The Influence of Selective Migration Patterns Among Smokers and Nonsmokers on Geographical Inequalities in Health

Abstract

The research reported here uses New Zealand data on smoking behavior that were collected in the 1981, 1996, and 2006 national censuses. Evaluation of the extent to which differential migration patterns among smokers, former smokers, and nonsmokers contributed toward geographical inequalities in health in New Zealand suggests that the effect of selective migration appears to be significant over the long term. This effect includes the arrival of large numbers of nonsmokers from abroad to the most affluent parts of New Zealand. The recording of these events and the high quality of the census in New Zealand provides evidence of one key mechanism whereby geographical inequalities in health between areas can be greatly exacerbated across a country—differential migration by health status. This assertion has important implications for studies monitoring spatial inequalities in health over time, and research investigating “place effects” on health.