinal effects of physical and social neighbourhood change on suicide mortality: A full population cohort study among movers and non-movers in the Netherlands

Associations between the residential neighbourhood environment and suicide mortality are well-established; however, most evidence is cross-sectional and not capable of incorporating place-based and residential moving-related neighbourhood changes. We studied how suicide mortality is associated with changes in the physical and social neighbourhood environment for movers and non-movers. Our retrospective analysis was based on longitudinal register data for the entire Dutch population aged 25-64 years enriched with annually time-varying data on the residential neighbourhood environment between 2007 and 2016. A total of 8,741,021 people were followed-up between 2007 and 2016 of which 10,019 committed suicide. Upward and downward neighbourhood change was measured by comparing neighbourhood conditions separately at two time points. Cox proportional hazard models indicated that movers had a significantly lower risk of suicide compared to non-movers. Suicide risk was lower for people experiencing improvements in social fragmentation and deprivation compared to those remaining in poor conditions. Change from rural to urban conditions also resulted in lower suicide risk, while a gain in green space put people at increased risk. For those stable neighbourhood conditions over time, suicide mortality was lower for men and women in urban vs. rural neighbourhoods as well as for women in neighbourhoods with low vs. high social fragmentation. Stable exposure to high levels of green space resulted in higher suicide risk among women. Interactions and stratification by moving type revealed associations between neighbourhood change and suicide were more pronounced in non-movers. Our findings suggest that neighbourhood improvements might contribute to a lower suicide risk, especially for long-term residents in poor neighbourhood conditions.

Life Course Neighborhood Deprivation Effects on Body Mass Index: Quantifying the Importance of Selective Migration

Neighborhood effects research is plagued by the inability to circumvent selection effects —the process of people sorting into neighborhoods. Data from two British Birth Cohorts, 1958 (ages 16, 23, 33, 42, 55) and 1970 (ages 16, 24, 34, 42), and structural equation modelling, were used to investigate life course relationships between body mass index (BMI) and area deprivation (addresses at each age linked to the closest census 1971–2011 Townsend score [TOWN], re-calculated to reflect consistent 2011 lower super output area boundaries). Initially, models were examined for: (1) area deprivation only, (2) health selection only and (3) both. In the best-fitting model, all relationships were then tested for effect modification by residential mobility by inclusion of interaction terms. For both cohorts, both BMI and area deprivation strongly tracked across the life course. Health selection, or higher BMI associated with higher area deprivation at the next study wave, was apparent at three intervals: 1958 cohort, BMI at age 23 y and TOWN at age 33 y and BMI at age 33 y and TOWN at age 42 y; 1970 cohort, BMI at age 34 y and TOWN at age 42 y, while paths between area deprivation and BMI at the next interval were seen in both cohorts, over all intervals, except for the association between TOWN at age 23 y and BMI at age 33 y in the 1958 cohort. None of the associations varied by moving status. In conclusion, for BMI, selective migration does not appear to account for associations between area deprivation and BMI across the life course.

Assessing the perceived changes in neighborhood physical and social environments and how they are associated with Chinese internal migrants' mental health

BACKGROUND

Migrants experience substantial changes in their neighborhood physical and social environments along their migration journeys, but little is known about how perceived changes in their neighborhood environment pre- and post-migration correlate with their mental health. Our aim was to examine the associations between recalled changes in the perceived neighborhood physical and social environments and migrants' mental health in the host city.

METHODS

We used cross-sectional data on 591 migrants in Shenzhen, China. We assessed their risk of mental illness using the General Health Questionnaire (GHQ). Neighborhood perceptions were collected retrospectively pre- and post-migration. We used random forests to analyze possibly non-linear associations between GHQ scores and changes in the neighborhood environment, variable importance, and for exploratory analysis of variable interactions.

RESULTS

Perceived changes in neighborhood aesthetics, safety, and green space were non-linearly associated with migrants' mental health: A decline in these characteristics was associated with poor mental health, while improvements in them were unrelated to mental health benefits. Variable importance showed that change in safety was the most influential neighborhood characteristic, although individual-level characteristics-such as self-reported physical health, personal income, and hukou (i.e., the Chinese household registration system)-appeared to be more important to explain GHQ scores and also strongly interacted with other variables. For physical health, we found different associations between changes in the neighborhood provoked by migration and mental health.

CONCLUSION

Our findings suggest that perceived degradations in the physical environment are related to poorer post-migration mental health. In addition, it seems that perceived changes in the neighborhood environment play a minor role compared to individual-level characteristics, in particular migrants' physical health condition. Replication of our findings in longitudinal settings is needed to exclude reverse causality.

