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Chen SQ, Cao Y, Ma JJ, Zhang XC, Hu SB. Construction and evaluation of a practical model for measuring health-adjusted life expectancy (HALE) in China. BMC Public Health 2024; 24:1667. [PMID: 38909195 PMCID: PMC11193283 DOI: 10.1186/s12889-024-19112-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/12/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND HALE is now a regular strategic planning indicator for all levels of the Chinese government. However, HALE measurements necessitate comprehensive data collection and intricate technology. Therefore, effectively converting numerous diseases into the years lived with disability (YLD) rate is a significant challenge for HALE measurements. Our study aimed to construct a simple YLD rate measurement model with high applicability based on the current situation of actual data resources within China to address challenges in measuring HALE target values during planning. METHODS First, based on the Chinese YLD rate in the Global Burden of Disease (GBD) 2019, Pearson correlation analysis, the global optimum method, etc., was utilized to screen the best predictor variables from the current Chinese data resources. Missing data for predictor variables were filled in via spline interpolation. Then, multiple linear regression models were fitted to construct the YLD rate measurement model. The Sullivan method was used to measure HALE. The Monte Carlo method was employed to generate 95% uncertainty intervals. Finally, model performances were assessed using the mean absolute error (MAE) and mean absolute percentage error (MAPE). RESULTS A three-input-parameter model was constructed to measure the age-specific YLD rates by sex in China, directly using the incidence of infectious diseases, the incidence of chronic diseases among persons aged 15 and older, and the addition of an under-five mortality rate covariate. The total MAE and MAPE for the combined YLD rate were 0.0007 and 0.5949%, respectively. The MAE and MAPE of the combined HALE in the 0-year-old group were 0.0341 and 0.0526%, respectively. There were slightly fewer males (0.0197, 0.0311%) than females (0.0501, 0.0755%). CONCLUSION We constructed a high-accuracy model to measure the YLD rate in China by using three monitoring indicators from the Chinese national routine as predictor variables. The model provides a realistic and feasible solution for measuring HALE at the national and especially regional levels, considering limited data.
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Affiliation(s)
- San Qian Chen
- School of Public Health, Jiangxi Medical College, Nanchang University, Donghu Campus, Nanchang, Jiangxi Province, 330006, PR China
- Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University, Nanchang, 330006, PR China
| | - Yu Cao
- School of Public Health, Jiangxi Medical College, Nanchang University, Donghu Campus, Nanchang, Jiangxi Province, 330006, PR China
- Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University, Nanchang, 330006, PR China
| | - Jing Jie Ma
- School of Public Health, Jiangxi Medical College, Nanchang University, Donghu Campus, Nanchang, Jiangxi Province, 330006, PR China
- Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University, Nanchang, 330006, PR China
| | - Xing Chao Zhang
- School of Public Health, Jiangxi Medical College, Nanchang University, Donghu Campus, Nanchang, Jiangxi Province, 330006, PR China
- Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University, Nanchang, 330006, PR China
| | - Song Bo Hu
- School of Public Health, Jiangxi Medical College, Nanchang University, Donghu Campus, Nanchang, Jiangxi Province, 330006, PR China.
- Jiangxi Provincial Key Laboratory of Disease Prevention and Public Health, Nanchang University, Nanchang, 330006, PR China.
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Yu J, Dwyer-Lindgren L, Bennett J, Ezzati M, Gustafson P, Tran M, Brauer M. A spatiotemporal analysis of inequalities in life expectancy and 20 causes of mortality in sub-neighbourhoods of Metro Vancouver, British Columbia, Canada, 1990-2016. Health Place 2021; 72:102692. [PMID: 34736154 PMCID: PMC7615115 DOI: 10.1016/j.healthplace.2021.102692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
Spatially varying baseline data can help identify and prioritise actions directed to determinants of intra-urban health inequalities. Twenty-seven years (1990-2016) of cause-specific mortality data in British Columbia, Canada were linked to three demographic data sources. Bayesian small area estimation models were used to estimate life expectancy (LE) at birth and 20 cause-specific mortality rates by sex and year. The gaps in LE for males and females ranged from 6.9 years to 9.5 years with widening inequality in more recent years. Inequality ratios increased for almost all causes, especially for HIV/AIDS and sexually transmitted infections, maternal and neonatal disorders, and neoplasms.
