Self-rated health and the "first move" around retirement: a longitudinal study of older Americans.

PURPOSE: I examine whether less favorable self-rated health raises the risk of outmigration more for young-old adults (aged 53-63 at the start of the 10-year longitudinal study in 1994) in nonmetro than metro counties and increases the odds that both groups of outmigrants will choose metro over nonmetro destinations. Finally, I examine whether nonmetro outmigrants are more likely than metro outmigrants to cite a health concern or a desire to get closer to relatives or friends as a reason for the migration.

METHODS: I use the Health and Retirement Study (HRS) to track the main residences of nonmetro and metro older adults from 1994-2003. With a discrete-time Event History Analysis, I assess the joint effects of nonmetro/metro residence in 1994 and self-rated health (updated at each biennial wave) upon the risk of a first migration. Those who migrated were asked to recall why.

FINDINGS: At worse levels of self-rated health, the odds of remaining in a nonmetro county of residence drop in favor of migrating to another nonmetro county. Among migrants, the worse the self-rated health, the higher the odds of within-type migration (nonmetro-nonmetro and metro-metro) over cross-type migration (nonmetro-metro and metro-nonmetro). The percentages of migrants citing a health concern or a desire to live closer to relatives or friends as a reason for migration do not differ by county type of origin.

CONCLUSIONS: An implication for rural health policy is that young-old adults with worse self-rated health tend to remain in nonmetro areas, even when they migrate.