Socio-environmental factors affecting mental health of people during Covid-19 in coastal urban areas of Bangladesh

At present the world is facing a boisterous challenge put by COVID-19 due to which countries are passing very difficult times. COVID-19 has now put both physical and mental impacts. However, how socioenvironmental factors affect mental health (stress and anxiety) during COVID-19 in developing countries is poorly understood, and so far, too few scholarly works have been accomplished focusing these countries. Therefore, this study aims to investigate the role of socioenvironmental factors on mental health of people during COVID-19 in the costal urban areas of Bangladesh, where we contemplate Composite COVID Stress Index (CCSI) and COVID Anxiety Scale (CAS) for analyzing mental health. Applying a cross-sectional web-based survey, 115 respondents were considered for this study. As analytical tools- Explanatory Factor Analysis (EFA) and Weighted Least Square (WLS) were applied, along with descriptive statistics. The results advocate that agitation, scarcity, trauma, and infodemic altogether affect the degree of stress during COVID-19 pandemic. Furthermore, a number of socioenvironmental factors namely agitation, scarcity, infodemic, age, literacy level, living condition (in terms of settlement type), source of drinking water, security status (in terms of criminal activity), and number of ailments significantly affect the degree of coronavirus triggered anxiety during the pandemic for the respondents. Thus, findings propose the need of both physical and psychological healthcare services, online-based healthcare programs and spread of authentic COVID-19 information and basic amenities sufficiency.

Are the Sick Left Behind at the Peripheries? Health Selection in Migration to Growing Urban Centres in Finland

We study health selection in rural–urban migration in Finland using register data. Specifically, we ask whether ‘movers’ differ from ‘stayers’ in their use of special health care services prior to moving. We focus on migration to twelve growing urban centres in different sub-groups of the population as well as in different regions, using multinomial logistic regression and multilevel modelling and by distinguishing between short- and long-distance moves. The results show that urban centres attract healthier individuals, while people with health problems are also prone to move, but not to urban centres. The results were similar when looking only at psychiatric diagnoses. The findings suggest that it is important to distinguish between different types of moves when studying health-selective migration. Studying the patterns of migration according to health enables us to understand drivers of regional health differences. Moreover, such evidence will help in projecting future demand for healthcare across the country.

Mental health selection: common mental disorder and migration between multiple states of deprivation in a UK cohort

OBJECTIVES

To assess whether the direction of movement along the social gradient was associated with changes in mental health status.

DESIGN

Longitudinal record-linkage study using a multistate model.

SETTING

Caerphilly, Wales, UK between 2001 and 2015.

PARTICIPANTS

The analytical sample included 10 892 (60.8% female) individuals aged 18-74 years.

PRIMARY AND SECONDARY OUTCOME MEASURES

Deprivation change at lower super output area level using the 2008 Welsh Index of Multiple Deprivation. Mental health was assessed in 2001 and 2008 using the Mental Health Inventory subscale of the short-form 36 V.2.

RESULTS

Mental health selection was shown whereby individuals with common mental health disorders were less likely to move to areas of lower deprivation but more likely to move to areas of greater deprivation.

CONCLUSION

Poor mental health seems to drive health selection in a similar way to poor physical health. Therefore, funding targeted at areas of higher deprivation should consider the demand to be potentially higher as individuals with poor mental health may migrate into that area.

Rural-urban patterns of disability: The role of migration

Disability rates are higher in rural than in urban areas of the United States, raising the question: do residential preferences and selective migration of people with disabilities play a role in higher rural disability rates? Utilising concepts of environmental fit from the disability literature and ideas from classic, residential preference, and household migration studies, we examine the 2011-2015 American Community Survey Public Use Microdata Sample to understand whether migration contributes to higher rural disability. Results show only slightly different propensities to stay in rural than in urban areas and similar destination choices of people with or without disability, suggesting that migration does little to explain higher rates of rural disability. However, we detect noteworthy differences in age migration schedules for persons with disability, persons without disability in households with disability, and persons without disability in households without disability. Disability emerges as a relevant, although underresearched, dimension in household migration research.

