IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v10y2013i4p1186-1201d24520.html
   My bibliography  Save this article

Modeling the Cumulative Effects of Social Exposures on Health: Moving beyond Disease-Specific Models

Author

Listed:
  • Heather L. White

    (Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
    Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada)

  • Patricia O'Campo

    (Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada
    Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 1N8, Canada
    Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
    Department of Population, Reproductive and Family Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA)

  • Rahim Moineddin

    (Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada
    Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 1N8, Canada
    Department of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada)

  • Flora I. Matheson

    (Institute for Clinical Evaluative Sciences, Toronto, ON M4N 3M5, Canada
    Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON M5C 1N8, Canada
    Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada)

Abstract

The traditional explanatory models used in epidemiology are “disease specific”, identifying risk factors for specific health conditions. Yet social exposures lead to a generalized, cumulative health impact which may not be specific to one illness. Disease-specific models may therefore misestimate social factors’ effects on health. Using data from the Canadian Community Health Survey and Canada 2001 Census we construct and compare “disease-specific” and “generalized health impact” (GHI) models to gauge the negative health effects of one social exposure: socioeconomic position (SEP). We use logistic and multinomial multilevel modeling with neighbourhood-level material deprivation, individual-level education and household income to compare and contrast the two approaches. In disease-specific models, the social determinants under study were each associated with the health conditions of interest. However, larger effect sizes were apparent when outcomes were modeled as compound health problems (0, 1, 2, or 3+ conditions) using the GHI approach. To more accurately estimate social exposures’ impacts on population health, researchers should consider a GHI framework.

