T Jelleyman1, N Spencer. 1. Child Health Services, Waitakere Hospital, 55-57 Lincoln Road, Henderson, Auckland, New Zealand. jelleyet@clear.net.nz
Abstract
OBJECTIVE: To assess evidence for residential mobility in childhood having an adverse association with health outcomes through the life course. METHODS: A systematic search of medical and social sciences literature was undertaken to identify research defining residential mobility as an independent variable and in which health outcomes were described and objectively measured. Studies were excluded that investigated international migration for asylum or were limited to educational outcomes. Two reviewers assessed each study using quality criteria with particular attention to the consideration of confounders and potential for bias. Data were extracted for analysis using a structured form. RESULTS: Twenty-two studies were included for this review. Outcomes identified in association with residential mobility included: higher levels of behavioural and emotional problems; increased teenage pregnancy rates; accelerated initiation of illicit drug use; adolescent depression; reduced continuity of healthcare. Studies assessed as having lower quality were less likely to demonstrate statistically significant effects. Heterogeneity precluded meta-analysis. CONCLUSIONS: Residential mobility interacts at neighbourhood, family and individual levels in cumulative and compounding ways with significance for the wellbeing of children. High frequency residential change is potentially a useful marker for the clinical risk of behavioural and emotional problems. The evidence supports the reorientation of health services effectively to engage these residentially mobile children for whom health and psychological needs may be identified. The impact of housing and economic policies on childhood residential mobility should be evaluated considering this evidence.
OBJECTIVE: To assess evidence for residential mobility in childhood having an adverse association with health outcomes through the life course. METHODS: A systematic search of medical and social sciences literature was undertaken to identify research defining residential mobility as an independent variable and in which health outcomes were described and objectively measured. Studies were excluded that investigated international migration for asylum or were limited to educational outcomes. Two reviewers assessed each study using quality criteria with particular attention to the consideration of confounders and potential for bias. Data were extracted for analysis using a structured form. RESULTS: Twenty-two studies were included for this review. Outcomes identified in association with residential mobility included: higher levels of behavioural and emotional problems; increased teenage pregnancy rates; accelerated initiation of illicit drug use; adolescent depression; reduced continuity of healthcare. Studies assessed as having lower quality were less likely to demonstrate statistically significant effects. Heterogeneity precluded meta-analysis. CONCLUSIONS: Residential mobility interacts at neighbourhood, family and individual levels in cumulative and compounding ways with significance for the wellbeing of children. High frequency residential change is potentially a useful marker for the clinical risk of behavioural and emotional problems. The evidence supports the reorientation of health services effectively to engage these residentially mobile children for whom health and psychological needs may be identified. The impact of housing and economic policies on childhood residential mobility should be evaluated considering this evidence.