Sensitive Periods of Moving on Mental Health and Academic Performance Among University Students

Moving within and across nations becomes a non-reversible increasing trend globally. The current research investigated the unique effect of residential mobility at different developmental stages (i.e., early childhood, late childhood, and adolescence) on university students' mental health and academic performance. In addition, we investigated the role of two different types of coping resources, i.e., resilience and family income, in moderating the negative effect of residential mobility. The data from 3753 first-year university students revealed that: (1) residential mobility in late childhood and adolescence (but not in early childhood) predicted poorer mental health among university students; (2) high resilience and higher family income alleviated the association of residential mobility in adolescence and mental health status; and (3) residential mobility in adolescence (but not in early childhood and late childhood) was associated with poorer academic performance but this pattern was not moderated by resilience or family income. The theoretical implications and practical implications of these findings were discussed.

A sibling study of whether maternal exposure to different types of natural space is related to birthweight

Background

Birthweight is an important determinant of health across the life course. Maternal exposure to natural space has been linked to higher birthweight, but stronger evidence of a causal link is needed. We use a quasi-experimental sibling study design to investigate if change in the mother’s exposure to natural space between births was related to birthweight, in urban Scotland.

Methods

Amount (% area) of total natural space, total accessible (public) natural space, parks, woodlands and open water within 100 m of the mother’s postcode was calculated for eligible births (n = 40 194; 1991–2010) in the Scottish Longitudinal Study (a semi-random 5.3% sample of the Scottish population). Associations between natural space and birthweight were estimated, using ordinary least squares and fixed effects models.

Results

Birthweight was associated with the total amount of natural space around the mother’s home (+8.2 g for interquartile range increase), but was unrelated to specific types of natural space. This whole-sample relationship disappeared in the sibling analysis, indicating residual confounding. The sibling models showed effects for total natural space with births to women who already had children (+20.1 g), and to those with an intermediate level of education (+14.1 g).

Conclusions

The importance of total natural space for birthweight suggests that benefits can be experienced near to as well as within natural space. Ensuring expectant mothers have good access to high quality neighbourhood natural space has the potential to improve the infant’s start in life, and consequently their health trajectory over the life course.

Longitudinal deprivation trajectories and risk of cardiovascular disease in New Zealand

We used longitudinal information on area deprivation status to explore the relationship between residential-deprivation mobility and Cardiovascular Disease (CVD). Data from 2,418,397 individuals who were: enrolled in any Primary Health Organisation within New Zealand (NZ) during at least 1 of 34 calendar quarters between 1st January 2006 and 30th June 2014; aged between 30 and 84 years (inclusive) at the start of the study period; had no prior history of CVD; and had recorded address information were analysed. Including a novel trajectory analysis, our findings suggest that movers are healthier than stayers. The deprivation characteristics of the move have a larger impact on the relative risk of CVD for younger movers than for older movers. For older movers any kind of move is associated with a decreased risk of CVD.

Place and preference effects on the association between mental health and internal migration within Great Britain

Individuals with mental health needs are more likely to migrate than the general population, but the effects of migration preference and place of residence are often overlooked. These issues are addressed through the application of a novel origin and destination multilevel model to survey data. In comparison to those with good mental health, individuals with poor mental health are more likely to make undesired moves and this is moderated, but not explained by place of residence. Implications for understanding the mental health and migration relationship, and its impact on service provision are then proposed.

Socioeconomic deprivation, mortality and health of within-city migrants: a population cohort study

BACKGROUND

Evidence linking selective migration (the situation where people in good health move from deprived to affluent areas, whilst people in poor health move in the opposite direction) within local areas to mortality is inconclusive.

METHODS

Mortality in within-city migrants was examined using a Sheffield population cohort, adjusted for moves to care homes. The cohort comprised 310 894 people aged 25+ years in 2001 followed up for 9.18 years, with 42 252 (13.6%) deaths. Information on pre-existing medical conditions, socioeconomic indicators and smoking was available from a sample survey.

RESULTS

Relative risks (95% CI) of mortality in migrants from deprived to affluent areas were lower compared with people remaining in deprived areas; 0.53 (0.42 to 0.65), 0.70 (0.61 to 0.80), 0.76 (0.68 to 0.86), 0.93 (0.88 to 1.00) and 0.98 (0.93 to 1.03) in the 25-44, 45-64, 65-74, 75-84 and 85+ year age bands, respectively. They also had lower prevalence ORs (95% CI) for bronchitis (0.59 (0.39 to 0.89)), asthma (0.70 (0.53 to 0.93)), depression (0.59 (0.38 to 0.94)), and were less likely to receive benefits (0.60 (0.47 to 0.76)) and less likely to smoke (0.66 (0.51 to 0.85)).Conversely, mortality relative risks in migrants from affluent to deprived areas were higher compared with people remaining in affluent areas; 1.71 (1.37 to 2.12), 1.59 (1.40 to 1.82), 1.44 (1.26 to 1.63), 1.18 (1.10 to 1.27) and 1.04 (1.00 to 1.09) in the corresponding age groups. They also had higher prevalence odds ratios for long-term illness (2.37 (1.71 to 3.29)), asthma (1.71 (1.25 to 2.35)), diabetes (3.03 (1.70 to 5.41)), depression (2.71 (1.74 to 4.21)), were more likely to receive benefits (2.25 (1.65 to 3.07)) and more likely to smoke (1.51 (1.12 to 2.05)).

