Are the Sick Left Behind at the Peripheries? Health Selection in Migration to Growing Urban Centres in Finland
- PDF / 1,277,897 Bytes
- 26 Pages / 439.37 x 666.142 pts Page_size
- 22 Downloads / 165 Views
Are the Sick Left Behind at the Peripheries? Health Selection in Migration to Growing Urban Centres in Finland Maria Vaalavuo1 · Mikko‑Waltteri Sihvola1,2 Received: 14 November 2019 / Accepted: 18 September 2020 © The Author(s) 2020
Abstract We study health selection in rural–urban migration in Finland using register data. Specifically, we ask whether ‘movers’ differ from ‘stayers’ in their use of special health care services prior to moving. We focus on migration to twelve growing urban centres in different sub-groups of the population as well as in different regions, using multinomial logistic regression and multilevel modelling and by distinguishing between short- and long-distance moves. The results show that urban centres attract healthier individuals, while people with health problems are also prone to move, but not to urban centres. The results were similar when looking only at psychiatric diagnoses. The findings suggest that it is important to distinguish between different types of moves when studying health-selective migration. Studying the patterns of migration according to health enables us to understand drivers of regional health differences. Moreover, such evidence will help in projecting future demand for healthcare across the country. Keywords Internal migration · Health care use · Health selection · Mobility · Register data · Urbanisation
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s1068 0-020-09568-8) contains supplementary material, which is available to authorized users. * Maria Vaalavuo [email protected] Mikko‑Waltteri Sihvola [email protected] 1
Centre for Health and Social Economics, Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland
2
Present Address: Statistics Finland, Helsinki, Finland
13
Vol.:(0123456789)
M. Vaalavuo, M.-W. Sihvola
1 Introduction The role of place, residential mobility and migration in health production, health care consumption, and health outcomes are increasingly important in the context of urbanisation. They can affect how health is distributed geographically as well as how services are accessed and used. We already know that there is important variation in the health status of individuals and healthcare expenditure across regions within countries (Smyth 2008; Skinner 2011). Furthermore, evidence shows that migration and demand-side factors are important for understanding these geographical differences (Moura et al. 2019). However, there are also contradictory findings on the associations between health and mobility. Some studies have shown that there is a positive association between poor health and shortdistance residential mobility as well as long-distance internal migration (Larson et al. 2004; Tunstall et al. 2014; Green et al. 2015), while others argue the opposite, in that movers are likely to be healthier than those who do not move (Boyle et al. 2002; Andersson and Drefahl 2016; Wilding et al. 2018). It is often difficult to compare existing studi
Data Loading...