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Affiliation(s)
- Jessica Yu
- School of Population of Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Laura Dwyer-Lindgren
- Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA, 98195, United States.
| | - James Bennett
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, United Kingdom.
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, United Kingdom; MRC Centre for Environment and Health, Imperial College London, London, United Kingdom; Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, United Kingdom.
| | - Paul Gustafson
- Department of Statistics, University of British Columbia, 3182 Earth Sciences Building, 2207 Main Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Martino Tran
- School of Community and Regional Planning, University of British Columbia, 433 - 6333 Memorial Road, Vancouver, BC, V6T 1Z2, Canada.
| | - Michael Brauer
- School of Population of Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z3, Canada; Institute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave. NE, Seattle, WA, 98195, United States.
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Chronic high risk of intimate partner violence against women in disadvantaged neighborhoods: An eight-year space-time analysis. Prev Med 2021; 148:106550. [PMID: 33848525 DOI: 10.1016/j.ypmed.2021.106550] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 02/25/2021] [Accepted: 04/08/2021] [Indexed: 01/10/2023]
Abstract
We conducted a small-area ecological longitudinal study to analyze neighborhood contextual influences on the spatio-temporal variations in intimate partner violence against women (IPVAW) risk in a southern European city over an eight-year period. We used geocoded data of IPVAW cases with associated protection orders (n = 5867) in the city of Valencia, Spain (2011-2018). The city's 552 census block groups were used as the neighborhood units. Neighborhood-level covariates were: income, education, immigrant concentration, residential instability, alcohol outlet density, and criminality. We used a Bayesian autoregressive approach to spatio-temporal disease mapping. Neighborhoods with low levels of income and education and high levels of residential mobility and criminality had higher relative risk of IPVAW. Spatial patterns of high risk of IPVAW persisted over time during the eight-year period analyzed. Areas of stable low risk and with increasing or decreasing risk were also identified. Our findings link neighborhood disadvantage to the existence and persistence over time of spatial inequalities in IPVAW risk, showing that high risk of IPVAW can become chronic in disadvantaged neighborhoods. Our analytic approach provides specific risk estimates at the small-area level that are informative for intervention purposes, and can be useful to assess the effectiveness of prevention efforts in reducing IPVAW.
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Ruan X, Li Y, Jin X, Deng P, Xu J, Li N, Li X, Liu Y, Hu Y, Xie J, Wu Y, Long D, He W, Yuan D, Guo Y, Li H, Huang H, Yang S, Han M, Zhuang B, Qian J, Cao Z, Zhang X, Xiao J, Xu L. Health-adjusted life expectancy (HALE) in Chongqing, China, 2017: An artificial intelligence and big data method estimating the burden of disease at city level. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 9:100110. [PMID: 34379708 PMCID: PMC8315391 DOI: 10.1016/j.lanwpc.2021.100110] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND A universally applicable approach that provides standard HALE measurements for different regions has yet to be developed because of the difficulties of health information collection. In this study, we developed a natural language processing (NLP) based HALE estimation approach by using individual-level electronic medical records (EMRs), which made it possible to calculate HALE timely in different temporal or spatial granularities. METHODS We performed diagnostic concept extraction and normalisation on 13•99 million EMRs with NLP to estimate the prevalence of 254 diseases in WHO Global Burden of Disease Study (GBD). Then, we calculated HALE in Chongqing, 2017, by using the life table technique and Sullivan's method, and analysed the contribution of diseases to the expected years "lost" due to disability (DLE). FINDINGS Our method identified a life expectancy at birth (LE0) of 77•9 years and health-adjusted life expectancy at birth (HALE0) of 71•7 years for the general Chongqing population of 2017. In particular, the male LE0 and HALE0 were 76•3 years and 68•9 years, respectively, while the female LE0 and HALE0 were 80•0 years and 74•4 years, respectively. Cerebrovascular diseases, cancers, and injuries were the top three deterioration factors, which reduced HALE by 2•67, 2•15, and 1•19 years, respectively. INTERPRETATION The results demonstrated the feasibility and effectiveness of EMRs-based HALE estimation. Moreover, the method allowed for a potentially transferable framework that facilitated a more convenient comparison of cross-sectional and longitudinal studies on HALE between regions. In summary, this study provided insightful solutions to the global ageing and health problems that the world is facing. FUNDING National Key R and D Program of China (2018YFC2000400).