CONCLUSIONS

People moving from deprived to affluent areas had lower mortality and better health, and vice versa, especially in the younger age groups. This study provides strong evidence linking selective migration within local areas to mortality.

Understanding the relationship between health and internal migration in the United Kingdom

Purpose

Studies on the relationship between migration and health status of individuals most often concentrate on international migrants. In contrast, the purpose of this paper is to examine the relationship between health and internal migration using the first 18 waves of the British Household Survey.

Design/methodology/approach

The authors use the 12-version of General Health Questionnaire (GHQ), an indicator of mental health, and physical health indicators as the health variables. This study uses different econometrics estimation methods in modelling the relationship in order to address omitted variable bias as well as unobserved heterogeneity. The econometric estimation methods include Pooled OLS, random effects (RE), fixed effects (FE) and then probit RE. The authors explore the relationship by comparing the health status of movers and non-movers and different types of internal migration such as between local authority districts and between regions.

Findings

The results of this research suggest that there is healthy migrant effect on migration within UK on some indicators of physical health like arm/leg, heart and migraine/headache problems, but not on mental health indicator. And the effects are similar for both males and females. It is advised therefore that the department of health should improve the health of those affected by these ailments so that they can have a chance to move perhaps to better their lots.

Originality/value

This study uses different econometrics estimation methods in modelling the relationship in order to address omitted variable bias as well as unobserved heterogeneity. The econometric estimation methods include Pooled OLS, RE, FE and then probit RE.

How do moving and other major life events impact mental health? A longitudinal analysis of UK children

Research has suggested that children who move home report poorer mental health than those who remain residentially stable. However, many previous studies have been based on cross sectional data and have failed to consider major life events as confounders. This study uses longitudinal data from ALSPAC, a UK population based birth cohort study, and employs within-between random effect models to decompose the association between moving in childhood and poor mental health. Results suggest that while unobserved between-individual differences between mobile and non-mobile children account for a large portion of this association, within-individual differences remain and indicate that moving may have a detrimental impact upon subsequent mental health. There is heterogeneity in children's response to moving, suggesting that a dichotomy of movers vs stayers is overly simplistic.

Illuminating the lifecourse of place in the longitudinal study of neighbourhoods and health

Place and health are inextricably entwined. Whilst insights have been gained into the associations between places, such as neighbourhoods, and health, the understanding of these relationships remains only partial. One of the reasons for this relates to time and change and the inter-relationships between the dynamic nature of both neighbourhoods and health. This paper argues that the lifecourse of place can be used as a conceptual framework to understand the evolution and ongoing development of neighbourhoods, and their impact on the geographies of health, past, present and future. Moreover, this paper discusses the capacity of a longitudinal form of enquiry - latent transition analysis - that is able to operationalise conceptual models of the lifecourse of place. To date, latent transition analysis has not been applied to the study of neighbourhoods and health. Drawing on research across a range of disciplines including developmental psychology, sociology, geography and epidemiology, this paper also considers praxis-based implications and recommendations for applications of latent transition analysis that aim to advance understanding of how neighbourhoods affect health in and over time.

The impact of limiting long term illness on internal migration in England and Wales: New evidence from census microdata

Previous research has suggested that poor health is associated with reduced migration; this knowledge stems from models based on past censuses, or longitudinal studies which imply that the factors influencing migration are the same between those in good and poor health. This paper addresses these issues by utilising health-stratified analyses on the 2011 Census Individual Secure Sample for England and Wales. Multilevel models predict the odds of moving for working age adults, controlling for key predictors of migration, estimating the effect of health status on the odds of moving and the destination-specific variance in migration. We find that those in poor health are less likely to move, after controlling for individual level characteristics. In contrast with expectations, economic inactivity, marriage and being in African, Caribbean, Black, Other or Mixed ethnic groups were not significant predictors of migration among the unhealthy sample, but were for the healthy sample. We conclude that migration is health-selective and propose implications for understanding area level concentrations of poor health in England and Wales.

