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Research Shows Moving May Increase Your Risk of Chronic Conditions

Woman packing boxes ahead of a move.
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Key Takeaways

  • A person’s risk of an uncontrolled chronic condition increases when they move to a place where that condition is more prevalent.
  • Where a person lives significantly impacts their likelihood of developing poor blood pressure or experiencing depressive symptoms.
  • Moving between counties or states has a greater impact on health outcomes than moving within the same county.

Moving can affect many aspects of a person’s life: their style of housing, the park their kids frequent, their favorite neighborhood restaurant, and even the way they file taxes. Now, scientists say this move can affect their likelihood of developing a chronic health condition too. 

In a study published earlier this month in the Journal of the American Medical Association, researchers tracked the likelihood of a person developing an uncontrolled chronic condition when they moved to a new neighborhood, county, or state. Researchers analyzed data from more than 5 million individuals who had at least one encounter with the Veterans Health Administration (VA) between 2008 and 2018. About one million of these individuals moved once, while the rest stayed put.

Researchers considered four major chronic conditions: obesity, high blood pressure, depressive symptoms, and diabetes.

Researchers found when a person moves, they are likely to see a change in their risk of developing poor blood pressure or experience depressive symptoms. Their risk of developing obesity or diabetes also changes, but not as significantly.

How Common Are Chronic Conditions?

According to the Centers for Disease Control and Prevention (CDC), six out of 10 American adults have a chronic health condition. These are the leading causes of death and disability, and treatment makes up much of the country’s $3.5 trillion annual healthcare costs.

What Is a Chronic Condition?

According to the Department of Health and Human Services, chronic conditions are conditions that last a year or more and require ongoing medical attention and/or limit activities of daily living. Examples include arthritis, depression, and cancer.

The prevalence of these conditions is different across counties and states. For example, the prevalence of people with multiple chronic conditions is 19% in Colorado compared with 38.2% in Kentucky. While the actual location in which people live can influence health outcomes, it's largely the people themselves that lead to this disparity. The residents of Colorado and Kentucky, for example, have different race and age demographics.

Place Matters

There are a number of individual decisions that impact a person’s risk of developing a chronic condition. Alcohol consumption, smoking, exercise, and diet are all factors that can contribute to high blood pressure, obesity, and diabetes. By following individuals as they move, Aaron Baum, PhD, assistant professor of global health at the Icahn School of Medicine at Mount Sinai, who co-authored the study, tells Verywell their model was able to more accurately show how important the actual place of residence was. 

“Ideally, you’d want to put the same person in a different place to see what the impact is on their health, and that’s really the idea behind this study,” Baum, who is also the lead economist at the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, says. “What was surprising to us is there was variation in how much place mattered across different chronic conditions.”

Researchers found that a significant change in likelihood of developing poor blood pressure or depressive symptoms based on a move. For example, when a person moves from a place with lower prevalence of high blood pressure to one with a higher prevalence, their risk increases, too. When people moved between areas, the prevalence of high blood pressure changed by 27.5% (increasing or decreasing, depending on the location). For depressive symptoms, the prevalence fluctuated by 15.2%.

Obesity and diabetes, on the other hand, don’t appear to be as affected by moving. The change in prevalence for these conditions fluctuated by 3.1% and 5%, respectively.

The Destination Matters Too

The study found that for a person who moved within a county, the change in prevalence of chronic conditions was relatively small. But as soon as a person moved to a new county or state, the new environment was more influential in determining health conditions. 

When someone moved from a zipcode with a 10% higher prevalence of chronic conditions compared to the rest of the U.S. to an area with 90% more prevalence of chronic conditions, there was a:

  • 7% increase in uncontrolled blood pressure
  • 2% increase in obesity
  • 1% increase in uncontrolled diabetes
  • 3% increase in depressive symptoms

“That sort of suggests that county-level and state-level factors—policies and other things that occur at those levels—might interplay with each other to influence health conditions,” Baum says. 

“If you’re a policy maker who is hoping to reduce geographic health disparities in the U.S., if you target only individual-level factors like trying to get patients to comply, self-manage, and adhere better to medications for chronic conditions, that’s all well and good,” Baum says. “But to fully eliminate the health disparities, our study suggests that you also have to focus on these contextual factors that are not on the individual level, but are related to the county and state that you live in.”

Ali Mokdad, PhD, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington, says these unknown factors are crucial. 

Decades of research show that socioeconomic conditions in different places are correlated with local health outcomes and mortality rates. A person’s risk of developing chronic conditions depends on their socio-economic status, access to medical care, and the quality of that care. 

“If someone loses their job, they move to a poorer area because it’s less expensive. When they move for a job or something good, they move to a better area,” Mokdad tells Verywell. “You don’t know why people are moving around—you don’t know what’s behind the move and whether they’re moving to a better area or a worse area as determined by their disease or socioeconomic factors.”

This study is another step in the right direction for understanding the role of geography in health outcomes. But, he says, more research is needed to parse out how environmental, socioeconomic, demographic, and other factors contribute to these health outcomes as well.

The data used in this study is also not wholly representative of the U.S. population. More than 90% of those surveyed are men and the median age was 65 years old. This population also receives medical care from the VA, while nearly 28 million non-elderly Americans were uninsured as of 2018.

Baum says there is evidence that trends found from the VA’s dataset are generalizable for men of the same age group who do not receive care from the VA. Additionally, the VA is the only health system that facilitates the movement of electronic data between hospitals in its system—this makes it valuable in understanding the role of geographic mobility on health outcomes. 

Mitigating Risks

Mokdad says this study shows that when someone moves, it’s in the best interest of the healthcare system and the patient to create an easy transition to the new hospital. If it’s left up to the patient, who will be busy handling the complexities of the move, setting up an appointment with their new healthcare provider may be left on the back burner. For those with chronic health conditions, this could create more problems. 

Medical practitioners should “get the knowledge out that if you move, we will help you transfer your medical file and call to make an appointment—we will arrange it for you,” he says. “We want you to stay in the medical system and not miss anything. We know when you move you’re so busy, so we will take care of you.”

In the same way that people planning to move shut their water off at their old address and start service at their new residence, switching to a new medical system should be prioritized as a part of the moving process for people with chronic conditions. 

What This Means For You

If you are planning to move, ask your doctor about how to transfer your medical files and find a new doctor before you go. If you live with a chronic condition, don’t delay in scheduling an appointment at your destination.

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Article Sources
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  1. Baum A, Wisnivesky J, Basu S, Siu AL, Schwartz MD. Association of geographic differences in prevalence of uncontrolled chronic conditions with changes in individuals’ likelihood of uncontrolled chronic conditionsJAMA. 2020;324(14):1429–1438. doi:10.1001/jama.2020.14381

  2. Centers for Disease Control and Prevention. Chronic Diseases in America. Last updated September 24, 2020.

  3. U.S. Department of Health and Human Services. About the Multiple Chronic Conditions Initiative. March 29, 2016.

  4. Centers for Disease Control and Prevention. State and Regional Prevalence of Diagnosed Multiple Chronic Conditions Among Adults Aged ≥18 Years — United States, 2014. July 29, 2016.

  5. Kaiser Family Foundation. Key Facts about the Uninsured Population. December 13, 2019.