The Postdiagnosis Mobility of People with AIDS

Abstract

This paper is an analysis of the postdiagnosis mobility of people diagnosed with AIDS (acquired immunodeficiency syndrome) in Florida. I infer intrastate mobility by comparing the county of diagnosis on an individual's AIDS case report with that on the matched death certificate; this allows the measurement of migration within the state of Florida for 4393 people through October, 1989–46% of the total cases by that time. Out-migration rates in rural counties are very high, approximately 50%, whereas those in large metropolitan counties are less than 10%; however, these rates depend on race. The data show that migrants moved to places with concentrations of health-care facilities, and that there is a flow of migrants from rural to urban places, particularly to large metropolitan areas. The results suggest that the spatial distribution of people with AIDS changes in the period after diagnosis, becoming more concentrated in places where there are good health-care facilities. There is descriptive evidence to suggest that the orientation of flows changes with the deteriorating health status of migrants from a distinctly rural to urban axis to a more diffuse pattern, but the statistical test for this change is inconclusive.