RT Journal Article
SR Electronic
T1 Toward the next generation of research into small area effects on health: a synthesis of multilevel investigations published since July 1998
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 853
OP 861
DO 10.1136/jech.2006.050740
VO 61
IS 10
A1 Mylène Riva
A1 Lise Gauvin
A1 Tracie A Barnett
YR 2007
UL http://jech.bmj.com/content/61/10/853.abstract
AB To map out area effects on health research, this study had the following aims: (1) to inventory multilevel investigations of area effects on self rated health, cardiovascular diseases and risk factors, and mortality among adults; (2) to describe and critically discuss methodological approaches employed and results observed; and (3) to formulate selected recommendations for advancing the study of area effects on health. Overall, 86 studies were inventoried. Although several innovative methodological approaches and analytical designs were found, small areas are most often operationalised using administrative and statistical spatial units. Most studies used indicators of area socioeconomic status derived from censuses, and few provided information on the validity and reliability of measures of exposures. A consistent finding was that a significant portion of the variation in health is associated with area context independently of individual characteristics. Area effects on health, although significant in most studies, often depend on the health outcome studied, the measure of area exposure used, and the spatial scale at which associations are examined.