Annals of Epidemiology
Volume 19, Issue 11 , Pages 834-840, November 2009

Factors Associated With Residential Mobility in Children With Leukemia: Implications For Assigning Exposures

  • Kevin Y. Urayama, MPH

      Affiliations

    • School of Public Health, University of California, Berkeley
    • Corresponding Author InformationAddress correspondence to: Kevin Y. Urayama, MPH, University of California, Berkeley, 2150 Shattuck Avenue, Suite 500, Berkeley, CA 94704. Tel.: 510-642-6398; Fax: 510-643-1735.
    • ,
  • Julie Von Behren, MPH

      Affiliations

    • Northern California Cancer Center, Berkeley
    • ,
  • Peggy Reynolds, PhD

      Affiliations

    • Northern California Cancer Center, Berkeley
    • ,
  • Andrew Hertz

      Affiliations

    • Northern California Cancer Center, Berkeley
    • ,
  • Monique Does, MPH

      Affiliations

    • School of Public Health, University of California, Berkeley
    • ,
  • Patricia A. Buffler, PhD, MPH

      Affiliations

    • School of Public Health, University of California, Berkeley

Received 6 November 2008; accepted 3 March 2009. published online 13 April 2009.

Purpose

In epidemiologic studies, neighborhood characteristics are often assigned to individuals based on a single residence despite the fact that people frequently move and, for most cancer outcomes, the relevant time-window of exposure is not known. The authors evaluated residential mobility patterns for a population-based series of childhood leukemia cases enrolled in the Northern California Childhood Leukemia Study.

Methods

Complete residential history from 1 year before birth to date of diagnosis was obtained for 380 cases diagnosed between 1995 and 2002. All residences were assigned U.S. Census block group designations using a geographic information system.

Results

Overall, two-thirds (65.8%) of children had moved between birth and diagnosis, and one-third (34.5%) moved during the first year of life. Approximately 25% of the mothers had moved during the year before the child's birth. Multivariable analysis indicated greater residential mobility to be associated with older age of the child at diagnosis, younger age of the mother at child's birth, and lower household income. Among those who had moved, residential urban/rural status for birth and diagnosis residences changed for about 20% of subjects, and neighborhood socioeconomic status for 35%.

Conclusions

These results suggest that neighborhood attribute estimates in health studies should account for patterns of residential mobility. Estimates based on a single residential location at a single point in time may lead to different inferences.

Key Words: Childhood Leukemia, Epidemiology, Exposure Classification, Residential Mobility, Socioeconomic Status

Selected Abbreviations and Acronyms: SES, socioeconomic status, NCCLS, Northern California Childhood Leukemia Study, GIS, geographic information system, US, United States, CA, California, MSA, metropolitan statistical area, RR, rate ratios, CI, confidence interval, CMSA, Consolidated Metropolitan Statistical Area

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PII: S1047-2797(09)00072-6

doi:10.1016/j.annepidem.2009.03.001

Annals of Epidemiology
Volume 19, Issue 11 , Pages 834-840, November 2009

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