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Residential mobility and potentially avoidable hospitalisations in a population-based cohort of New Zealand children
  1. Kim Nathan1,
  2. Oliver Robertson1,
  3. Polly Atatoa Carr2,
  4. Philippa Howden-Chapman1,
  5. Nevil Pierse1
  1. 1 Department of Public Health, University of Otago Wellington, Wellington, New Zealand
  2. 2 Te Ngira: Institute for Population Research, University of Waikato, Hamilton, New Zealand
  1. Correspondence to Kim Nathan, Department of Public Health, University of Otago Wellington, Wellington 6242, New Zealand; kim.nathan{at}


Background Residential moves are common in early childhood and associations have been found between residential mobility and adverse child health and well-being outcomes. Although there are studies on potentially avoidable hospitalisations (PAH) in children, few have examined PAH in relation to residential mobility. Our aim, therefore, was to investigate residential mobility and PAH in a population-based cohort of New Zealand children.

Methods Using a retrospective cohort design, we analysed data from the Integrated Data Infrastructure for a cohort of 314 283 children born since the start of 2004, who had at least one residential address recorded by 2 years of age. Residential mobility was derived from address data and PAH were determined from hospital discharge data.

Results Half of the cohort children (52%) experienced at least one residential move by 2 years of age, and 22% experienced two or more moves. Fifteen per cent of the cohort experienced one or more PAH between 2 and 4 years of age. A linear association between residential mobility and PAH was found (relative risk (RR)=1.18, CI 1.17 to 1.19) and this remained robust when adjusting for several covariates. Sensitivity analyses for ambulatory care sensitive hospitalisations (ACSH) and PAH attributable to the housing/physical environment (PAH-HE) produced results very similar to those for PAH (ACSH: adjusted RR (aRR)=1.10, CI 1.09 to 1.11; PAH-HE: aRR=1.11, CI 1.10 to 1.12).

Conclusion This study found a linear association between higher residential mobility and an increased likelihood of PAH in young children. Avenues for further investigation are suggested.

  • child health
  • housing
  • public health

Data availability statement

Data may be obtained from a third party and are not publicly available. Due to privacy regulations around the Integrated Data Infrastructure, data from this study are not available for sharing.

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Data availability statement

Data may be obtained from a third party and are not publicly available. Due to privacy regulations around the Integrated Data Infrastructure, data from this study are not available for sharing.

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  • Contributors KN conceptualised the study, undertook the statistical analyses, drafted the manuscript and carried out revisions. OR undertook data curation, including transforming and integrating data for analysis, and critically reviewed the manuscript. PAC, PH-C and NP provided supervision and guidance on the conceptualisation and design of the study, the statistical analyses and the interpretation of results, and critically reviewed the manuscript. All authors approved the final version as submitted and agree to be accountable for all aspects of the work. KN is the study guarantor.

  • Funding This work was supported by a University of Otago Doctoral Scholarship (KN), the Ministry of Business, Innovation and Employment (MBIE) Endeavour Programme Grant - Public Housing and Urban Regeneration: Maximising Wellbeing (grant ID: 20476), and the Health Research Council of New Zealand (grant ID: 20/683).

  • Disclaimer These results are not official statistics. They have been created for research purposes from the Integrated Data Infrastructure (IDI) which is carefully managed by Stats NZ. For more information about the IDI please visit Access to the data used in this study was provided by Stats NZ under conditions designed to give effect to the security and confidentiality provisions of the Statistics Act 1975. The results presented in this study are the work of the author, not Stats NZ or individual data suppliers. The results are based in part on tax data supplied by Inland Revenue to Stats NZ under the Tax Administration Act 1994 for statistical purposes. Any discussion of data limitations or weaknesses is in the context of using the IDI for statistical purposes and is not related to the data’s ability to support Inland Revenue’s core operational requirements.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.