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Affiliation(s)
- Xiaowen Ruan
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Yue Li
- China Population and Development Research Center, 12 Dahuisi Road, Haidian District, Beijing 100801, China
| | - Xiaohui Jin
- Ping An Technology (Shenzhen) Co., Ltd., No. 316, Laoshan Road, Pudong New District, Shanghai 200122, China
| | - Pan Deng
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Jiaying Xu
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Na Li
- Ping An Technology (Shenzhen) Co., Ltd., Ping An International Finance Centre, No. 3, South Xinyuan Road, Chaoyang District, Beijing 100011, China
| | - Xian Li
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Yuqi Liu
- Ping An Technology (Shenzhen) Co., Ltd., Ping An International Finance Centre, No. 3, South Xinyuan Road, Chaoyang District, Beijing 100011, China
| | - Yiyi Hu
- Ping An Technology (Shenzhen) Co., Ltd., No. 316, Laoshan Road, Pudong New District, Shanghai 200122, China
| | - Jingwen Xie
- Ping An Technology (Shenzhen) Co., Ltd., No. 316, Laoshan Road, Pudong New District, Shanghai 200122, China
| | - Yingnan Wu
- Ping An Technology (Shenzhen) Co., Ltd., Ping An International Finance Centre, No. 3, South Xinyuan Road, Chaoyang District, Beijing 100011, China
| | - Dongyan Long
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Wen He
- Ping An Technology (Shenzhen) Co., Ltd., Ping An International Finance Centre, No. 3, South Xinyuan Road, Chaoyang District, Beijing 100011, China
| | - Dongsheng Yuan
- Ping An Technology (Shenzhen) Co., Ltd., No. 316, Laoshan Road, Pudong New District, Shanghai 200122, China
| | - Yifei Guo
- Ping An Technology (Shenzhen) Co., Ltd., No. 316, Laoshan Road, Pudong New District, Shanghai 200122, China
| | - Heng Li
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - He Huang
- Chongqing Municipal Health Commission, No. 232 Renmin Road, Yuzhong District, Chongqing 400015, China
| | - Shan Yang
- Chongqing Municipal Health Commission, No. 232 Renmin Road, Yuzhong District, Chongqing 400015, China
| | - Mei Han
- Ping An Technology (Shenzhen) Co., Ltd., Ping An Tech, US Research Lab, Suite 150, 3000 EI Camino Real, Palo Alto, CA 94306, United States
| | - Bojin Zhuang
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Jiang Qian
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Zhenjie Cao
- Ping An Technology (Shenzhen) Co., Ltd., Ping An Tech, US Research Lab, Suite 150, 3000 EI Camino Real, Palo Alto, CA 94306, United States
| | - Xuying Zhang
- China Population and Development Research Center, 12 Dahuisi Road, Haidian District, Beijing 100801, China
| | - Jing Xiao
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
| | - Liang Xu
- Ping An Technology (Shenzhen) Co., Ltd., Ping'an International Financial Center, Futian District, Shenzhen 518001, China
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Kim I, Kang HY, Khang YH. Life Expectancy in Areas around Subway Stations in the Seoul Metropolitan Area in Korea, 2008-2017. J Korean Med Sci 2020; 35:e365. [PMID: 33200592 PMCID: PMC7669455 DOI: 10.3346/jkms.2020.35.e365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aimed to calculate life expectancy in the areas around 614 subway stations on 23 subway lines in the Seoul metropolitan area of Korea from 2008 to 2017. METHODS We used the National Health Information Database provided by the National Health Insurance Service, which covers the whole population of Korea. The analysis was conducted on the level of the smallest administrative units within a 200-m radius of each subway station. Life expectancy was calculated by constructing an abridged life table using the number of population and deaths in each area and 5-year age groups (0, 1-4, …, 85+) during the whole study period. RESULTS The median life expectancy in the areas around 614 subway stations was 82.9 years (interquartile range, 2.2 years; minimum, 77.6 years; maximum, 87.4 years). The life expectancy of areas around subway stations located in Seoul was higher than those in Incheon and Gyeonggi-do, but variation within the region was observed. Significant differences were observed between some adjacent subway stations. In Incheon and Gyeonggi-do, substantially higher life expectancy was found around subway stations in newly developed urban areas, and lower life expectancy was found in central Incheon and suburbs in Gyeonggi-do. CONCLUSION When using areas around subway stations as the unit of analysis, variation in life expectancy in the Seoul metropolitan area was observed. This approach may reduce the stigma associated with presenting health inequalities at the level of the smallest administrative units and foster public awareness of health inequalities.
