Can frequent moves contribute to childhood hospitalizations?

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[June 03, 2016]  By Lisa Rapaport

(Reuters Health) - Kids who move a lot during their first year of life may end up in the hospital more often than children who stay put in the same home, a recent study suggests.

Researchers focused on what they suspect may be preventable emergency department visits for childhood ailments like ear infections, dehydration and dental problems. Problems like this, if properly treated, might not escalate to the point of needing hospital care, the researchers note in the journal Pediatrics.

“Many of these hospitalizations could be avoided by regular contact and engagement with primary health care providers,” said lead study author Hayley Hutchings of Swansea University in the U.K.

“Moving even once may result in severing of links with primary health care providers, which may mean that parents present to the emergency department more often when their child is ill or has been injured because they don’t have links to primary care in place anymore,” Hutchings added by email.

To assess the association between frequent moves and hospitalizations, Hutchings and colleagues analyzed data on residential moves for almost 238,000 Welsh babies in their first year of life emergency department admissions for these kids from age 1 to 5.

Most of the kids in the study didn’t move at all when they were babies. Almost 32,000 of them, or about 13 percent, moved once before their first birthdays. Another 2 percent, or almost 5,000 infants, moved at least twice.

Compared with no moves, children with one relocation in their first year of life were 14 percent more likely to visit the hospital for a potentially preventable problem, the researchers report.

With at least two moves, the increased risk of preventable hospitalizations was 45 percent higher than for not moving at all.

After at least two moves, children were 44 percent more likely to have emergency department admissions for ear, nose and throat infections, the study found.

Kids who moved more than once were also 51 percent more likely to be admitted for dehydration or gastrointestinal problems, 61 percent more likely to have asthma admissions, and 58 percent more likely to visit the hospital for epilepsy or convulsions.

In addition, these frequent movers were 33 percent more likely to have emergency department admissions for injuries and 30 percent more likely to visit the hospital for dental problems.

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The study doesn’t prove that moving causes hospitalizations or that every emergency department admission could be avoided by good primary care, the study team cautions.

Another limitation of the study is that researchers lacked data on the reasons families moved, which could influence children’s health. The study also relied on parents to register changes of address with the National Health Service, which might underestimate the number of times some children relocated.

The motivation for the family move may have health implications for kids, said Katherine Marcal, a researcher in social work at Washington University in St. Louis who wasn’t involved in the study.

“If the family is moving due to enduring financial stress, the child may face additional adversities such as food insecurity, neighborhood violence, or lack of access to health care,” Marcal said by email.

When moving is unavoidable, parents can still take steps to ensure a safe home environment that helps prevent health problems for kids, said Foteini Tseliou, a researcher at Queen’s University in Belfast, Ireland, who wasn’t involved in the study.

“Creating a safe environment for highly mobile families could include minimizing in-house hazards, preserving good housing standards with adequate ventilation to safeguard from respiratory problems, and maintaining a network that can support them through the stress of residential moves both on them and their offspring,” Tseliou said by email.

SOURCE: http://bit.ly/1qyV1oi Pediatrics, online June 3, 2016

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