Abstract
Objectives
To explore if risk of cardiovascular disease (CVD) for participants who moved before their first CVD event is higher than for stayers, and examine whether the relationship is moderated by ethnicity.
Methods
The sample comprised 2,068,360 New Zealand residents enrolled in any Primary Health Organisation, aged between 30 and 84 years, had complete demographic information, and no prior history of CVD. Cox proportional regression was used to compare CVD risk between movers and stayers. The analysis was conducted for the whole sample and stratified by ethnicity.
Results
The combined analysis suggested that movers have a lower risk of CVD than stayers. This is consistent for all ethnic groups with some variation according to experience of deprivation change following residential mobility.
Conclusions
Although mobile groups may have a higher risk of CVD than immobile groups overall, risk of CVD in the period following a residential mobility event is lower than for stayers. Results are indicative of a short-term healthy migrant effect comparable to that observed for international migrants.
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References
Bentham G (1988) Migration and morbidity: implications for geographic studies of disease. Soc Sci Med 26:49–54
Blakely T, Ajwani S, Robson B, Tobias M, Bonne M (2004) Decades of disparity: widening ethnic mortality gaps from 1980 to 1999. NZ Med J 117(1199):U995
Boyle P, Norman P, Rees P (2002) Does migration exaggerate the relationship between deprivation and limiting long-term illness? A Scottish analysis. Soc Sci Med 55:21–31
Bradburn MJ, Clark TG, Love SB, Altman DG (2003) Survival analysis part II: multivariate data analysis—an introduction to concepts and methods. BJC 89:431–436
Darlington-Pollock F, Norman P, Lee A, Grey C, Mehta S, Exeter D (2016) To move or not to move? Exploring the relationship between residential mobility, risk of cardiovascular disease and ethnicity in New Zealand? Soc Sci Med 165:128–140
Exeter DJ, Boyle P, Norman P (2011) Deprivation (im)mobility and cause-specific premature mortality in Scotland. Soc Sci Med 72:389–397
Exeter DJ, Sabel CE, Hanham G, Lee AC, Wells S (2015) Movers and stayers: the geography of residential mobility and CVD hospitalisations in Auckland, New Zealand. Soc Sci Med 133:331–339
Finney N (2011) Understanding ethnic differences in the migration of young adults within Britain from a lifecourse perspective. Trans Inst Br Geogr 36(3):455–470
Grey C, Wells S, Riddell T et al (2010) A comparative analysis of cardiovascular disease risk profiles of five Pacific ethnic groups in New Zealand primary practice: PREDICT CVD-13. NZ Med J 123(1325):41–52
Grey C, Jackson R, Wells S, Marshall R, Riddell T, Kerr AJ (2014) Twenty-eight day and one-year case fatality after hospitalisation with an acute coronary syndrome: a nationwide data linkage study. Aust N Z J Public Health 38(3):216–220
Kerr AJ, McLachlan A, Furness S, Broad J, Riddell T, Jackson R, Wells S (2008) The burden of modifiable cardiovascular risk factors in the coronary care unit by age, ethnicity and socioeconomic status—PREDICT CVD-9. NZ Med J 121(1285):20–33
Larson A, Bell M, Young AF (2004) Clarifying the relationships between health and residential mobility. Soc Sci Med 59(10):2149–2160
Levesque LE, Hanley JA, Kezouh A, Suissa S (2008) Problem of immortal time bias in cohort studies: example using statins for prevention progression of diabetes. BMJ 340:908–911
Martikainen P, Sipilä P, Blomgren J, van Lenthe FJ (2008) The effects of migration on the relationship between area socioeconomic structure and mortality. Health Place 14:361–366
Mehta S, Wells S, Riddell T et al (2014) Initiation and maintenance of cardiovascular medications following cardiovascular risk assessment in a larger primary care cohort: PREDICT CVD-16. Eur J Prev Cardiol 21(2):192–202
Mi X, Hammill BG, Curtis LH, Greiner MA, Setoguchi S (2013) Impact of immortal person-time and time scale in comparative effectiveness research for medical devices: a case for implantable cardioverter-defibrillators. J Clin Epidemiol 66(8):S138–S144
Ministry of Health (2004) Ethnicity data protocols for the health and disability sector. Ministry of Health, Wellington
Ministry of Health (2010) Tatau kahukura: Māori health chart book, 2nd edn. Ministry of Health, Wellington
Ministry of Health (2016) Enrolment in a primary health organisation. http://www.health.govt.nz/our-work/primary-health-care/about-primary-health-organisations/enrolment-primary-health-organisation. Accessed Nov 2016
Norman P, Boyle P, Rees P (2005) Selective migration, health and deprivation: a longitudinal analysis. Soc Sci Med 60:2755–2771
Razum O, Zeeb H, Rohrmann S (2000) The ‘healthy migrant effect’—not merely a fallacy of inaccurate denominator figures. Int J Epidemiol 29(1):191–192
Riddell T, Jackson R, Wells S, Broad J, Bannink L (2007) Assessing Māori/non-Māori differences in cardiovascular disease risk and risk management in routine primary care practice using web-based clinical decision support: PREDICT CVD-2. NZ Med J 120(1250):U2445
Salmond C, Crampton P, Atkinson J (2007) NZDep2006 index of deprivation. University of Otago, Wellington
Statistics NZ (2017) Data in the IDI. http://www.stats.govt.nz/browse_for_stats/snapshots-of-nz/integrated-data-infrastructure/idi-data.aspx. Accessed June 2017
Warin B, Exeter DJ, Zhao J, Kenealy T, Wells S (2016) Geography matters: the prevalence of diabetes in the Auckland region by age, gender and ethnicity. NZ Med J 31(8.1):393
Wells S, Riddell T, Kerr A et al (2015) Cohort profile: the PREDICT cardiovascular disease cohort in New Zealand Primary Care (PREDICT-CVD 19). Int J Epidemiol 46(1):22
Yang X, Kong AP, Luk AO, Ozaki R et al (2014) Validation of methods to control for immortal time bias in a pharmacoepidemiologic analysis of renin-angiotensin system inhibitors in type 2 diabetes. J Epidemiol 24(4):267–273
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Ethical approval for this study was first granted by the Multi-Region Ethics Committee in 2011 (ref: MEC/11/EXP/078) with subsequent approvals from the Health and Disabilities Ethics Committee.
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Darlington-Pollock, F., Shackleton, N., Norman, P. et al. Differences in the risk of cardiovascular disease for movers and stayers in New Zealand: a survival analysis. Int J Public Health 63, 173–179 (2018). https://doi.org/10.1007/s00038-017-1011-4
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DOI: https://doi.org/10.1007/s00038-017-1011-4