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Affiliation(s)
- Ikhan Kim
- Department of Health Policy and Management, Jeju National University School of Medicine, Jeju, Korea
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Yeon Kang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Young Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Institue of Health Policy and Management, Seoul National University Medical Research Center, Seoul, Korea.
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Bilal U, Alazraqui M, Caiaffa WT, Lopez-Olmedo N, Martinez-Folgar K, Miranda JJ, Rodriguez DA, Vives A, Diez-Roux AV. Inequalities in life expectancy in six large Latin American cities from the SALURBAL study: an ecological analysis. Lancet Planet Health 2019; 3:e503-e510. [PMID: 31836433 PMCID: PMC6926471 DOI: 10.1016/s2542-5196(19)30235-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Latin America is one of the most unequal regions in the world, but evidence is lacking on the magnitude of health inequalities in urban areas of the region. Our objective was to examine inequalities in life expectancy in six large Latin American cities and its association with a measure of area-level socioeconomic status. METHODS In this ecological analysis, we used data from the Salud Urbana en America Latina (SALURBAL) study on six large cities in Latin America (Buenos Aires, Argentina; Belo Horizonte, Brazil; Santiago, Chile; San José, Costa Rica; Mexico City, Mexico; and Panama City, Panama), comprising 266 subcity units, for the period 2011-15 (expect for Panama city, which was for 2012-16). We calculated average life expectancy at birth by sex and subcity unit with life tables using age-specific mortality rates estimated from a Bayesian model, and calculated the difference between the ninth and first decile of life expectancy at birth (P90-P10 gap) across subcity units in cities. We also analysed the association between life expectancy at birth and socioeconomic status at the subcity-unit level, using education as a proxy for socioeconomic status, and whether any geographical patterns existed in cities between subcity units. FINDINGS We found large spatial differences in average life expectancy at birth in Latin American cities, with the largest P90-P10 gaps observed in Panama City (15·0 years for men and 14·7 years for women), Santiago (8·9 years for men and 17·7 years for women), and Mexico City (10·9 years for men and 9·4 years for women), and the narrowest in Buenos Aires (4·4 years for men and 5·8 years for women), Belo Horizonte (4·0 years for men and 6·5 years for women), and San José (3·9 years for men and 3·0 years for women). Higher area-level socioeconomic status was associated with higher life expectancy, especially in Santiago (change in life expectancy per P90-P10 change unit-level of educational attainment 8·0 years [95% CI 5·8-10·3] for men and 11·8 years [7·1-16·4] for women) and Panama City (7·3 years [2·6-12·1] for men and 9·0 years [2·4-15·5] for women). We saw an increase in life expectancy at birth from east to west in Panama City and from north to south in core Mexico City, and a core-periphery divide in Buenos Aires and Santiago. Whereas for San José the central part of the city had the lowest life expectancy and in Belo Horizonte the central part of the city had the highest life expectancy. INTERPRETATION Large spatial differences in life expectancy in Latin American cities and their association with social factors highlight the importance of area-based approaches and policies that address social inequalities in improving health in cities of the region. FUNDING Wellcome Trust.
