Development and Use of Neighborhood Health Analysis:Residential Mobility in Context

Katie Murray, The Providence PlanThe Urban Institute April 24, 2003

Why Investigate Residential Mobility?

Known levels of mobility in Providence student population – annual snapshot, at least 1 in 4 students stays in Providence but changes residence

Health Dept. perspective: challenges of serving urban mobile populations

Neighborhood strengthening agendas: strategies that will serve mobile families

Prior research confirms impacts of residential mobility on learning and performance. Minimal research of impact on childhood health outcomes

Opportunity to access unique Health Dept. data set for address tracking

What is the extent of childhood residential mobility in RI?

Residential Mobility among Providence Public School Students, 1987-2001

n=57,642

53%

23%

12%

7%

3% 3%

0 moves 1 move 2 moves 3 moves 4 moves 5-11moves

Residential Mobility among Children in KidsNet System, 1997-2001 births

n=65,795

66%

22%

7%

3%1% <1%

0 moves 1 move 2 moves 3 moves 4 moves 5-7moves

HEALTH, 1997-2001

Residential mobility impacts whether a child receives continuous care from the same primary care provider.

Residential Mobility and Childhood Health Outcomes

Residential Mobility and Number of Different Primary Care Providers

84%

77% 76%74%

16%

20%23% 24%

26%

80%

0 moves 1 move 2 moves 3 moves 4+ moves

1 provider

2 or more providers

Residential Mobility and Childhood Health Outcomes

Children in mobile families have less contact with any primary care provider than other children. Most notable among children less than 2 years old.

Residential mobility does not affect whether a child received the required 2 blood lead screenings by age 3.

Children born to teens, single women, women with low levels of education or income, and women who received inadequate prenatal care are most likely to experience mobility at a young age.

Two-thirds of mobile children were identified as “development risk positive” at birth by RI Department of Health.

Residential Mobility and Educational Outcomes Students in mobile households are 2-4 times more likely to repeat at least one grade than students who don’t move.

Providence School Dept, 1987-2001

13%

39%

47%

55%

61%

73%

26%

No moves 1 move 2 moves 3 moves 4 moves 5 moves 6+ moves

Students that repeated at least one grade by number of moves

Residential Mobility and Educational Outcomes

Children in residentially stable households are twice as likely to meet the required standards in tests of reading and math than mobile children.

Residential mobility correlate with absenteeism – students who moved missed an average of 19 days of school compared to 13 days for students who did not move.

19

29

34

2928

36 3521

22

23

27

3126

25

32

22

23

2522

23

2520

614

16

30N/A

33

24

11

24

33

30N/A

16

146

20 25

23

22 25

23

22

32

25

2631

27

23

22

213536

2829

34

29

1213

17

3718

15

3

7

2

10 11

8

4

5

9

Early childhood mobility

Early childhood and student residential mobility

Student mobility

Shading denotes tracts where mobility exceeded 1SD of city average:

Census Tracts More than One Standard Deviation above the City Average in Residential Mobility

Census Tracts with High Rates of Residential Mobility

Census tracts with extreme residential mobility also exhibited high crime and poverty rates, below average property values, and poor indicators of maternal and child health.

24

21

23

27 30N/A

33

32

31

34

35

28 29

20

18

1716

151

22

19

13

14

12

3

2

5

64

7

8

36

37

26

25

9

1110

Census Tracts More than One Standard Deviation above the City Average in Selected Areas of Child Health and Neighborhood Well-Being

0123

456*7

Cumulative factors where tract exceeds 1 SD of city average

*Note: no tract exceeded the city average in six areas

As measured by 15 indicators of well-being

Residential Mobility Student Early Childhood Maternal & Child HealthLess than 12 years of educationTeen birthsDelayed prenatal careInsufficient prenatal visitsLow birth weightBlood lead exposure CrimePart I violentPart I property IncomeMedian family income Property CharacteristicsVacant dwelling unitsRenter occupancy rates

Most Distressed Tracts

Next Steps

Phase II: Modeling and analysis with local social epidemiologist

Parent Consultants to have discussions with parents – why do they move?

Tie efforts for outreach to neighborhood based Community Health Centers

Tie into existing family strengthening agendas: Making Connections and Ready to Learn Providence

Revisit developmental risk criteria or more strategically use the criteria to target mothers/newborns needing service

Full Report at www.provplan.org