Life Course, Green Space and Health: Incorporating Place into Life Course Epidemiology

Researchers interested in the relationships between place and health have been slow to incorporate a life course perspective, probably due to the lack of readily available historical environmental data. This hinders the identification of causal relationships. It also restricts our understanding as to whether there are accumulative effects over the life course and if there are critical periods in people’s lives when places are particularly pertinent. This study considers the feasibility of constructing longitudinal data on the availability of urban green space. The suitability of various historical and contemporary data sources is considered, including paper maps, aerial photographs and tabular land use data. Measures of urban green space are created for all neighbourhoods across the Edinburgh region of Scotland at various points during the past 100 years. We demonstrate that it is feasible to develop such measures, but there are complex issues involved in doing so. We also test the utility of the measures via an analysis of how accessibility to green space might alter over the life course of both people, and their residential neighbourhoods. The findings emphasise the potential for utilising historical data to significantly enhance understanding of the relationships between nature and health, and between health and place more generally. We encourage researchers to use data from other locations to consider including a longitudinal perspective to examine relationships between people’s health and their environment.

Moving on: How depressive symptoms, social support, and health behaviors predict residential mobility

BACKGROUND

There are major health inequalities between residential areas. However, it remains unclear whether these inequalities are due to social causation or selective residential mobility, because little is known about the associations between health-related factors and selective residential mobility. This study examined how depressive symptoms, social support, and health behaviors are associated with subsequent residential mobility, as measured by frequency, distance, and direction of moves.

METHODS

Participants were selected from the Young Finns prospective cohort study (N = 3017) with four study waves in 1992, 1997, 2001, and 2007. Complete residential mobility history was gathered for each participant from registry data. Residential mobility was assessed over three-year periods following each study wave. The direction of mobility was measured as changes in residential location's population density, health index, mortality index, and unemployment. Area characteristics were used as covariates together with the participants' age, sex, and education.

RESULTS

Individuals reporting higher social support from friends were more likely to move (b = 0.20; 95% confidence interval (CI): 0.08, 0.37) and move more frequently (b = 0.08; 95% CI: 0.01, 0.14), whereas individuals reporting higher social support from their family members were less likely to move (b = -0.08; 95% CI: -0.14, -0.02). Better health behaviors were associated with longer moving distances (b = 0.14; 95% CI: 0.06, -0.23). None of the individual characteristics were associated with the direction of moves as measured by changes in municipality characteristics. CONCLUSIONS SOME OF THE HEALTH-RELATED CHARACTERISTICS ARE ASSOCIATED WITH RESIDENTIAL MOBILITY IN FINLAND HOWEVER, THESE INDIVIDUAL CHARACTERISTICS DO NOT SEEM TO PREDICT SYSTEMATIC SELECTIVE RESIDENTIAL MOBILITY ACROSS MUNICIPALITIES WITH DIFFERENT REGIONAL HEALTH PROFILES.

Difficult Life Events, Selective Migration and Spatial Inequalities in Mental Health in the UK

Objective

Research has indicated that people moving towards neighbourhoods with disadvantaged socio-economic status have poor health, in particular mental health, but the reasons for this are unclear. This study aims to assess why people moving towards more socio-economically deprived areas have poor mental health. It focuses upon the role of difficult life events that may both trigger moves and damage mental health. This study investigates how mental health and socio-spatial patterns of mobility vary between people moving following difficult life events and for other reasons.

Methods

Longitudinal analysis of British Household Panel Survey data describing adults’ moves between annual survey waves, pooled over ten years, 1996-2006 (N=122,892 observations). Respondents were defined as ‘difficult life event movers’ if they had experienced relationship breakdown, housing eviction/repossession, or job loss between waves. Respondents were categorised as moving to more or less deprived quintiles using their Census Area Statistic residential ward Carstairs score. Mental health was indicated by self-reported mental health problems. Binary logistic regression models of weighted data were adjusted for age, sex, education and social class.

Results

The migration rate over one year was 8.5%; 14.1% of movers had experienced a difficult life event during this time period. Adjusted regression model odds of mental health problems among difficult life event movers were 1.67 (95% CI 1.35-2.07) relative to other movers. Odds of difficult life events movers, compared to other movers, moving to a less deprived area, relative to an area with a similar level of deprivation, were 0.70 (95% CI 0.58-0.84). Odds of mental health problems among difficult life event movers relocating to more deprived areas were highly elevated at 2.40 (95% CI 1.63-3.53), relative to stayers.

Conclusion

Difficult life events may influence health selective patterns of migration and socio-spatial trajectories, reducing moves to less deprived neighbourhoods among people with mental illness.