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Affiliation(s)
- Usama Bilal
- Department of Epidemiology and Biostatistics, Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Marcio Alazraqui
- Instituto de Salud Colectiva, Universidad Nacional de Lanús, Buenos Aires, Argentina
| | - Waleska T Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Nancy Lopez-Olmedo
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Kevin Martinez-Folgar
- Department of Epidemiology and Biostatistics, Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA; Instituto de Nutrición de Centroamérica y Panamá (INCAP), Guatemala
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases and School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel A Rodriguez
- Department of City and Regional Planning and Institute for Transportation Studies, University of California Berkeley, Berkeley, CA, USA
| | - Alejandra Vives
- Departamento de Salud Pública, Escuela de Medicina, and CEDEUS, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ana V Diez-Roux
- Department of Epidemiology and Biostatistics, Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
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Marco M, Gracia E, López-Quílez A, Freisthler B. Child maltreatment and alcohol outlets in Spain: Does the country drinking culture matters? CHILD ABUSE & NEGLECT 2019; 91:23-30. [PMID: 30818249 DOI: 10.1016/j.chiabu.2019.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 02/10/2019] [Accepted: 02/19/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Alcohol outlet density has been linked to rates of substantiated maltreatment both cross-sectionally and over time. Most of these studies have been conducted in Anglo-Saxon countries, especially in the U.S., but other countries, where alcohol outlets and alcohol consumption may have different social meanings, are clearly underrepresented in the literature. OBJECTIVE The aim of this study was to analyze whether alcohol outlet density is associated with neighborhood-level child maltreatment risk in a South-European city. PARTICIPANTS AND SETTING A longitudinal study was conducted in the city of Valencia (Spain). As spatial units, we used 552 census block groups. Family units with child maltreatment protection measures from 2004 to 2015 were geocoded (n = 1799). METHODS A Bayesian spatio-temporal autoregression model was conducted to model the outcome variable. RESULTS Results indicated that, once controlled for other neighborhood-level characteristics, the influence of off-premise density and restaurant/cafe density were not relevant, while bar density showed a negative relationship with child maltreatment risk. Spatially lagged alcohol outlet variables were also not relevant in the model. CONCLUSIONS Our results suggest the importance of taking into account the cultural influences on the relationship between alcohol outlets and child maltreatment risk. Future cross-cultural research is needed for better understanding this relationship.
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Affiliation(s)
- Miriam Marco
- Department of Social Psychology, University of Valencia, Avda. Blasco Ibáñez, 21, Valencia, 46010, Spain.
| | - Enrique Gracia
- Department of Social Psychology, University of Valencia, Avda. Blasco Ibáñez, 21, Valencia, 46010, Spain.
| | - Antonio López-Quílez
- Department of Statistics and Operations Research, University of Valencia, Dr. Moliner, 50, Burjassot, Valencia, 46100, Spain.
| | - Bridget Freisthler
- College of Social Work, The Ohio State University, Stillman Hall, 1947 College Rd., Columbus, OH, 42310, USA.
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Gracia E, López-Quílez A, Marco M, Lila M. Mapping child maltreatment risk: a 12-year spatio-temporal analysis of neighborhood influences. Int J Health Geogr 2017; 16:38. [PMID: 29047364 PMCID: PMC5648468 DOI: 10.1186/s12942-017-0111-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 10/12/2017] [Indexed: 12/31/2022] Open
Abstract
Background ‘Place’ matters in understanding prevalence variations and inequalities in child maltreatment risk. However, most studies examining ecological variations in child maltreatment risk fail to take into account the implications of the spatial and temporal dimensions of neighborhoods. In this study, we conduct a high-resolution small-area study to analyze the influence of neighborhood characteristics on the spatio-temporal epidemiology of child maltreatment risk. Methods We conducted a 12-year (2004–2015) small-area Bayesian spatio-temporal epidemiological study with all families with child maltreatment protection measures in the city of Valencia, Spain. As neighborhood units, we used 552 census block groups. Cases were geocoded using the family address. Neighborhood-level characteristics analyzed included three indicators of neighborhood disadvantage—neighborhood economic status, neighborhood education level, and levels of policing activity—, immigrant concentration, and residential instability. Bayesian spatio-temporal modelling and disease mapping methods were used to provide area-specific risk estimations. Results Results from a spatio-temporal autoregressive model showed that neighborhoods with low levels of economic and educational status, with high levels of policing activity, and high immigrant concentration had higher levels of substantiated child maltreatment risk. Disease mapping methods were used to analyze areas of excess risk. Results showed chronic spatial patterns of high child maltreatment risk during the years analyzed, as well as stability over time in areas of low risk. Areas with increased or decreased child maltreatment risk over the years were also observed. Conclusions A spatio-temporal epidemiological approach to study the geographical patterns, trends over time, and the contextual determinants of child maltreatment risk can provide a useful method to inform policy and action. This method can offer a more accurate description of the problem, and help to inform more localized prevention and intervention strategies. This new approach can also contribute to an improved epidemiological surveillance system to detect ecological variations in risk, and to assess the effectiveness of the initiatives to reduce this risk.
