Exploring the Import of Health-Related Residential Mobility to Local Area Studies

描述/摘要：虽然大多数关于地方对健康影响的研究都是生态的或对横截面数据的多层次分析，但研究结果往往被解释为社区环境影响健康的证据，而不仅仅是居住人口的组成。这种解释隐含地假设当地人口是静态的，尽管他们显然是动态的，他们所经历的变化可能与健康有关。如果跨地区的居民流动与健康相关，那么对横断面研究结果的常见背景解释可能会产生误导。很少有调查人员解决这个问题，因为很少有数据集提供关于健康和移徙的信息，也没有足够大的样本来研究各地区的移徙。然而，在2000年人口普查中，调查对象在人口普查前5年的居住地信息首次被收集到邮政编码水平，为探索这一研究问题提供了机会。然而，由于该项目的邮政编码数据相对较新，并且只有成功申请使用机密人口普查数据的调查人员才能获得，因此尚未确定其质量。我们被授权在密歇根人口普查研究数据中心分析这些数据，以检验选择性移民有助于观察到的当地地理健康模式的假设。这个探索性和发展性项目将以我们以前的工作为基础，首先更新我们在1980年和1990年使用适用于人口普查和人口动态统计数据的标准人口统计技术进行的2000年当地发病率和死亡率分析。其次，我们将探讨2000年人口普查数据在邮政编码水平上的先前居住地的质量。第三，我们将估计健康与1995年至2000年期间一个人迁入或迁出我们特定地区的概率之间的关系，以及2000年差异迁移对每个地区人口健康的影响。总体上评估2000年人口普查以前居住地数据的有效性，特别是研究社区具体行动的有效性，是发展性的。它将为许多对社区动态感兴趣的研究人员提供非常有价值的信息，用于各种科学目的，包括与健康无关的目的。此外，由于地方研究越来越多地用于公共卫生政策，探索选择性移民是否是一种可持续的竞争性解释，以理解不同地方观察到的死亡率概况的巨大差异，这对于确定种族/民族和社会经济健康差异研究最有希望的未来方向至关重要。研究人员发现，人们在美国居住的地方与他们的健康和预期寿命有关，即使是相同种族、性别或年龄的人，或者生活在具有相似社会经济特征的社区的人也是如此。但是，大多数此类研究无法区分这种联系是反映了不同的社会和自然环境对健康的影响，还是人们移居新地方的决定可能与他们的健康有关。拟议的研究使用了新的人口普查数据，这应该使我们能够区分这些相互竞争的解释，从而可能为继续研究和制定政策提供更好的基础，以减少健康方面的社会差距。

DESCRIPTION (provided by applicant): Exploring the Import of Health-related Residential Mobility to Local Area Studies Description / Summary: Although most studies of place effects on health are ecological or multilevel analyses of cross-sectional data, findings are often interpreted as evidence that neighborhood context impacts health beyond the composition of the resident population. This interpretation implicitly assumes that local populations are static, although clearly they are dynamic, and the changes they experience could be health-related. If residential mobility across local areas is health-related, common contextual interpretations of cross-sectional findings might be misleading. Few investigators have addressed this question because few data sets provide information on health and migration and have sufficiently large samples to study migration across local areas. However, information on respondents' place of residence 5 years prior to the Census was collected to the ZIP code level for the first time in the 2000 Census, providing the opportunity to explore this research question. Yet, because ZIP code data for this item are relatively new and available only to investigators who successfully apply to use confidential census data, their quality has not been established. We have been authorized to analyze these data at the Michigan Census Research Data Center to test the hypothesis that selective migration contributes to the observed local geographic patterning of health. This exploratory and developmental project will build on our previous work by first updating to the year 2000 local area morbidity and mortality analyses we conducted for 1980 and1990 using standard demographic statistical techniques applied to census and vital statistics data. Second, we will explore the quality of 2000 Census data on prior place of residence at the ZIP code level. Third, we will estimate the association between health and the probability that a person moved into or out of our specific local areas between the years 1995 and 2000, and the impact of differential migration on the health of the population remaining in each area in 2000. The assessment of the validity of 2000 Census data on prior place of residence, overall, and for studying community-specific moves, in particular, is developmental. It will provide highly valuable information to the many researchers interested in neighborhood dynamics for various scientific purposes, including ones that are not health-related. In addition, because local area studies are increasingly used to inform public health policy, exploring whether selective migration is a sustainable competing explanation to place effects for understanding dramatic differences in mortality profiles observed across local areas is critical for identifying the most promising future directions for research on racial/ethnic and socioeconomic health disparities. Project / Narrative Researchers have found that where people live in the United States is associated with their health and life- expectancy, even among people of the same race, gender, or age or living in communities with similar socioeconomic characteristics. But most such studies cannot distinguish between whether this association reflects the impact of different social and physical environments on health or the possibility that people=s decision to move to new places might be related to their health. The proposed research uses new Census data that should allow us to distinguish between these competing explanations and, thus, may provide an improved basis for continued research and policy making to reduce social disparities in health.