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Using agent-based modelling to test hypotheses on the role of neighbourhood social mechanisms in the development of small-area health inequalities
  1. Kim Alexandra Zolitschka1,
  2. Oliver Razum1,
  3. Odile Sauzet1,2
  1. 1Epidemiology & International Public Health, Bielefeld University, Bielefeld School of Public Health (BiSPH), Bielefeld, Germany
  2. 2Data Analysis Group, Department of Business Administration and Economics, Bielefeld University, Bielefeld, Germany
  1. Correspondence to Dr Odile Sauzet, Bielefeld school of Public Health, Bielefeld University, Bielefeld, Germany; odile.sauzet{at}uni-bielefeld.de

Abstract

Background Small-area health inequalities may originate from differentials in the spatial distribution of environmental stressors on health. The role played by neighbourhood social mechanisms on small-area health inequalities is difficult to evaluate. We demonstrate that agent-based modelling (ABM) is a useful technique to overcome existing limitations. It allows testing hypotheses that social contagion has the potential to modify the effects of environmental stressors by reducing or increasing small-area health inequalities.

Methods Parameters defining the strength of the effect of social contagion on health behaviour were used together with a stochastic model to obtain for every year the health outcome of every agent based on health the previous year, environmental stressors and health behaviour. Unequal spatial distribution of stressors was operationalised with spatial correlation structure. We measured changes in health inequalities using parameters of the spatial correlation structure of health after 10 years. In a further round of simulations, social contagion depended on the environmental stressors.

Results A social contagion mechanism led to a reduction of small-area health inequalities together with an increase in the spatial reach of the effect of environmental stressors. An association between environmental stressor and social contagion mechanism led to a stronger localisation of the effect of environmental stressors.

Conclusions Hypotheses about the role of neighbourhood social mechanisms can be tested using ABM. The respective models provide a better understanding of mechanisms in the causal chain between environmental stressors and health inequalities. This can pave the way to the development of a new type of neighbourhood-based intervention informed by social mechanisms.

  • Health inequalities
  • RESEARCH DESIGN
  • ENVIRONMENTAL HEALTH

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Footnotes

  • Contributors OS and OR conceptualised the study and contributed to the manuscript. KAZ performed, and analysed the simulations, and wrote a first draft of the manuscript. OS is the guarantor of this work.

  • Funding This work was supported by Deutsche Forschungsgemeinschaft (DFG), grant number 336562538.

  • Disclaimer The funder played no role in study design, analysis and reporting.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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