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Affiliation(s)
- Enrique Gracia
- Department of Social Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain.
| | - Antonio López-Quílez
- Department of Statistics and Operations Research, University of Valencia, C/Doctor Moliner, 50, 46100, Burjassot, Valencia, Spain
| | - Miriam Marco
- Department of Social Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain
| | - Marisol Lila
- Department of Social Psychology, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain
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9
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Dwyer-Lindgren L, Stubbs RW, Bertozzi-Villa A, Morozoff C, Callender C, Finegold SB, Shirude S, Flaxman AD, Laurent A, Kern E, Duchin JS, Fleming D, Mokdad AH, Murray CJL. Variation in life expectancy and mortality by cause among neighbourhoods in King County, WA, USA, 1990–2014: a census tract-level analysis for the Global Burden of Disease Study 2015. LANCET PUBLIC HEALTH 2017; 2:e400-e410. [DOI: 10.1016/s2468-2667(17)30165-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/27/2017] [Accepted: 07/20/2017] [Indexed: 10/18/2022]
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10
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Jonker MF, D'Ippolito E, Eikemo TA, Congdon PD, Nante N, Mackenbach JP, Kamphuis CBM. The effect of regional politics on regional life expectancy in Italy (1980-2010). Scand J Public Health 2017; 45:121-131. [PMID: 28152652 DOI: 10.1177/1403494816686266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The evidence on the association between politics and health is scarce considering the importance of this topic for population health. Studies that investigated the effect of different political regimes on health outcomes show inconsistent results. METHODS Bayesian time-series cross-section analyses are used to examine the overall impact of regional politics on variations in Italian regional life expectancy (LE) at birth during the period 1980-2010. Our analyses control for trends in and unobserved determinants of regional LE, correct for temporal as well as spatial autocorrelation, and employ a flexible specification for the timing of the political effects. RESULTS In the period from 1980 to 1995, we find no evidence that the communist, left-oriented coalitions and Christian Democratic, centre-oriented coalitions have had an effect on regional LE. In the period from 1995 onwards, after a major reconfiguration of Italy's political regimes and a major healthcare reform, we again find no evidence that the Centre-Left and Centre-Right coalitions have had a significant impact on regional LE. CONCLUSION The presented results provide no support for the notion that different regional political regimes in Italy have had a differential effect on regional LE, even though Italian regions have had considerable and increasing autonomy over healthcare and health-related policies and expenditures.
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Affiliation(s)
- Marcel F Jonker
- 1 Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.,2 Department of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands
| | - Edoardo D'Ippolito
- 3 Department of Public Health, Health Services Research Laboratory, University of Siena, Italy
| | - Terje A Eikemo
- 1 Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.,4 Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Peter D Congdon
- 5 School of Geography, Queen Mary University of London, London, UK
| | - Nicola Nante
- 3 Department of Public Health, Health Services Research Laboratory, University of Siena, Italy
| | - Johan P Mackenbach
- 1 Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Carlijn B M Kamphuis
- 1 Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
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11
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Congdon P. Area variations in multiple morbidity using a life table methodology. HEALTH SERVICES AND OUTCOMES RESEARCH METHODOLOGY 2016; 16:58-74. [PMID: 27257403 PMCID: PMC4867778 DOI: 10.1007/s10742-015-0142-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/30/2015] [Accepted: 12/18/2015] [Indexed: 10/30/2022]
Abstract
Analysis of healthy life expectancy is typically based on a binary distinction between health and ill-health. By contrast, this paper considers spatial modelling of disease free life expectancy taking account of the number of chronic conditions. Thus the analysis is based on population sub-groups with no disease, those with one disease only, and those with two or more diseases (multiple morbidity). Data on health status is accordingly modelled using a multinomial likelihood. The analysis uses data for 258 small areas in north London, and shows wide differences in the disease burden related to multiple morbidity. Strong associations between area socioeconomic deprivation and multiple morbidity are demonstrated, as well as strong spatial clustering.
