Modelling the Geography of Health
Inequalities between geographical units can easily be described by the variance of the outcome between units, but it is unclear what effect the way in which a country is broken down into geographical areas for the purpose of administration may have on this variance. We explored the extent to which the variance of the mortality rate for different European countries depends on the mean size and variation in size of the regions in each country. Countries in which regions have a greater variation in population size tend to display greater variation in death rates, suggesting that international comparisons of geographic inequalities may be hampered by such administrative constraints. Research into the modifiable areal unit problem based on different sized areas in Helsinki demonstrated that the choice of area size had a limited impact on the assessment of geographical inequalities in mortality after taking account of individual level characteristics such as occupational social class, economic activity, education, housing tenure and living arrangements.
Molaodi OR, Leyland AH, Ellaway A, Kearns A, Harding S. Neighbourhood food and physical activity environments in England, UK: does ethnic density matter?. International Journal of Behavioral Nutrition and Physical Activity 2012;9:75pubmed open access
Jackson A, Davies CA, Leyland AH. Do differences in the administrative structure of populations confound comparisons of geographic health inequalities?. BMC Medical Research Methodology 2010;10:74pubmed open access
Tarkiainen L, Martikainen P, Laaksonen M, Leyland AH. Comparing the effects of neighbourhood characteristics on all-cause mortality using two hierarchical areal units in the capital region of Helsinki. Health & Place 2010;16:409-12pubmed
Lumme S, Leyland AH, Keskimäki I. Multilevel modeling of regional variation in equity in health care. Medical Care 2008;46:976-983pubmed
Manda SOM, Leyland AH. An empirical comparison of maximum likelihood and Bayesian estimation methods for multivariate disease mapping. South African Statistical Journal 2007;41:1-21
Næss Ø, Piro F N, Nafstad P, Smith DG, Leyland AH. Air pollution, social deprivation, and mortality: a multilevel cohort study. Epidemiology 2007;18:686-694pubmed open access
Chaix B, Leyland AH, Sabel CE, Chauvin P, Rastam L, Kristersson H, Merlo J. Spatial clustering of mental disorders and associated characteristics of the neighbourhood context in Malmo, Sweden, in 2001. Journal of Epidemiology & Community Health 2006;60:427-435pubmed
Leyland AH, Davies CA. Empirical Bayes methods for disease mapping. Statistical Methods in Medical Research 2005;14:17-34pubmed
Davies CA, Leyland AH. Spatial patterns of cancer mortality in Europe. In: Kirch W, editor Public health in Europe: 10 years EUPHA. Berlin: Springer-Verlag, 2004:227-243.
Leyland AH. Increasing inequalities in premature mortality in Great Britain. Journal of Epidemiology & Community Health 2004;58:296-302pubmed open access
Leyland AH, Langford I H, Rasbash J, Goldstein H. Multivariate spatial models for event data. Statistics in Medicine 2000;19:2469-2478pubmed
Langford IH, Leyland AH, Rasbash J, Goldstein H. Multilevel modelling of the geographical distributions of rare diseases. Applied Statistics 1999;48:253-268pubmed
- Geographical unit Area.
- Neurotic disorders (neuroses) Mental imbalance causing distress but not affecting daily functioning.
- Psychoactive substance A chemical substance (drug) that alters brain function, possibly affecting mood, perception or behaviour.
- Variance A statistical measure of the dispersion in a variable.