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Multilevel and Clustering Analysis of Health Outcomes in Small Areas

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  • Peter Congdon

    (Imperial College School of Medicine
    Directorate of Public Health)

Abstract

This paper considers models of the variable incidence of health outcomes in geographical areas and of variable regression effects of socio-economic variables on such outcomes. It adopts a Bayesian approach to variation in relative risk and regression effects, and assesses different prior specifications of risk (e.g. a latent class structure versus a spatially correlated structure). Implications are considered for smoothing and mapping rare health outcomes. The analysis is for electoral wards in London, with the health-deprivation link forming the focus for regression effects. Implications for inferences about risk factors and for health-need ratings (before and after smoothing) are also considered.

Suggested Citation

  • Peter Congdon, 1997. "Multilevel and Clustering Analysis of Health Outcomes in Small Areas," European Journal of Population, Springer;European Association for Population Studies, vol. 13(4), pages 305-338, December.
    • Handle: RePEc:spr:eurpop:v:13:y:1997:i:4:d:10.1023_a:1005937516293
    DOI: 10.1023/A:1005937516293
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    References listed on IDEAS

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    1. Schwartz, S., 1994. "The fallacy of the ecological fallacy: The potential misuse of a concept and the consequences," American Journal of Public Health, American Public Health Association, vol. 84(5), pages 819-824.
    2. Julian Besag & James Newell, 1991. "The Detection of Clusters in Rare Diseases," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 154(1), pages 143-155, January.
    3. Langford, Ian H. & Bentham, Graham, 1996. "Regional variations in mortality rates in England and Wales: An analysis using multi-level modelling," Social Science & Medicine, Elsevier, vol. 42(6), pages 897-908, March.
    4. Roger J. Marshall, 1991. "A Review of Methods for the Statistical Analysis of Spatial Patterns of Disease," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 154(3), pages 421-441, May.
    5. Germáan Rodríguez & Noreen Goldman, 1995. "An Assessment of Estimation Procedures for Multilevel Models with Binary Responses," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 158(1), pages 73-89, January.
    6. Marijtje A. J. van Duijn & Ulf Böckenholt, 1995. "Mixture Models for the Analysis of Repeated Count Data," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 44(4), pages 473-485, December.
    7. Julian Besag & Jeremy York & Annie Mollié, 1991. "Bayesian image restoration, with two applications in spatial statistics," Annals of the Institute of Statistical Mathematics, Springer;The Institute of Statistical Mathematics, vol. 43(1), pages 1-20, March.
    8. Peter Congdon, 1996. "The Epidemiology of Suicide in London," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 159(3), pages 515-533, May.
    9. Wedel, M, et al, 1993. "A Latent Class Poisson Regression Model for Heterogeneous Count Data," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 8(4), pages 397-411, Oct.-Dec..
    10. Harvey Goldstein & David J. Spiegelhalter, 1996. "League Tables and Their Limitations: Statistical Issues in Comparisons of Institutional Performance," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 159(3), pages 385-409, May.
    11. Roy Carr-Hill & Geoffrey Hardman & Stephen Martin & Stuart Peacock & Trevor Sheldon & Peter Smith, 1994. "A formula for distributing NHS revenues based on small area use of hospital beds," Working Papers 022cheop, Centre for Health Economics, University of York.
    12. Robert Haining, 1991. "Estimation With Heteroscedastic And Correlated Errors: A Spatial Analysis Of Intra‐Urban Mortality Data," Papers in Regional Science, Wiley Blackwell, vol. 70(3), pages 223-241, July.
    13. Flowerdew, Robin & Green, Mick, 1992. "Developments in Areal Interpolation Methods and GIS," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 26(1), pages 67-78, April.
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    Cited by:

    1. Gamerman, Dani & Moreira, Ajax R. B., 2004. "Multivariate spatial regression models," Journal of Multivariate Analysis, Elsevier, vol. 91(2), pages 262-281, November.

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