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Bringing the individual back to small-area variation studies: A multilevel analysis of all-cause mortality in Andalusia, Spain.

Merlo, Juan LU ; Viciana-Fernández, Francisco J and Ramiro-Fariñas, Diego (2012) In Social Science and Medicine 75(8). p.1477-1487
Abstract
We performed a multilevel analysis (including individuals, households, census tracts, municipalities and provinces) on a 10% sample (N=230,978) from the Longitudinal Database of the Andalusian Population (LDAP). We aimed to investigate place effects on 8-year individual mortality risk. Moreover, besides calculating association (yielding odds ratios, ORs) between area socio-economic circumstances and individual risk, we wanted to estimate variance and clustering using the variance partition coefficient (VPC). We explicitly proclaim the relevance of considering general contextual effects (i.e. the degree to which the context, as a whole, affects individual variance in mortality risk) under at least two circumstances. The first of these... (More)
We performed a multilevel analysis (including individuals, households, census tracts, municipalities and provinces) on a 10% sample (N=230,978) from the Longitudinal Database of the Andalusian Population (LDAP). We aimed to investigate place effects on 8-year individual mortality risk. Moreover, besides calculating association (yielding odds ratios, ORs) between area socio-economic circumstances and individual risk, we wanted to estimate variance and clustering using the variance partition coefficient (VPC). We explicitly proclaim the relevance of considering general contextual effects (i.e. the degree to which the context, as a whole, affects individual variance in mortality risk) under at least two circumstances. The first of these concerns the interpretation of specific contextual effects (i.e. the association between a particular area characteristic and individual risk) obtained from multilevel regression analyses. The second involves the interpretation of geographical variance obtained from classic ecological spatial analyses. The so-called "ecological fallacy" apart, the lack of individual-level information renders geographical variance unrelated to the total individual variation and, therefore, difficult to interpret. Finally, we stress the importance of considering the familial household in multilevel analyses. We observed an association between percentage of people with a low educational level in the census tract and individual mortality risk (OR, highest v. lowest quintile=1.14; 95% confidence interval, CI 1.08-1.20). However, only a minor proportion of the total individual variance in the probability of dying was at the municipality (M) and census tract (CT) levels (VPC(M)=0.2% and VPC(CT)=0.3%). Conversely, the household (H) level appeared much more relevant (VPC(H)=18.6%) than the administrative geographical areas. Without considering general contextual effects, both multilevel analyses of specific contextual effects and ecological studies of small-area variation may provide a misleading picture that overstates the role of administrative areas as contextual determinants of individual differences in mortality. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Social Science and Medicine
volume
75
issue
8
pages
1477 - 1487
publisher
Elsevier
external identifiers
  • wos:000308902200018
  • pmid:22795359
  • scopus:84864623642
ISSN
1873-5347
DOI
10.1016/j.socscimed.2012.06.004
language
English
LU publication?
yes
id
686b8f63-4c54-45d6-95c0-a2d57b5f37dd (old id 2967162)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22795359?dopt=Abstract
date added to LUP
2012-08-09 18:36:10
date last changed
2017-09-10 03:16:43
@article{686b8f63-4c54-45d6-95c0-a2d57b5f37dd,
  abstract     = {We performed a multilevel analysis (including individuals, households, census tracts, municipalities and provinces) on a 10% sample (N=230,978) from the Longitudinal Database of the Andalusian Population (LDAP). We aimed to investigate place effects on 8-year individual mortality risk. Moreover, besides calculating association (yielding odds ratios, ORs) between area socio-economic circumstances and individual risk, we wanted to estimate variance and clustering using the variance partition coefficient (VPC). We explicitly proclaim the relevance of considering general contextual effects (i.e. the degree to which the context, as a whole, affects individual variance in mortality risk) under at least two circumstances. The first of these concerns the interpretation of specific contextual effects (i.e. the association between a particular area characteristic and individual risk) obtained from multilevel regression analyses. The second involves the interpretation of geographical variance obtained from classic ecological spatial analyses. The so-called "ecological fallacy" apart, the lack of individual-level information renders geographical variance unrelated to the total individual variation and, therefore, difficult to interpret. Finally, we stress the importance of considering the familial household in multilevel analyses. We observed an association between percentage of people with a low educational level in the census tract and individual mortality risk (OR, highest v. lowest quintile=1.14; 95% confidence interval, CI 1.08-1.20). However, only a minor proportion of the total individual variance in the probability of dying was at the municipality (M) and census tract (CT) levels (VPC(M)=0.2% and VPC(CT)=0.3%). Conversely, the household (H) level appeared much more relevant (VPC(H)=18.6%) than the administrative geographical areas. Without considering general contextual effects, both multilevel analyses of specific contextual effects and ecological studies of small-area variation may provide a misleading picture that overstates the role of administrative areas as contextual determinants of individual differences in mortality.},
  author       = {Merlo, Juan and Viciana-Fernández, Francisco J and Ramiro-Fariñas, Diego},
  issn         = {1873-5347},
  language     = {eng},
  number       = {8},
  pages        = {1477--1487},
  publisher    = {Elsevier},
  series       = {Social Science and Medicine},
  title        = {Bringing the individual back to small-area variation studies: A multilevel analysis of all-cause mortality in Andalusia, Spain.},
  url          = {http://dx.doi.org/10.1016/j.socscimed.2012.06.004},
  volume       = {75},
  year         = {2012},
}