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Paul Norman, University of Leeds
(Project no. 401001)
Background:
There is growing evidence that selective sorting has a role in changing health-deprivation relationships (Boyle et al. 2004; Norman et al. 2005; Boyle et al. 2009). Various forms of 'selection' exist including social selection and health selection (Bartley 2004; Marmot 2004). In terms of their health, people may have (dis-) advantageous characteristics and/or live in (dis-) advantageous places. Over time, some people's characteristics and locations may change and some people's circumstances may stay the same. Stable circumstances (whether good or bad) or transitions to better or worse situations may be due to selection effects. The function of health as cause or effect in selection is unclear. The causal direction could be either way: health may influence socioeconomic position but social circumstances may affect health (Blane 1999) but it seems more likely that, for example, unemployment leads to poor health than vice versa (Moser et al. 1984).
Previous work on the topic:
This project will update previous projects (10347 & 30033) which used the ONS Longitudinal Study (LS) to investigate the role of health selective migration in influencing whether the health-deprivation relationship changes over time (Norman et al. 2005; Boyle & Norman 2009). The balance of evidence to date suggests that migrants in good health moving to less deprived areas and migrants with poor health either moving to or being 'stuck' in more deprived at least maintain and can exaggerate the health inequalities between differently deprived areas. Recent research finds age-dimensions to these relationships (Norman & Boyle 2013). Not all studies find the same effects though (e.g. Popham et al. 2011 for Glasgow) and some elements are yet to be clarified such as the role of time (Curtis et al. 2009) and of geographic scale (Brown & Leyland 2010).
Proposed work:
The main research avenue will determine whether, using the transitions from origin to destination for the time-frame 2001 to 2011 (and then 1991 to 2011), there is a difference in health outcomes for those persons who move from more to less deprived areas in comparison with those who move from less to more deprived areas and with those persons who stay in the same type of area. The focus would be on a study population present at successive censuses and would comprise all persons but will most likely work with a subset of household residents (excluding communal establishment residents). Other research avenues will consider the relationship between distance moved and health and whether there are health differences for recent and longer-term immigrants.
Area characteristics:
This project will supply various lookup tables which will be attached to LS member records. These will include ward level Carstairs deprivation and population density measures for residential areas at successive censuses. Further lookup tables will be supplied which link the area of residence of LS members for previous censuses to more recent geographies so that trends can be described in a contemporary manner.
References:
Bartley M (2004) Health inequality: an introduction to theories, concepts and methods. Polity: Cambridge
Blane D (1999) The life course, the social gradient, and health. In Marmot M & Wilkinson R (eds.) Social Determinants of Health. Oxford University Press: Oxford
Boyle P & Norman P (2009) Migration and health. Chapter 19 in The Companion to Health and Medical Geography Brown T, McLafferty S & Moon G (eds.). Wiley-Blackwell: Chichester: 346-374
Boyle P, Norman P & Popham F (2009) Social mobility: evidence that it can widen health inequalities. Social Science & Medicine 68(10): 1835-1842
Boyle P, Norman P & Rees P (2004) Changing places: do changes in the relative deprivation of areas influence limiting long-term illness and mortality among non-migrant people living in non-deprived households? Social Science & Medicine. 58: 2459-2471
Brown, D., & Leyland, A.H. (2010). Scottish mortality rates 2000-02 by deprivation and small area population mobility. Social Science & Medicine, 71(11): 1951-1957
Curtis S, Setia M S & Quesnel-Vallee A (2009) Socio-geographic mobility and health status: A longitudinal analysis using the National Population Health Survey of Canada. Social Science & Medicine, 69(12), 1845-1853
Marmot M (2004) Status Syndrome: how your social standing directly affects your health. Bloomsbury: London
Moser K A, Fox A J & Jones D R (1984) Unemployment and mortality in the OPCS Longitudinal Study. Lancet 2 1324-29
Norman P & Boyle P (2013) Are health inequalities evident at all ages? Cross-sectional and longitudinal studies of the England & Wales Census. European Journal of Public Health (submitted)
Norman P, Boyle P & Rees P (2005) Selective migration, health and deprivation: a longitudinal analysis. Social Science & Medicine 60(12): 2755-2771
Popham, F., Boyle, P.J., O'Reilly, D., & Leyland A. H. (2011) Selective internal migration. Does it explain Glasgow's worsening mortality record? Health & Place 17 1212-1217