Residential Mobility and Child and Maternal Health

According to recent figures from U.S. Census Bureau Geographic Mobility data almost one in five of all children ages 1-4 moved in 2016 and up to 75% of children move at least one time by the age of 5. Those children also demonstrate health deficits (Jelleyman & Spencer 2008; Leventhal & Newman 2010). The prevalence of residential mobility among the children in early childhood through adolescence and the subsequent links with health points to a critical unmet need in the lives of residentially mobile children and their mothers. This proposed project has several goals and objectives and hypotheses regarding residential mobility among children and their mothers. The study's first goal is to identify the links between residential mobility and child and maternal health care access health conditions and mental health and wellbeing when the children are in infancy through adolescence using rigorous research methods to address selection bias. The second goal is to examine cascades of relations - in other words are links with residential and child and maternal health outcomes then in turn related to other child and maternal health outcomes. The study's third goal seeks to determine the cross-over or interdependent effects from child or maternal health then to maternal to child health at a later point in time. We will employ data from the Fragile Families and Child Wellbeing Study a longitudinal study that followed children and mothers for 15 years starting when the children were born. Data were collected at regular intervals allowing for a detailed examination of the timing of residential mobility and current and later consequences for health. Fragile Families consists of a sample of approximately 3 000 children born to primarily unwed mothers in 20 urban areas. The sample is socioeconomically racially and ethnically diverse. Residential mobility cannot be experimentally manipulated; accordingly we will employ propensity score methods to match to the extent possible children (and their mothers) who moved with those who have not. In addition we will employ multiple imputation to address missing data inherent in any longitudinal studies. We will propensity-score weighted multiple regression for our first goal to ascertain the links between residential mobility and child and maternal health. Then we will use path modeling techniques to determine how initial associations between residential mobility and health persist and lead to related health outcomes over time by developmental period and for mothers and children. Products will include two peer-reviewed publications two blog posts and accompanying social media posts to ensure broad reach to expert and lay audiences. Accompanying these products will be targeted outreach to relevant stakeholders such as professional organizations and providers invested in improving child and maternal health through mitigating adverse social determinants of health. We will evaluate the progress of this project by closely monitoring project timelines and deliverables and will ensure broad reach by monitoring the number of product downloads and social media shares. This project will address MCHB Strategic Research Principles 1 (improve maternal and child health infrastructure) 3 (promote healthy development and well-being of children) and 4 (promoting the health and well-being of families). First (Principle 1) the project will help identify mechanisms to improve access to regular health care among mobile mothers and children. In terms of Principles 3 and 4 we will examine how health disparities emerge among residentially mobile children and mothers to suggest points of intervention to promote health among these families