School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
School of Public Health, Harvard, Boston, MA, USA.
Soc Sci Med. 2015 Jul;136-137:27-34. doi: 10.1016/j.socscimed.2015.05.011. Epub 2015 May 9.
Evidence surrounding the importance of neighbourhood on health has been mostly restricted to observational data analyses. However, observational data are often the only source of information available to test this association and can fail to accurately draw out casual effects. This study employs a pseudo-experimental design to provide a novel test for the evidence of neighbourhood effects on health, using migration as a mechanism for assessing the role of neighbourhood. Coarsened exact matching was employed on the British Household Panel Survey (2006-2008) to analyse the association between migration (by area type, measured using a classification of mortality patterns) and health. Although an overall significant positive association between migration and health was observed, once the effect was disaggregated by location and destination it disappeared. Rather, evidence of health selective migration was found whereby individuals of poorer health migrated to areas that displayed poorer health and social characteristics (and vice versa). Migration is an important process that through the social sorting of individuals in terms of their health, contributes to the growing polarisation and inequality in health patterns. The study helps to build upon previous research through providing a new and stronger form of analysis that reduces the influence of bias on results. Incorporating this under-utilised methodology and research design in future studies could help develop public health and geographical research.
关于邻里环境对健康重要性的证据，大多局限于观察性数据分析。然而，观察性数据往往是检验这种关联的唯一可用信息来源，并且可能无法准确地推断出因果效应。本研究采用拟实验设计，利用移民作为评估邻里作用的机制，为邻里效应对健康的影响提供新的证据检验。利用英国家庭面板调查（2006-2008 年）中的粗略精确匹配来分析移民（按区域类型衡量，采用死亡率模式分类）与健康之间的关系。尽管总体上观察到移民与健康之间存在显著正相关，但一旦按地点和目的地对效应进行细分，这种相关性就消失了。相反，发现了健康选择性移民的证据，即健康状况较差的个人迁移到健康和社会特征较差的地区（反之亦然）。移民是一个重要的过程，它通过个人在健康方面的社会分类，导致健康模式的日益两极化和不平等。本研究通过提供一种新的、更强有力的分析形式，减少了偏倚对结果的影响，为以往的研究提供了补充。在未来的研究中纳入这种利用不足的方法和研究设计，可以帮助发展公共卫生和地理研究。
