Urban-rural variations in health in the Netherlands

Does selective migration play a part?

RA Verheij*, HD van de Mheen, DH de Bakker, PP Groenewegen, JP Mackenbach

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Study objective

Urban-rural health differences are observed in many countries, even when socioeconomic and demographic characteristics are controlled for. People Living in urban areas are often found to be less healthy. One of the possible causes for these differences is selective migration with respect to health or health risk factors. This hypothesis is hardly ever empirically tested. This paper tries to assess the existence of selective urban-rural migration.

Design

Health indicators and health risk factors were measured in a 1991 population sample. Moves were registered between 1991 and 1995. Using logistic regression analyses, comparisons were made between, firstly, urban to rural movers and rural to urban movers and secondly, between movers and stayers.

Setting

Region surrounding the city of Eindhoven in south eastern part of the Netherlands.

Subjects

Data were used of 15 895 respondents aged 20-74 in 1991. By 1995 613 subjects had moved from urban to rural and 191 subjects from rural to urban.

Main results

Bivariate nor multivariate analyses show hardly any differences between movers into urban and movers into rural areas. Bivariate analyses on movers and stayers show that movers are healthier than stayers. However, when socioeconomic and demographic variables are controlled for, movers appear to be less healthy, with the exception of the younger ape groups.

Conclusions

Areas that attract many migrants from and lose few migrants to other degrees of urbanicity will in the long run obtain healthier populations, because of demographic and socioeconomic characteristics. However, if these characteristics are accounted for, the opposite is true, with the exception of younger age groups. In extreme cases this may cause spurious findings in cross sectional research into the relation between urbanicity and health. Absolute numbers of migrants need to be very high, however, to make this noticeable at the aggregate level.

Original languageEnglish
Pages (from-to)487-493
JournalJournal of Epidemiology and Community Health
Volume52
Issue number8
DOIs
Publication statusPublished - 1998
Externally publishedYes

Keywords

  • RESIDENTIAL-MOBILITY
  • UNITED-STATES
  • MORTALITY
  • EXPLANATION
  • MORBIDITY
  • CHILDHOOD
  • CITY

Cite this

Verheij, RA ; van de Mheen, HD ; de Bakker, DH ; Groenewegen, PP ; Mackenbach, JP. / Urban-rural variations in health in the Netherlands : Does selective migration play a part?. In: Journal of Epidemiology and Community Health. 1998 ; Vol. 52, No. 8. pp. 487-493.
@article{3debd8c95d604e6bad7c4117ce7bc87e,
title = "Urban-rural variations in health in the Netherlands: Does selective migration play a part?",
abstract = "Study objectiveUrban-rural health differences are observed in many countries, even when socioeconomic and demographic characteristics are controlled for. People Living in urban areas are often found to be less healthy. One of the possible causes for these differences is selective migration with respect to health or health risk factors. This hypothesis is hardly ever empirically tested. This paper tries to assess the existence of selective urban-rural migration.DesignHealth indicators and health risk factors were measured in a 1991 population sample. Moves were registered between 1991 and 1995. Using logistic regression analyses, comparisons were made between, firstly, urban to rural movers and rural to urban movers and secondly, between movers and stayers.SettingRegion surrounding the city of Eindhoven in south eastern part of the Netherlands.SubjectsData were used of 15 895 respondents aged 20-74 in 1991. By 1995 613 subjects had moved from urban to rural and 191 subjects from rural to urban.Main resultsBivariate nor multivariate analyses show hardly any differences between movers into urban and movers into rural areas. Bivariate analyses on movers and stayers show that movers are healthier than stayers. However, when socioeconomic and demographic variables are controlled for, movers appear to be less healthy, with the exception of the younger ape groups.ConclusionsAreas that attract many migrants from and lose few migrants to other degrees of urbanicity will in the long run obtain healthier populations, because of demographic and socioeconomic characteristics. However, if these characteristics are accounted for, the opposite is true, with the exception of younger age groups. In extreme cases this may cause spurious findings in cross sectional research into the relation between urbanicity and health. Absolute numbers of migrants need to be very high, however, to make this noticeable at the aggregate level.",
keywords = "RESIDENTIAL-MOBILITY, UNITED-STATES, MORTALITY, EXPLANATION, MORBIDITY, CHILDHOOD, CITY",
author = "RA Verheij and {van de Mheen}, HD and {de Bakker}, DH and PP Groenewegen and JP Mackenbach",
year = "1998",
doi = "10.1136/jech.52.8.487",
language = "English",
volume = "52",
pages = "487--493",
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Urban-rural variations in health in the Netherlands : Does selective migration play a part? / Verheij, RA; van de Mheen, HD; de Bakker, DH; Groenewegen, PP; Mackenbach, JP.

