The move, the person, or the area? Exploring risk of Cardiovascular Disease in New Zealand
Darlington-Pollock, F., Exeter, D., Norman, P. & Shackleton, N. (2017) UK Administrative Data Research Network Annual Research Conference, Royal College of Surgeons, Edinburgh, UK, 1 - 2 June 2017
The relationship between migration and health is a burgeoning field of research. In particular, research has examined the influence of health-selective migration on health inequalities, finding that migration between areas can contribute to widening health inequalities in the population. However, much of this research focusses on subjective measures of self-assessed health, masks differences between ethnic groups, and is unable to account for the sequencing of health events and migration or residential mobility events. This paper addresses these limitations, presenting a body of work examining the relationship between residential mobility, cardiovascular disease (CVD), experience of deprivation (change) and ethnicity in New Zealand. Using linked nationally held routine health data, it is possible to determine the sequencing of health events and migration events and examine differences in risk of CVD for movers compared to stayers stratified by ethnicity.
First, the paper examines the association between 'mobility' status 9movers versus stayers) and risk of CVD by ethnic group using logistic regression. Second Cox proportional regression is used to compare the risk of CVD for movers who move before their first CVD event with stayers: this accounts for the sequencing of the health and migration events. Finally, sequence analysis is used to evaluate the extent to which risk of CVD varies between mobile groups depending on their deprivation trajectory.