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Residential mobility and potentially avoidable hospitalisations in a population-based cohort of New Zealand children
Kim Nathan1, Oliver Robertson2, Polly Atatoa Carr3
1Department of Public Health, University of Otago Wellington, Wellington, New Zealand kim.nathan@otago.ac.nz.
Insights
Frequent childhood residential moves are linked to more hospitalizations. Higher residential mobility in young children increases the risk of potentially avoidable hospitalizations (PAH).
Area of Science:
- Child Health Research
- Public Health
- Epidemiology
Background:
- Residential mobility is common in early childhood.
- Previous research links residential mobility to adverse child health outcomes.
- Few studies have examined potentially avoidable hospitalizations (PAH) in relation to residential mobility.
Purpose of the Study:
- To investigate the association between residential mobility and potentially avoidable hospitalizations (PAH) in a population-based cohort of New Zealand children.
Main Methods:
- Retrospective cohort design using data from the Integrated Data Infrastructure.
- Analyzed data for 314,283 children born since 2004 with recorded addresses by age 2.
- Derived residential mobility from address data and PAH from hospital discharge data.
Main Results:
- 52% of children experienced at least one residential move by age 2; 22% experienced two or more.
- 15% of the cohort had one or more PAH between ages 2 and 4.
- A linear association was found between residential mobility and PAH (RR=1.18), remaining robust after covariate adjustment. Similar associations were found for ambulatory care sensitive hospitalizations (aRR=1.10) and PAH attributable to the housing/physical environment (aRR=1.11).
Conclusions:
- Higher residential mobility is linearly associated with an increased likelihood of potentially avoidable hospitalizations in young children.
- Findings highlight the impact of residential instability on child health.
- Further research is suggested to explore underlying mechanisms and interventions.
Background:
Residential moves are common in early childhood and associations have been found between residential mobility and adverse child health and well-being outcomes. Although there are studies on potentially avoidable hospitalisations (PAH) in children, few have examined PAH in relation to residential mobility. Our aim, therefore, was to investigate residential mobility and PAH in a population-based cohort of New Zealand children.
Methods:
Using a retrospective cohort design, we analysed data from the Integrated Data Infrastructure for a cohort of 314 283 children born since the start of 2004, who had at least one residential address recorded by 2 years of age. Residential mobility was derived from address data and PAH were determined from hospital discharge data.
Results:
Half of the cohort children (52%) experienced at least one residential move by 2 years of age, and 22% experienced two or more moves. Fifteen per cent of the cohort experienced one or more PAH between 2 and 4 years of age. A linear association between residential mobility and PAH was found (relative risk (RR)=1.18, CI 1.17 to 1.19) and this remained robust when adjusting for several covariates. Sensitivity analyses for ambulatory care sensitive hospitalisations (ACSH) and PAH attributable to the housing/physical environment (PAH-HE) produced results very similar to those for PAH (ACSH: adjusted RR (aRR)=1.10, CI 1.09 to 1.11; PAH-HE: aRR=1.11, CI 1.10 to 1.12).
Conclusion:
This study found a linear association between higher residential mobility and an increased likelihood of PAH in young children. Avenues for further investigation are suggested.
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