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

Abstract

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.

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

“…This finding corroborates with previous research indicating that common predictors of migration do not explain the association between mental health and internal migration (Tunstall et al, 2014).…”

“…Less attention has been paid to the influence of mental health on migration behaviour. In contrast to physical health, internal migrants are more likely to self-report mental health problems than non-migrants (Larson et al, 2004;Tunstall et al, 2014). Extant research is primarily drawn from populations with severe and rare mental health conditions (Harvey et al, 1996;Ngamini Ngui et al, 2013), although analyses using instruments designed to measure common mental disorders find similar associations between moving and mental health (Tunstall et al, 2015).…”

Life course of place: A longitudinal study of mental health and place

“…Third, levels of mobility among the LBC1936 participants is likely to be low relative to the general population as recruitment into the cohort relied on the participant residing in the Edinburgh region at age 70. This issue is potentially pertinent because highly mobile populations are generally at higher risk of negative health outcomes (Tunstall, Mitchell et al., ), and more likely to be exposed to a wider range of environmental settings. Future work could usefully adopt our general approach with a larger cohort of individuals, such as those available in one of the British birth cohorts.…”

“…This is perhaps surprising when we consider the literature on health‐selective mobility, which has tended to find that residential migration leads to substantial changes to the social and physical settings that people live their lives and often has lifelong implications for their health and well‐being (Gatrell, ; Pearce & Dorling, ; Wilding et al., ). Previous work in the UK has tended to show that selective migration patterns help to explain why people with poor physical and mental health disproportionately locate in more socially disadvantaged places (Tunstall, Mitchell et al., ), although selective migration processes seem to be less significant in understanding their concentration in disadvantageous physical environments (Tunstall, Pearce et al., ). This is important because it means that environmental measures based on place of residence at one point in time may mis‐specify environmental exposure (due a person's migration between different types of environments and/or substantial levels of neighbourhood change in the place they reside) and provide inaccurate estimates of the environment–health relationships.…”

Longitudinal deprivation trajectories and risk of cardiovascular disease in New Zealand

“…their better health) are misleading (Larson et al, 2004). For example, Tunstall et al (2014) found lower rates of poor general health and higher rates of poor mental health in aggregate analysis. But when stratified by age group, movers of all ages had equivalent or higher rates of poor general health and poor mental health relative to stayers.…”