1. Development and Use of Neighborhood Health Analysis: Residential Mobility in Context Katie Murray, The Providence Plan The Urban Institute April 24, 2003

2. Why Investigate Residential Mobility?  Known levels of mobility in Providence student population – annual snapshot, at least 1 in 4 students stays in Providence but changes residence  Health Dept. perspective: challenges of serving urban mobile populations  Neighborhood strengthening agendas: strategies that will serve mobile families  Prior research confirms impacts of residential mobility on learning and performance. Minimal research of impact on childhood health outcomes  Opportunity to access unique Health Dept. data set for address tracking

3. What is the extent of childhood residential mobility in RI?

4. HEALTH, 1997-2001  Residential mobility impacts whether a child receives continuous care from the same primary care provider. Residential Mobility and Childhood Health Outcomes

5.  Children in mobile families have less contact with any primary care provider than other children. Most notable among children less than 2 years old.  Residential mobility does not affect whether a child received the required 2 blood lead screenings by age 3.  Children born to teens, single women, women with low levels of education or income, and women who received inadequate prenatal care are most likely to experience mobility at a young age.  Two-thirds of mobile children were identified as “development risk positive” at birth by RI Department of Health.

6. Residential Mobility and Educational Outcomes  Students in mobile households are 2-4 times more likely to repeat at least one grade than students who don’t move. Providence School Dept, 1987-2001 Students that repeated at least one grade by number of moves

7. Residential Mobility and Educational Outcomes  Children in residentially stable households are twice as likely to meet the required standards in tests of reading and math than mobile children.  Residential mobility correlate with absenteeism – students who moved missed an average of 19 days of school compared to 13 days for students who did not move.

8. Census Tracts with High Rates of Residential Mobility  Census tracts with extreme residential mobility also exhibited high crime and poverty rates, below average property values, and poor indicators of maternal and child health.

9. As measured by 15 indicators of well-being  Residential Mobility Student Early Childhood  Maternal & Child Health Less than 12 years of education Teen births Delayed prenatal care Insufficient prenatal visits Low birth weight Blood lead exposure  Crime Part I violent Part I property  Income Median family income  Property Characteristics Vacant dwelling units Renter occupancy rates Most Distressed Tracts

10. Next Steps  Phase II: Modeling and analysis with local social epidemiologist  Parent Consultants to have discussions with parents – why do they move?  Tie efforts for outreach to neighborhood based Community Health Centers  Tie into existing family strengthening agendas: Making Connections and Ready to Learn Providence  Revisit developmental risk criteria or more strategically use the criteria to target mothers/newborns needing service

11. Full Report at www.provplan.org