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Moving can be hazardous to your child's health

Adverse effects were found in adults who had to change homes in childhood, according to a long-term study of 1.4 million Danish children.

This unique residential mobility study tracked 1.4 million people from their 15th birthdays until their early forties. This extensive, long-term study followed Danish children into adulthood showing that moving to a new home during childhood increased their likelihood for multiple adverse adult outcomes.

The study appears in the American Journal of Preventive Medicine.

Data was collected on all people born in Denmark from 1971 to 1997 — including documenting every residential childhood move from birth to 14 years. Each move was associated with the age of the child so that the impact of early-in-life moves could be contrasted with moves during the early teen years.

With a number of comprehensive national registries at their disposal, the team of researchers was able to measure and correlate subsequent negative events in adulthood, including attempted suicide, violent criminality, psychiatric illness, substance misuse, and natural and unnatural deaths.

"Owing to its uniquely complete and accurate registration of all residential changes in its population, Denmark is the only country where it is currently possible to conduct such a comprehensive national investigation of childhood residential mobility and risk of adverse outcomes in later life," explained lead investigator Roger T. Webb, PhD, Centre for Mental Health and Safety, University of Manchester (UK).

Risk of adverse outcomes from residential mobility in childhood was classified into three categories: (1) self-directed and interpersonal violence: including attempted suicide or violent criminality, (2) mental illness and substance misuse or any psychiatric diagnosis including substance misuse, and (3) premature mortality by natural or unnatural means.

Thirty-seven percent of people studied relocated across a municipal boundary at least once before reaching their 15th birthdays, with multiple relocations occurring most frequently during infancy.

Across all adverse outcomes studied, the highest risks were among individuals who moved frequently during early adolescence.

Statistical analysis was particularly strong. With each additional house move, there was a risk increase. For example, data analysis showed risk increased with multiple moves at any age versus a single move. And, a sharp spike in risk for violent offense was observed following multiple relocations within a single year. The attempted suicide risk also increased steadily with rising age at the time of the move, and was markedly raised if multiple annual relocations occurred during early adolescence (12-14 years of age).

Interestingly the initial theory that adverse outcomes might be more prevalent in households with lower socioeconomic status (SES) was not borne out by this study. Instead, very elevated risk due to residential moves from early through mid adolescence applied to all SES levels.

"Childhood residential mobility is associated with multiple long-term adverse outcomes. Although frequent residential mobility could be a marker for familial psychosocial difficulties, the elevated risks were observed across the socioeconomic spectrum, and mobility may be intrinsically harmful.

"Health and social services, schools, and other public agencies should be vigilant of the psychological needs of relocated adolescents, including those from affluent as well as deprived families."

Roger T. Webb PhD, Centre for Mental Health and Safety, University of Manchester, United Kingdom and lead investigator.

Abstract Introduction
Links between childhood residential mobility and multiple adverse outcomes through to maturity, and effect modification of these associations by familial SES, are incompletely understood.

A national cohort of people born in Denmark in 1971–1997 were followed from their 15th birthdays until their early forties (N=1,475,030). Residential moves during each age year between birth and age 14 years were examined, with follow-up to 2013. Incidence rate ratios for attempted suicide, violent criminality, psychiatric illness, substance misuse, and natural and unnatural deaths were estimated. The analyses were conducted during 2014–2015.

Elevated risks were observed for all examined outcomes, with excess risk seen among those exposed to multiple versus single relocations in a year. Risks grew incrementally with increasing age of exposure to mobility. For violent offending, attempted suicide, substance misuse, and unnatural death, sharp spikes in risk linked with multiple relocations in a year during early/mid-adolescence were found. With attempted suicide and violent offending, the primary outcomes, a distinct risk gradient was observed with increasing age at exposure across the socioeconomic spectrum.

The links between childhood residential mobility and negative outcomes in later life appear widespread across multiple endpoints, with elevation in risk being particularly marked if frequent residential change occurs during early/mid-adolescence. Heightened vigilance is indicated for relocated adolescents and their families, with a view to preventing longer-term adverse outcomes in this population among all socioeconomic groups. Risk management will require close cooperation among multiple public agencies, particularly child, adolescent, and adult mental health services.
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Across all adverse outcomes studied, the highest risks were among
individuals who moved frequently during early adolescence..
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