بهداشت عمومی و روانی سیاست گذاران برای محیط های اجتماعی و اقتصادی و فیزیکی کمتر محروم در انگلستان

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.

Selective migration is commonly believed to have an important influence upon both individual health, by determining individual exposures to environments, and area health, by shaping area population composition (Boyle, 2004, Rogerson and Han, 2002 and Spallek et al., 2011). However, research regarding the health of migrants, and how their selection relates to the characteristics of areas they move between, has neglected some types of health outcomes and environments. This study uses British Household Panel Survey (BHPS) data to describe the relationship between individual health and residential mobility between neighbourhoods in UK. The analysis builds upon previous research in the UK firstly, by comparing the general and mental health of migrants of different ages and secondly, by assessing moves between neighbourhoods with different levels of both socio-economic and physical environment deprivation.

This study indicated that young and old movers within the UK may be at risk of poor health. It showed that mental health problems are elevated among movers to more socio-economically deprived areas. Residential mobility may therefore contribute to the processes through which health and socio-economic disadvantage are reinforced and accumulate across the life course. The implication of these patterns of migration for health may be particularly pertinent to European countries experiencing new patterns of migration related to high unemployment and austerity policies. This includes the UK where the introduction of changes to social housing benefits, capping receipt of benefits and limiting spare rooms (the ‘bedroom tax’), may exacerbate health and socio-economically selective patterns of migration (Pearce, 2013). Conversely, the study is also the first to demonstrate mental health problems are elevated among people moving to better physical environments. Further analysis exploring the reasons people move may support understanding of why people in the UK with poor mental health are moving towards more socio-economically deprived areas and away from poor physical environments.