Suggested Citation

  • Heather L. White & Patricia O'Campo & Rahim Moineddin & Flora I. Matheson, 2013. "Modeling the Cumulative Effects of Social Exposures on Health: Moving beyond Disease-Specific Models," IJERPH, MDPI, vol. 10(4), pages 1-16, March.
    • Handle: RePEc:gam:jijerp:v:10:y:2013:i:4:p:1186-1201:d:24520
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/10/4/1186/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/10/4/1186/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ari S. Lewis & Sonja N. Sax & Susan C. Wason & Sharan L. Campleman, 2011. "Non-Chemical Stressors and Cumulative Risk Assessment: An Overview of Current Initiatives and Potential Air Pollutant Interactions," IJERPH, MDPI, vol. 8(6), pages 1-54, June.
    2. Cristina Conflitti, 2009. "Opinion Surveys on the Euro: a Multilevel Multinomial Logistic Analysis," Working Papers ECARES ECARES 2009-015, ULB -- Universite Libre de Bruxelles.
    3. Brownson, R.C. & Newschaffer, C.J. & Ali-Abarghoui, F., 1997. "Policy research for disease prevention: Challenges and practical recommendations," American Journal of Public Health, American Public Health Association, vol. 87(5), pages 735-739.
    4. Sorensen, G. & Barbeau, E. & Hunt, M.K. & Emmons, K., 2004. "Reducing Social Disparities in Tobacco Use: A Social-Contextual Model for Reducing Tobacco Use among Blue-Collar Workers," American Journal of Public Health, American Public Health Association, vol. 94(2), pages 230-239.
    5. Matheson, Flora I. & Moineddin, Rahim & Glazier, Richard H., 2008. "The weight of place: A multilevel analysis of gender, neighborhood material deprivation, and body mass index among Canadian adults," Social Science & Medicine, Elsevier, vol. 66(3), pages 675-690, February.
    6. O'Campo, P. & Gielen, A.C. & Faden, R.R. & Xue, X. & Kass, N. & Wang, M.-C., 1995. "Violence by male partners against women during the childbearing year: A contextual analysis," American Journal of Public Health, American Public Health Association, vol. 85(8), pages 1092-1097.
    7. Acevedo-Garcia, D. & Lochner, K.A. & Osypuk, T.L. & Subramanian, S.V., 2003. "Future directions in residential segregation and health research: A multilevel approach," American Journal of Public Health, American Public Health Association, vol. 93(2), pages 215-221.
    8. Potvin, L. & Gendron, S. & Bilodeau, A. & Chabot, P., 2005. "Integrating social theory into public health practice," American Journal of Public Health, American Public Health Association, vol. 95(4), pages 591-595.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Yanrong Qiu & Kaihuai Liao & Yanting Zou & Gengzhi Huang, 2022. "A Bibliometric Analysis on Research Regarding Residential Segregation and Health Based on CiteSpace," IJERPH, MDPI, vol. 19(16), pages 1-21, August.
    2. Tse-Chuan Yang & Stephen A Matthews, 2015. "Death by Segregation: Does the Dimension of Racial Segregation Matter?," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-26, September.
    3. Melissa P L Chan & Robert S Weinhold & Reuben Thomas & Julia M Gohlke & Christopher J Portier, 2015. "Environmental Predictors of US County Mortality Patterns on a National Basis," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-25, December.
    4. Stefanie DeLuca & Philip M. E. Garboden & Peter Rosenblatt, 2013. "Segregating Shelter," The ANNALS of the American Academy of Political and Social Science, , vol. 647(1), pages 268-299, May.
    5. Narayan Sastry & Bonnie Ghosh-Dastidar & John Adams & Anne R. Pebley, 2003. "The Design of Multilevel Survey of Children, Families, and Communities: The Los Angeles Family and Neighborhood Survey," Working Papers 03-21, RAND Corporation.
    6. Di Novi, Cinzia & Jacobs, Rowena & Migheli, Matteo, 2018. "Smoking Inequality across Genders and Socio-economic Classes. Evidence from Longitudinal Italian Data," Department of Economics and Statistics Cognetti de Martiis. Working Papers 201802, University of Turin.
    7. Wong, William Chi Wai & Chen, Wei Qing & Goggins, William B. & Tang, Catherine S. & Leung, Phil W., 2009. "Individual, familial and community determinants of child physical abuse among high-school students in China," Social Science & Medicine, Elsevier, vol. 68(10), pages 1819-1825, May.
    8. Werner Maier & Christa Scheidt-Nave & Rolf Holle & Lars E Kroll & Thomas Lampert & Yong Du & Christin Heidemann & Andreas Mielck, 2014. "Area Level Deprivation Is an Independent Determinant of Prevalent Type 2 Diabetes and Obesity at the National Level in Germany. Results from the National Telephone Health Interview Surveys ‘German Hea," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-11, February.
    9. Weden, Margaret M & Astone, Nan M & Bishai, David, 2006. "Racial, ethnic, and gender differences in smoking cessation associated with employment and joblessness through young adulthood in the US," Social Science & Medicine, Elsevier, vol. 62(2), pages 303-316, January.
    10. Miller, Susan C. & Papandonatos, George & Fennell, Mary & Mor, Vincent, 2006. "Facility and county effects on racial differences in nursing home quality indicators," Social Science & Medicine, Elsevier, vol. 63(12), pages 3046-3059, December.
    11. Neeru Gupta & Dan Lawson Crouse & Ismael Foroughi & Thalia Nikolaidou, 2021. "Gendering Neighbourhood Marginalization Metrics in Mental Health Services Research: A Cross-Sectional Exploration of a Rural and Small Urban Population," IJERPH, MDPI, vol. 18(21), pages 1-11, October.
    12. Masi, Christopher M. & Hawkley, Louise C. & Harry Piotrowski, Z. & Pickett, Kate E., 2007. "Neighborhood economic disadvantage, violent crime, group density, and pregnancy outcomes in a diverse, urban population," Social Science & Medicine, Elsevier, vol. 65(12), pages 2440-2457, December.
    13. Factor, Roni & Kawachi, Ichiro & Williams, David R., 2011. "Understanding high-risk behavior among non-dominant minorities: A social resistance framework," Social Science & Medicine, Elsevier, vol. 73(9), pages 1292-1301.
    14. Nykiforuk, Candace & Campbell, Sharon & Cameron, Roy & Brown, Stephen & Eyles, John, 2007. "Relationships between community characteristics and municipal smoke-free bylaw status and strength," Health Policy, Elsevier, vol. 80(2), pages 358-368, February.
    15. Glorian Sorensen & Susan Peters & Karina Nielsen & Eve Nagler & Melissa Karapanos & Lorraine Wallace & Lisa Burke & Jack T. Dennerlein & Gregory R. Wagner, 2019. "Improving Working Conditions to Promote Worker Safety, Health, and Wellbeing for Low-Wage Workers: The Workplace Organizational Health Study," IJERPH, MDPI, vol. 16(8), pages 1-16, April.
    16. Ana Claudia Figueiro & Sydia Rosana Oliveira & Zulmira Hartz & Yves Couturier & Jocelyne Bernier & Maria Freire & Isabella Samico & Maria Guadalupe Medina & Ronice Franco Sa & Louise Potvin, 2017. "A tool for exploring the dynamics of innovative interventions for public health: the critical event card," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(2), pages 177-186, March.
    17. Catherine P. Slade & Simon K. Medcalfe & C. Kevin Fortner & Kristin V. Walker, 2023. "Residential Segregation as a Policy Priority to Address Health Disparities: a Multilevel Analysis," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 18(4), pages 1715-1735, August.
    18. Miles, Rebecca, 2006. "Neighborhood disorder and smoking: Findings of a European urban survey," Social Science & Medicine, Elsevier, vol. 63(9), pages 2464-2475, November.
    19. Jamie E. Collins & Leslie I. Boden & Daniel A. Gundersen & Jeffrey N. Katz & Gregory R. Wagner & Glorian Sorensen & Jessica A. R. Williams, 2021. "Workplace Integrated Safety and Health Program Uptake in Nursing Homes: Associations with Ownership," IJERPH, MDPI, vol. 18(21), pages 1-11, October.
    20. Jason Boardman & Casey Blalock & Fred Pampel & Peter Hatemi & Andrew Heath & Lindon Eaves, 2011. "Population Composition, Public Policy, and the Genetics of Smoking," Demography, Springer;Population Association of America (PAA), vol. 48(4), pages 1517-1533, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:10:y:2013:i:4:p:1186-1201:d:24520. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.