title: Residential movement patterns of families of young children with chronic conditions in Ontario, Canada: a population-based cohort study.
abstract: BACKGROUND
  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.
authors: Eyal
authors: E
authors: Cohen
authors: Nicole
authors: N
authors: Yantzi
authors: Jun
authors: J
authors: Guan
authors: Kelvin
authors: K
authors: Lam
authors: Astrid
authors: A
authors: Guttmann
mesh_terms: D000704:Analysis of Variance; D001249:Asthma; D002170:Canada; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007230:Infant, Low Birth Weight; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012135:Respiratory Sounds; D012189:Retrospective Studies
references: J Dev Behav Pediatr. 1992 Aug;13(4):248-55
references: 1506462
references: Spinal Cord. 2010 Jan;48(1):45-50
references: 19546877
references: Pediatrics. 2012 Dec;130(6):e1463-70
references: 23184117
references: Nurs Res. 1988 Jul-Aug;37(4):196-201
references: 3293024
references: Health Place. 2010 May;16(3):452-60
references: 20060767
references: Arch Pediatr Adolesc Med. 2009 Jul;163(7):608-15
references: 19581543
references: CMAJ. 2008 Apr 22;178(9):1177-80
references: 18427094
references: CMAJ. 2004 Jul 20;171(2):139-45
references: 15262882
references: Spinal Cord. 2009 Aug;47(8):604-9
references: 19274059
references: Pediatrics. 2009 Dec;124 Suppl 4:S352-60
references: 19948599
references: Pediatrics. 2002 Apr;109(4):656-60
references: 11927711
references: Birth Defects Res A Clin Mol Teratol. 2011 Dec;91(12):1011-8
references: 22002854
references: Arch Pediatr Adolesc Med. 2001 Nov;155(11):1219-24
references: 11695930
references: J Behav Med. 1980 Jun;3(2):123-45
references: 7420418
references: Health Place. 1999 Jun;5(2):157-71
references: 10670997
references: Health Place. 2006 Dec;12(4):570-9
references: 16168702
references: Pediatrics. 2009 Jan;123(1):413-6
references: 19117909
references: Pediatrics. 2000 Jul;106(1 Pt 2):205-9
references: 10888693
references: Int J Environ Res Public Health. 2013 Mar 28;10(4):1312-23
references: 23538728
references: Issues Compr Pediatr Nurs. 2002 Jul-Sep;25(3):167-88
references: 12230829
references: J Pediatr Nurs. 1993 Aug;8(4):226-32
references: 8410643
references: Soc Sci Med. 2003 Sep;57(6):1091-7
references: 12878108
references: Soc Sci Med. 2008 Oct;67(8):1331-9
references: 18639967
references: Pediatrics. 2008 Oct;122(4):e922-37
references: 18829788
references: J Intellect Disabil Res. 2003 May-Jun;47(Pt 4-5):217-30
references: 12787154
references: Soc Sci Med. 2001 Jun;52(12):1777-91
references: 11352405
references: Pediatr Allergy Immunol. 2006 Feb;17(1):69-76
references: 16426258
references: Arch Pediatr Adolesc Med. 2011 Nov;165(11):1020-6
references: 22065182
references: BMJ. 2003 Nov 22;327(7425):1219-21
references: 14630762
references: Pediatrics. 2009 Jun;123(6):e996-1004
references: 19482751
references: Am J Public Health. 1998 Apr;88(4):610-7
references: 9551003