Dijkstra Aletta, Kibele Eva U B, Verweij Antonia, van der Lucht Fons, Janssen Fanny
Unit of PharmacoEpidemiology and PharmacoEconomics, Pharmacy Department, University of Groningen, Groningen, The Netherlands Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands Healthy Ageing Population and Society (HAPS), University of Groningen, Groningen, The Netherlands.
Eur J Public Health. 2015 Dec;25(6):944-50. doi: 10.1093/eurpub/ckv192.
Health disparities between population declining and non-declining areas have received little attention, even though population decline is an established phenomenon in Europe. Selective migration, in which healthier people move out of deprived areas, can possibly explain worse health in declining regions. We assessed whether selective migration can explain the observed worse average health in declining regions as compared with non-declining regions in the Netherlands.
Combining data from the Dutch Housing and Living Survey held in 2002 and 2006 with Dutch registry data, we studied the relation between health status and migration in a 5-year period at the individual level by applying logistic regression. In our sample of 130,600 participants, we compared health status, demographic and socioeconomic factors of movers and stayers from declining and non-declining regions.
People in the Netherlands who migrated are healthier than those staying behind [odds ratio (OR): 1.80]. This effect is larger for persons moving out of declining regions (OR: 1.76) than those moving into declining regions (OR: 1.47). When controlled for demographic and socioeconomic characteristics, these effects are not significant. Moreover, only a small part of the population migrates out of (0.29%) or into (0.25%) declining regions in the course of 5 years.
Despite the relation between health and migration, the effect of selective migration on health differences between declining and non-declining regions in the Netherlands is small. Both health and migration are complexly linked with socioeconomic and demographic factors.
尽管人口减少在欧洲已是既定现象，但人口减少地区与非减少地区之间的健康差异却很少受到关注。选择性迁移，即健康状况较好的人从贫困地区迁出，可能是人口减少地区健康状况较差的原因。我们评估了在荷兰，选择性迁移是否能够解释所观察到的人口减少地区与非减少地区相比平均健康状况更差的现象。
我们将2002年和2006年荷兰住房与生活调查的数据与荷兰登记数据相结合，通过应用逻辑回归在个体层面研究了5年期间健康状况与迁移之间的关系。在我们130,600名参与者的样本中，我们比较了来自人口减少地区和非减少地区的迁移者和留守者的健康状况、人口统计学和社会经济因素。
荷兰的迁移者比留守者更健康[优势比（OR）：1.80]。从人口减少地区迁出的人（OR：1.76）比迁入人口减少地区的人（OR：1.47）这种效应更大。当控制人口统计学和社会经济特征时，这些效应并不显著。此外，在5年期间，只有一小部分人口迁出（0.29%）或迁入（0.25%）人口减少地区。
尽管健康与迁移之间存在关联，但在荷兰，选择性迁移对人口减少地区和非减少地区之间健康差异的影响很小。健康和迁移都与社会经济和人口统计学因素复杂地联系在一起。
