University of Edinburgh, Edinburgh EH8 9XP, United Kingdom.
University of Glasgow, Glasgow G12 8RZ, United Kingdom.
Soc Sci Med. 2014 Oct;118:97-107. doi: 10.1016/j.socscimed.2014.07.038. Epub 2014 Jul 29.
Residential mobility may play an important role in influencing both individual health, by determining individual exposures to environments, and area health, by shaping area population composition. This study is the first analysis of migration within the UK to compare general and mental health among adults by age group and consider moves between neighbourhoods with different levels of both socio-economic and physical environment disadvantage. The analysis assesses 122,570 cases from the annual British Household Panel Survey, 1996-2006, based upon pooled data describing moves between consecutive waves of the survey. It assesses the rates and binary logistic regression model odds of self-reported general health and mental health problems of movers and stayers by age group. It also compares movers between Census Area Statistics wards in the UK with different levels of Carstairs and Multiple Environmental Deprivation Index (MEDIx) scores. At all ages, movers had similar or higher odds of poor general and mental health relative to non-movers. Risk of mental health problems were particularly elevated among movers and remained significant after adjustment for socio-demographic variables in most age groups. In adjusted analysis of all adults odds of poor general and mental health were most elevated among movers to more socio-economically deprived areas, with the highest odds for mental health (1.54 95% CI 1.27-1.86). In contrast, risk of poor mental health among total adults was greatest among movers to better physical environments (1.40 95% CI 1.16-1.70). This study therefore finds little evidence of 'healthy migrant effects' among recent movers within the UK and suggests movers have particularly elevated risk of mental health problems. It also indicates that selective migration may not contribute to poor health found in UK neighbourhoods with multiple physical environment deprivation. Further analysis should explore why people with mental health problems are more likely to move to socio-economically deprived neighbourhoods.
居民流动性可能通过决定个体接触环境的方式对个体健康产生重要影响,也可能通过影响区域人口构成对区域健康产生影响。本研究首次分析了英国国内的人口迁移情况,比较了不同年龄组成年人的总体健康和精神健康,并考虑了不同社会经济和物质环境劣势的邻里之间的迁移。该分析基于连续几波调查中描述的迁移数据,评估了 1996-2006 年英国年度家庭面板调查中的 122570 例病例。该分析评估了按年龄组划分的移动者和留守者的自我报告的总体健康和精神健康问题的发生率和二元逻辑回归模型的几率。它还比较了英国人口普查区统计区中具有不同卡斯特斯和多重环境剥夺指数(MEDIx)得分的区之间的移动者。在所有年龄段,移动者的总体健康和精神健康不良的几率与非移动者相似或更高。在大多数年龄组中,调整社会人口统计学变量后,精神健康问题的风险仍然很高。在所有成年人的调整分析中,移动到社会经济条件较差地区的成年人的总体健康和精神健康不良的几率最高,而精神健康的几率最高(1.54 95%CI 1.27-1.86)。相比之下,在总体成年人中,精神健康不良的风险在迁移到更好的物质环境的人群中最高(1.40 95%CI 1.16-1.70)。因此,本研究在英国近期的移动者中几乎没有发现“健康移民效应”的证据,并且表明移动者的精神健康问题风险特别高。它还表明,选择性迁移可能不会导致英国多个物质环境匮乏的邻里中发现的健康状况不佳。进一步的分析应探讨为什么有精神健康问题的人更有可能迁移到社会经济贫困的邻里。