Toward the next generation of research into small area effects on health: a synthesis of multilevel investigations published since July 1998

Riva, Mylène; Gauvin, Lise; Barnett, Tracie A.

doi:10.1136/jech.2006.050740

Cited by 295 publications

(274 citation statements)

References 123 publications

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“…Evidence has also shown that neighbourhoods can have an influence on individual health, through mechanisms such as the effects of living in areas of deprivation, geographical influences on social relations or the accessibility to services (Pickett & Pearl 2001;Riva et al 2007;Diez Roux 2001). It is useful to examine the differences in health between places rather than just to assume that space is a passive factor that acts as a container for the existence of individuals who do not interact with people in the areas in which they live (Harris et al 2005).…”

Section: Introductionmentioning

confidence: 99%

A neighbourhood level mortality classification of England and Wales, 2006–2009

2014

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The paper provides an overview of a neighbourhood level classification of mortality for England and Wales (2006-2009). Standardised mortality ratios for 63 causes of death were calculated for middle super output areas (weighted by prevalence). A k-means partitional method was used to classify the data. An eight cluster solution was found to best segment mortality patterns. Clusters mostly differentiated in terms of prevalence, however the importance of neurodegenerative diseases and causes related to unhealthy behaviours were important. The results describe a neighbourhood classification that can be an important tool to help inform policy development, resource allocation and targeting of services.

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Section: Introductionmentioning

confidence: 99%

A neighbourhood level mortality classification of England and Wales, 2006–2009

2014

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“…Geographic inequalities in health have been shown to vary between areas with contrasting socioeconomic conditions (Curtis, 2004;Ellen, Mijanovich, & Dillman, 2001;Pickett & Pearl, 2001;Riva, Gauvin, & Barnett, 2007). Many of the studies reviewed by these authors concentrated within urban areas.…”

Section: Introductionmentioning

confidence: 99%

Unravelling the extent of inequalities in health across urban and rural areas: Evidence from a national sample in England

Riva

Curtis

Gauvin

et al. 2009

Social Science & Medicine

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Studies of inequalities in health between rural and urban settings have produced mixed and sometimes conflicting results, depending on the national setting of the study, the level of geographic detail used to define rural areas and the health indicators studied. By focusing on morbidity data from a national sample of individuals, this study aims to examine the extent of inequalities in health between urban and rural areas, as well as inequalities in health across rural areas of England. Multilevel analyses for poor self-rated health, overweight and obesity, and common mental disorders are reported for a sample of 30,776 individuals aged 18 years and older (obtained from the Health Survey for England years 2000-2003 combined) and distributed across 3645 small areas classed in four categories: two groups of urban areas (Greater London area or 'other cities') and two types of rural settings (semi-rural areas or villages). Results show that rural dwellers were significantly less likely than residents of urban areas to report their health as being fair or poor and to report common mental disorders, independent of their socio-demographic characteristics. However, as for urban settlements, there were significant variations in health across semi-rural areas and across villages, indicating the presence of health inequalities within rural settings in England. These inequalities were not fully explained by the individual composition of the areas or by the available measures of area socioeconomic conditions, indicating that in rural

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“…However, many multilevel analyses performed so far have been mainly focused on the study of associations between contextual variables and individual health, considering the analysis of variance as secondary information (Blakely & Woodward, 2000;Diez Roux, 2008). In contrast, others scholars have explicitly concluded that the analysis of variance provides indispensable information for understanding place effects on health (Boyle MH & Willms JD, 1999;Clarke P & Wheaton B, 2007;Duncan et al, 1993;Merlo, 2003;Merlo et al, 2004;Merlo et al, 2009;Riva et al, 2007) Moreover, all around the world, a persistent amount of observational information on place effects is still being obtained from ecological/spatial studies of "small-area variations" , frequently in the form of coloured atlases and disease maps (Benach et al, 2003;Benach et al, 2004;Borrell et al, 2010;Collaboration, 2010;MacNab & Dean, 2002;Middleton et al, 2008;Ocana-Riola & Mayoral-Cortes, 2010;Ocana-Riola et al, 2008a;Pickle et al, 1999;Shaw, 2008;Turrell & Mengersen, 2000). From an empirical perspective, the advantages of multilevel versus ecological regression analyses were clearly identified by the seminal work performed by Aitkins and Longford (Aitkin M & Longford N, 1986) as well as by Jones,4 Duncan, Moon, Subramanian and colleagues (Bullen et al, 1996;Duncan et al, 1993Duncan et al, , 1995Duncan et al, , 1996Duncan et al, , 1998Duncan et al, , 1999Jones et al, 1991;Subramanian et al, 2009;Twigg et al, 2000).…”

mentioning

confidence: 99%

“…In spite of the fundamental relevance of general contextual effects when investigating sociogeographical influences on individual health, only a relatively small part of the multilevel analyses published until today have reported measures of variance (Riva et al, 2007), and still fewer of them explicitly discuss general and specific contextual effects within the same discourse .…”

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confidence: 99%