Adverse Outcomes to Early Middle Age Linked With Childhood Residential Mobility

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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.