Predictors of early life residential mobility in urban and rural Pennsylvania children with acute lymphoblastic leukemia and implications for environmental exposure assessment.

Autor: Clark CJ; Yale School of Public Health, Department of Environmental Health Sciences, 60 College St., New Haven, CT, 06510, USA. cassie.clark@yale.edu., Warren JL; Yale School of Public Health, Department of Biostatistics, 60 College St., New Haven, CT, 06510, USA., Saiers JE; Yale School of the Environment, 195 Prospect Street, New Haven, CT, 06511, USA., Ma X; Yale School of Public Health, Department of Chronic Disease Epidemiology, 60 College St., New Haven, CT, 06510, USA., Bell ML; Yale School of the Environment, 195 Prospect Street, New Haven, CT, 06511, USA., Deziel NC; Yale School of Public Health, Department of Environmental Health Sciences, 60 College St., New Haven, CT, 06510, USA.
Jazyk: angličtina
Zdroj: Journal of exposure science & environmental epidemiology [J Expo Sci Environ Epidemiol] 2024 Nov; Vol. 34 (6), pp. 990-999. Date of Electronic Publication: 2023 Dec 26.
DOI: 10.1038/s41370-023-00636-9
Abstrakt: Background: Residential mobility can introduce exposure misclassification in pediatric epidemiology studies using birth address only.
Objective: We examined whether residential mobility varies by sociodemographic factors and urbanicity/rurality among children with cancer.
Methods: Our study included 400 children born in Pennsylvania during 2002-2015 and diagnosed with leukemia at ages 2-7 years. Addresses were obtained from state registries at birth and diagnosis. We considered three aspects of mobility between birth and diagnosis: whether a child moved, whether a mover changed census tract, and distance moved. We evaluated predictors of these aspects in urban- and rural-born children using chi-square, t-tests, and regression analyses.
Results: Overall, 58% of children moved between birth and diagnosis; suburban/rural-born children were more likely to move than urban-born children (67% versus 57%). The mean distance moved was 16.7 km in suburban/rural-born and 14.8 km in urban-born movers. In urban-born children, moving between birth and diagnosis was associated with race, education, participation in the Nutrition Program for Women, Infants and Children (WIC), and census tract-level income (all χ 2 p < 0.01). Urban-born movers tended to be born in a census tract with a higher Social Vulnerability Index than non-movers (t-test p < 0.01). No factors were statistically significantly associated with any of the residential mobility metrics in suburban/rural-born children, although the sample size was small.
Impact Statement: In this study of a vulnerable population of children with cancer, we found that rural-born children were more likely to move than urban-born children, however, the frequency of movers changing census tracts was equivalent. Mobility in urban-born children, but not rural-born, was associated with several social factors, although the sample size for rural-born children was small. Mobility could be an important source of misclassification depending on the spatial heterogeneity and resolution of the exposure data and whether the social factors are related to exposures or health outcomes. Our results highlight the importance of considering differences in mobility between urban and rural populations in spatial research.
Competing Interests: Competing interests: The authors declare no competing interests. Ethical approval: The study protocol was approved by the Institutional Review Board of Yale University (HIC #2000021809) and the Pennsylvania Department of Health (IF-0430) and reviewed and approved by the US Environmental Protection Agency (HSR-001162).
(© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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