American Journal of Epidemiology Advance Access originally published online on June 22, 2005
American Journal of Epidemiology 2005 162(2):171-182; doi:10.1093/aje/kwi175
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
ORIGINAL CONTRIBUTIONS |
Comparison of a Spatial Perspective with the Multilevel Analytical Approach in Neighborhood Studies: The Case of Mental and Behavioral Disorders due to Psychoactive Substance Use in Malmö, Sweden, 2001
1 Research Unit in Epidemiology, Information Systems, and Modelisation (INSERM U707), National Institute of Health and Medical Research, Paris, France
2 Department of Community Medicine, Malmö University Hospital, Lund University, Malmö, Sweden
3 Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
4 Department of Epidemiology, Center for Social Epidemiology and Population Health (CSEPH), University of Michigan, Ann Arbor, MI
Correspondence to Dr. Basile Chaix, INSERM U707, Faculté de Médecine Saint-Antoine, 27, rue Chaligny, 75571 Paris cedex 12, France (e-mail: chaix{at}u707.jussieu.fr).
Most studies of neighborhood effects on health have used the multilevel approach. However, since this methodology does not incorporate any notion of space, it may not provide optimal epidemiologic information when modeling variations or when investigating associations between contextual factors and health. Investigating mental disorders due to psychoactive substance use among all 65,830 individuals aged 40–59 years in 2001 in Malmö, Sweden, geolocated at their place of residence, the authors compared a spatial analytical perspective, which builds notions of space into hypotheses and methods, with the multilevel approach. Geoadditive models provided precise cartographic information on spatial variations in prevalence independent of administrative boundaries. The multilevel model showed significant neighborhood variations in the prevalence of substance-related disorders. However, hierarchical geostatistical models provided information on not only the magnitude but also the scale of neighborhood variations, indicating a significant correlation between neighborhoods in close proximity to each other. The prevalence of disorders increased with neighborhood deprivation. Far stronger associations were observed when using indicators measured in spatially adaptive areas, centered on residences of individuals, smaller in size than administrative neighborhoods. In neighborhood studies, building notions of space into analytical procedures may yield more comprehensive information than heretofore has been gathered on the spatial distribution of outcomes.
epidemiologic methods; logistic models; mental disorders; social environment; spatial analysis; substance-related disorders
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. L. Pruitt, M. J. Shim, P. D. Mullen, S. W. Vernon, and B. C. Amick III Association of Area Socioeconomic Status and Breast, Cervical, and Colorectal Cancer Screening: A Systematic Review Cancer Epidemiol. Biomarkers Prev., October 1, 2009; 18(10): 2579 - 2599. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Cagney, T. A. Glass, K. A. Skarupski, L. L. Barnes, B. S. Schwartz, and C. F. Mendes de Leon Neighborhood-Level Cohesion and Disorder: Measurement and Validation in Two Older Adult Urban Populations J Gerontol B Psychol Sci Soc Sci, May 1, 2009; 64B(3): 415 - 424. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Mair, A V D. Roux, and S Galea Are neighbourhood characteristics associated with depressive symptoms? A review of evidence J Epidemiol Community Health, November 1, 2008; 62(11): 940 - 946. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B Chaix, M Lindstrom, M Rosvall, and J Merlo Neighbourhood social interactions and risk of acute myocardial infarction J Epidemiol Community Health, January 1, 2008; 62(1): 62 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Riva, L. Gauvin, and T. A Barnett Toward the next generation of research into small area effects on health: a synthesis of multilevel investigations published since July 1998 J Epidemiol Community Health, October 1, 2007; 61(10): 853 - 861. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Chaix, M. Rosvall, and J. Merlo Assessment of the magnitude of geographical variations and socioeconomic contextual effects on ischaemic heart disease mortality: a multilevel survival analysis of a large Swedish cohort J Epidemiol Community Health, April 1, 2007; 61(4): 349 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Chaix, M. Rosvall, and J. Merlo Recent Increase of Neighborhood Socioeconomic Effects on Ischemic Heart Disease Mortality: A Multilevel Survival Analysis of Two Large Swedish Cohorts Am. J. Epidemiol., January 1, 2007; 165(1): 22 - 26. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. MERLO and B. CHAIX Neighbourhood effects and the real world beyond randomized community trials: a reply to Michael J Oakes Int. J. Epidemiol., October 1, 2006; 35(5): 1361 - 1363. [Full Text] [PDF]
|
|
|
|
|
|
S. Galea and J. Ahern Invited Commentary: Considerations about Specificity of Associations, Causal Pathways, and Heterogeneity in Multilevel Thinking Am. J. Epidemiol., June 15, 2006; 163(12): 1079 - 1082. [Full Text] [PDF]
|
|
|
|
|
|
B. Chaix, M. Rosvall, J. Lynch, and J. Merlo Disentangling contextual effects on cause-specific mortality in a longitudinal 23-year follow-up study: impact of population density or socioeconomic environment? Int. J. Epidemiol., June 1, 2006; 35(3): 633 - 643. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Chaix, A. H Leyland, C. E Sabel, P. Chauvin, L. Rastam, H. Kristersson, and J. Merlo Spatial clustering of mental disorders and associated characteristics of the neighbourhood context in Malmo, Sweden, in 2001 J Epidemiol Community Health, May 1, 2006; 60(5): 427 - 435. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Chaix, S. Gustafsson, M. Jerrett, H. Kristersson, T. Lithman, A. Boalt, and J. Merlo Children's exposure to nitrogen dioxide in Sweden: investigating environmental injustice in an egalitarian country. J Epidemiol Community Health, March 1, 2006; 60(3): 234 - 241. [Abstract] [Full Text] [PDF]
|
|