Area variations in health: a spatial multilevel modeling approach.

Area variations in health: a spatial multilevel modeling approach.
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DOI:
10.1016/j.healthplace.2012.03.010
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发表时间:
2012-07
期刊:
影响因子:
4.8
通讯作者:
Subramanian SV
Subramanian SV
中科院分区:
医学2区
文献类型:
--
作者:
Arcaya M;Brewster M;Zigler CM;Subramanian SV

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地理嵌入式行政单位的空间和成员资格都可能产生健康差异,导致健康状况良好和不佳的地理集群。尽管这两种类型的依赖之间存在着重要的差异,但一种很容易被误认为是另一种,而且两者都在起作用的可能性通常被忽视。我们适合一系列的层次结构和空间明确的多层次模型,以美国县级寿命数据集的预期寿命在1999年,以展示方法的数据分析和解释时,多个来源的区域聚类。我们展示了检测,解释和区分空间和地理成员效应的证据的方法,并讨论了空间或/和成员维度分析数据的关键考虑因素。我们发现的证据表明,预期寿命是由国内的地理过程,并通过空间过程驱动。我们认为,同时考虑空间和成员资格的过程中产生有价值的见解,在健康的区域变化的模式。
Both space and membership in geographically-embedded administrative units can produce variations in health, resulting in geographic clusters of good and poor health. Despite important differences between these two types of dependence, one is easily mistaken for the other, and the possibility that both are at work is commonly ignored. We fit a series of hierarchical and spatially-explicit multilevel models to a U.S. county-level life dataset of life expectancy in 1999 to demonstrate approaches for data analysis and interpretation when multiple sources of area-clustering are present. We demonstrate the methods to detect, interpret, and differentiate evidence of spatial and geographic membership effects and discuss key considerations for analyzing data with spatial or/and membership dimensions. We find evidence that life expectancy is driven by both within-state geographic process, and by spatial processes. We argue that considering spatial and membership processes simultaneously yields valuable insights into the patterning of area variations in health.
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