In: Journal of Epidemiology and Community Health, Vol. 52, No. 8, 1998, p. 487-493.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Urban-rural variations in health in the Netherlands

T2 - Does selective migration play a part?

AU - Verheij, RA

AU - van de Mheen, HD

AU - de Bakker, DH

AU - Groenewegen, PP

AU - Mackenbach, JP

PY - 1998

Y1 - 1998

N2 - Study objectiveUrban-rural health differences are observed in many countries, even when socioeconomic and demographic characteristics are controlled for. People Living in urban areas are often found to be less healthy. One of the possible causes for these differences is selective migration with respect to health or health risk factors. This hypothesis is hardly ever empirically tested. This paper tries to assess the existence of selective urban-rural migration.DesignHealth indicators and health risk factors were measured in a 1991 population sample. Moves were registered between 1991 and 1995. Using logistic regression analyses, comparisons were made between, firstly, urban to rural movers and rural to urban movers and secondly, between movers and stayers.SettingRegion surrounding the city of Eindhoven in south eastern part of the Netherlands.SubjectsData were used of 15 895 respondents aged 20-74 in 1991. By 1995 613 subjects had moved from urban to rural and 191 subjects from rural to urban.Main resultsBivariate nor multivariate analyses show hardly any differences between movers into urban and movers into rural areas. Bivariate analyses on movers and stayers show that movers are healthier than stayers. However, when socioeconomic and demographic variables are controlled for, movers appear to be less healthy, with the exception of the younger ape groups.ConclusionsAreas that attract many migrants from and lose few migrants to other degrees of urbanicity will in the long run obtain healthier populations, because of demographic and socioeconomic characteristics. However, if these characteristics are accounted for, the opposite is true, with the exception of younger age groups. In extreme cases this may cause spurious findings in cross sectional research into the relation between urbanicity and health. Absolute numbers of migrants need to be very high, however, to make this noticeable at the aggregate level.

AB - Study objectiveUrban-rural health differences are observed in many countries, even when socioeconomic and demographic characteristics are controlled for. People Living in urban areas are often found to be less healthy. One of the possible causes for these differences is selective migration with respect to health or health risk factors. This hypothesis is hardly ever empirically tested. This paper tries to assess the existence of selective urban-rural migration.DesignHealth indicators and health risk factors were measured in a 1991 population sample. Moves were registered between 1991 and 1995. Using logistic regression analyses, comparisons were made between, firstly, urban to rural movers and rural to urban movers and secondly, between movers and stayers.SettingRegion surrounding the city of Eindhoven in south eastern part of the Netherlands.SubjectsData were used of 15 895 respondents aged 20-74 in 1991. By 1995 613 subjects had moved from urban to rural and 191 subjects from rural to urban.Main resultsBivariate nor multivariate analyses show hardly any differences between movers into urban and movers into rural areas. Bivariate analyses on movers and stayers show that movers are healthier than stayers. However, when socioeconomic and demographic variables are controlled for, movers appear to be less healthy, with the exception of the younger ape groups.ConclusionsAreas that attract many migrants from and lose few migrants to other degrees of urbanicity will in the long run obtain healthier populations, because of demographic and socioeconomic characteristics. However, if these characteristics are accounted for, the opposite is true, with the exception of younger age groups. In extreme cases this may cause spurious findings in cross sectional research into the relation between urbanicity and health. Absolute numbers of migrants need to be very high, however, to make this noticeable at the aggregate level.

KW - RESIDENTIAL-MOBILITY

KW - UNITED-STATES

KW - MORTALITY

KW - EXPLANATION

KW - MORBIDITY

KW - CHILDHOOD

KW - CITY

U2 - 10.1136/jech.52.8.487

DO - 10.1136/jech.52.8.487

M3 - Article

VL - 52

SP - 487

EP - 493

JO - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

SN - 0143-005X

IS - 8

ER -