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Affiliation(s)
- Peter Congdon
- School of Geography and Life Sciences Institute, Queen Mary University of London, London, UK
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12
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Andrianou XD, Charisiadis P, Andra SS, Makris KC. Spatial and seasonal variability of urinary trihalomethanes concentrations in urban settings. ENVIRONMENTAL RESEARCH 2014; 135:289-295. [PMID: 25462678 DOI: 10.1016/j.envres.2014.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 09/19/2014] [Accepted: 09/22/2014] [Indexed: 06/04/2023]
Abstract
A complex network of sources and routes of exposure to disinfection by-products (DBP), such as trihalomethanes (THM) has been driving the wide variability of daily THM intake estimates in environmental epidemiological studies. We hypothesized that the spatiotemporal variability of THM exposures could be differentially expressed with their urinary levels among residents whose households are geographically clustered in district-metered areas (DMA) receiving the same tap water. Each DMA holds unique drinking-water pipe network characteristics, such as pipe length, number of pipe leaking incidences, number of water meters by district, average minimum night flow and average daily demand. The present study assessed the spatial and seasonal variability in urinary THM levels among residents (n=310) of geocoded households belonging to two urban DMA of Nicosia, Cyprus, with contrasting water network properties. First morning urine voids were collected once in summer and then in winter. Results showed that the mean sum of the four urinary THM analytes (TTHM) was significantly higher during summer for residents of both areas. Linear mixed effects models adjusted for age, season and gender, illustrated spatially-resolved differences in creatinine-adjusted urinary chloroform and TTHM levels between the two studied areas, corroborated by differences observed in their pipe network characteristics. Additional research is warranted to shed light on the contribution of spatially-resolved and geographically-clustered environmental exposures coupled with internal biomarker of exposure measurements towards better understanding of health disparities within urban centers.
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Affiliation(s)
- Xanthi D Andrianou
- Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health in association with the Harvard School of Public Health, Cyprus University of Technology, Irenes 95, Limassol 3041, Cyprus
| | - Pantelis Charisiadis
- Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health in association with the Harvard School of Public Health, Cyprus University of Technology, Irenes 95, Limassol 3041, Cyprus
| | - Syam S Andra
- Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health in association with the Harvard School of Public Health, Cyprus University of Technology, Irenes 95, Limassol 3041, Cyprus
| | - Konstantinos C Makris
- Water and Health Laboratory, Cyprus International Institute for Environmental and Public Health in association with the Harvard School of Public Health, Cyprus University of Technology, Irenes 95, Limassol 3041, Cyprus.
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13
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Gracia E, López-Quílez A, Marco M, Lladosa S, Lila M. Exploring neighborhood influences on small-area variations in intimate partner violence risk: a Bayesian random-effects modeling approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:866-82. [PMID: 24413701 PMCID: PMC3924479 DOI: 10.3390/ijerph110100866] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 12/31/2013] [Accepted: 01/02/2014] [Indexed: 11/16/2022]
Abstract
This paper uses spatial data of cases of intimate partner violence against women (IPVAW) to examine neighborhood-level influences on small-area variations in IPVAW risk in a police district of the city of Valencia (Spain). To analyze area variations in IPVAW risk and its association with neighborhood-level explanatory variables we use a Bayesian spatial random-effects modeling approach, as well as disease mapping methods to represent risk probabilities in each area. Analyses show that IPVAW cases are more likely in areas of high immigrant concentration, high public disorder and crime, and high physical disorder. Results also show a spatial component indicating remaining variability attributable to spatially structured random effects. Bayesian spatial modeling offers a new perspective to identify IPVAW high and low risk areas, and provides a new avenue for the design of better-informed prevention and intervention strategies.
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Affiliation(s)
- Enrique Gracia
- Department of Social Psychology, University of Valencia, Valencia 46010, Spain; E-Mails: (M.M.); (M.L.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +34-963-864-573; Fax: +34-963-864-668
| | - Antonio López-Quílez
- Department of Statistics and Operations Research, University of Valencia, Burjassot 46100, Spain; E-Mails: (A.L.-Q.); (S.L.)
| | - Miriam Marco
- Department of Social Psychology, University of Valencia, Valencia 46010, Spain; E-Mails: (M.M.); (M.L.)
| | - Silvia Lladosa
- Department of Statistics and Operations Research, University of Valencia, Burjassot 46100, Spain; E-Mails: (A.L.-Q.); (S.L.)
| | - Marisol Lila
- Department of Social Psychology, University of Valencia, Valencia 46010, Spain; E-Mails: (M.M.); (M.L.)
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