Residential movement patterns of families of young children with chronic conditions in Ontario, Canada: a population-based cohort study

International Journal for Equity in Health

Astrid Guttmann¹  Kelvin Lam³  Jun Guan³  Nicole Yantzi²  Eyal Cohen¹ 

[1] Division of Pediatric Medicine, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada;Department of Environmental Studies, Laurentian University, Sudbury, ON, Canada;Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

关键词: Children;    Geography;    Chronic conditions;    Socioeconomic status;    Health services research;    Health;    Socio-economic;    Complex chronic conditions;    Chronic diseases;    Movement;   

Others  :  811627
DOI  :  10.1186/1475-9276-12-62

 received in 2013-01-03, accepted in 2013-07-13,  发布年份 2013

【 摘 要 】

Introduction

Care giving for children with chronic diseases can lead to financial strain and compromised family well being. Little is known about whether these stresses lead to changes in residential movement patterns as they relate to income adequacy and proximity to care.

Methods

We compared the residential movement patterns and associated changes in neighbourhood income of children with mild to severe chronic diseases compared with those that are healthy. A cohort of infants born from 2002–2007 in Ontario, Canada was followed for 5 years and divided into those with single- or multiple- body system complex chronic conditions (CCCs); low birth weight (LBW); asthma/recurrent wheeze (A/RW) and the control group of otherwise healthy children.

Results

Of 598,716 children studied, 15,207 had a single CCC, 3,600 multiple CCCs, 33,206 LBW, 57,137 A/RW and 489,566 were healthy. Lowest income quintile children were most likely to move residence. Compared with healthy controls, chronic disease cohorts, apart from those with asthma, were more likely to be born in the lowest income quintile neighbourhood and to move. Among children who moved, all chronic disease cohorts were significantly more likely to move to a low income quintile neighborhood (adjusted odds ratios for all chronic disease cohorts of 1.1-1.2). There were no differences across cohorts in residential movement close to a children’s hospital.

Conclusions

Young children with chronic conditions, particularly those born in low income neighbourhoods, are more likely to move residence than other healthy young children. However, it does not seem that proximity to specialized care is driving this movement. Further research is required to determine if these movement patterns impact the ability of children with chronic conditions to secure health services.

【 授权许可】

   
2013 Cohen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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