Healthy migrants? Limiting long term illness and long distance migration in England

Sam Wilding, University of Southampton
David Martin, University of Southampton
Graham Moon, University of Southampton

Migration, the relocation from one place of residence to another, has intrinsically different meanings depending on the distance moved. Long distance moves impose comparably greater costs on the individual than short distance moves: the abandonment of social ties and greater financial costs. Thus long distance migration is a selective process where degrees of social disadvantage decrease the propensity to migrate over long distances. Poor health is consistently associated with lower rates of long distance migration in the literature. Existing research is primarily based on census data from 1991 and 2001, has not accounted for the clustering of migrants in destinations and has not assessed whether long distance moves tend to be into specific types of areas. We aim to assess whether health status is a significant predictor of long distance migration after overcoming three shortcomings. We use the latest release of census microdata (2010/11), modelling the health differences in long distance migration through a multilevel perspective and assessing residual patterns by area typology. We uncover age-specific health differences in long distance migration patterns; young unhealthy adults are more likely to have moved long distance, whilst older unhealthy adults are less likely to have moved long distance. Residual analysis shows that prosperous areas have high proportions of long distance migrants. We conclude that long distance migration is health-selective and therefore geographical variations in poor health are affected by migration flows. Our findings imply that healthcare commissioning must account for regional patterns of out and in-migration when projecting future healthcare demand.