Can You Move to Better Health?

How does housing affect our health? What motivates our housing choices? Can health be improved by moving to a 'better' environment?

[This article was written by Apolline Saucy (Postdoctoral Researcher) and Cathryn Tonne (Associate Research Professor).]

Can you remember the last time you moved? I can definitely remember my last move and it involved a lot of boxes, sweat, dust and a takeaway pizza to celebrate a successful day. Moving home is often a major life event and can mean significant changes in daily routines. For young people, moving away from home can be a symbol of newfound independence. Others may choose to move in preparation for the arrival of a new family member. For still others, moving may be the result of a change of job, country, age or loss of autonomy. But have you ever thought about how this change might affect your health?

How the Places We Choose to Live (or Can Afford to Live) Affect Our Health

For many years, people have been studying how we interact with our environment and how it can affect our behaviour and health. For example, people living in highly polluted areas have a higher risk of asthma, heart attacks and even reduced life expectancy. Similarly, a lack of public transport and safe neighbourhoods can limit opportunities for active transport and healthier lifestyles. Most importantly, we are not all equal when it comes to environmental hazards. Personal finances are an important factor in choosing where to live, as the most desirable - and often healthier - places to live come at a higher cost.

In the EXPANSE project, we wanted to understand how the places people choose to live (or can afford to live) affect environmental exposures, health and health inequalities. To do this, we followed children and adults who moved house to understand how their living conditions improved or worsened when they moved.

EXPANSE is a five-year European research project that aims to answer one of the most important questions facing urban planners, policy makers and residents in Europe: How can we maximise our health in modern urban environments?

Our project, led by Cathryn Tonne, focuses on the development and evaluation of intervention strategies to prevent cardio-metabolic and pulmonary diseases. We use physical activity as a natural experiment to understand how we can promote health by modifying different aspects of the urban exposome at population and individual levels.

In our study:

• People mostly moved to new environments that were similar to their original home, not better or worse. However, moving to healthier environments was more common among families with young children, especially those with higher parental education.
• Among adults, we also saw that people with higher education were more likely to move to greener and more privileged neighbourhoods, but sometimes also to more polluted ones.
• In general, age and life stage were important factors in the decision to move and the choice of where to live.
• Moving to healthier urban environments was largely determined by individual and family socio-economic situation.
• We also found that individual socio-demographic characteristics were more important in determining where people moved than whether they had a pre-existing chronic disease (e.g. heart disease, cancer, which may motivate people to live closer to health services).

Source: Effect of residential relocation on environmental exposures in European cohorts: An exposome-wide approach, Environment International, 2023.

Health Can Be Improved by Moving to a 'Better' Environment

Living environments are more complex than a set of environmental hazards that are either good or bad for health. Dense and walkable city centres can provide good access to services and opportunities for exercise and socialising, but they are often affected by higher concentrations of traffic-related pollution and noise. Our research uses the concept of the 'urban exposome', which reflects this complexity by considering the combined effects of different aspects of the living environment, including physical hazards, but also its built and social characteristics.

In the next phase of our study, we will investigate whether improving the urban exposome by moving can also reduce childhood obesity and other adverse health outcomes. Demonstrating that health can be improved by moving to a 'better' environment is crucial for public health and urban planning, as it will inform both which interventions targeting the living environment can lead to direct health improvements, and the potential reversibility of adverse health outcomes associated with these changes. Unfortunately, not everyone has the luxury of moving to a healthier environment, but this research can inform which urban and transport planning strategies may be most important in improving environmental health and health equity.

Read more about our study: Effect of residential relocation on environmental exposures in European cohorts: An exposome-wide approach.