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- Title
Methods of Estimating or Accounting for Neighborhood Associations With Health Using Complex Survey Data.
- Authors
Brumback, Babette A.; Cai, Zhuangyu; Dailey, Amy B.
- Abstract
Reasons for health disparities may include neighborhood-level factors, such as availability of health services, social norms, and environmental determinants, as well as individual-level factors. Investigating health inequalities using nationally or locally representative data often requires an approach that can accommodate a complex sampling design, in which individuals have unequal probabilities of selection into the study. The goal of the present article is to review and compare methods of estimating or accounting for neighborhood influences with complex survey data. We considered 3 types of methods, each generalized for use with complex survey data: ordinary regression, conditional likelihood regression, and generalized linear mixed-model regression. The relative strengths and weaknesses of each method differ from one study to another; we provide an overview of the advantages and disadvantages of each method theoretically, in terms of the nature of the estimable associations and the plausibility of the assumptions required for validity, and also practically, via a simulation study and 2 epidemiologic data analyses. The first analysis addresses determinants of repeat mammography screening use using data from the 2005 National Health Interview Survey. The second analysis addresses disparities in preventive oral health care using data from the 2008 Florida Behavioral Risk Factor Surveillance System Survey.
- Subjects
STATISTICS methodology; DATA analysis; EPIDEMIOLOGY research methodology; COMPARATIVE studies; COMPUTER simulation; ORAL hygiene; REGRESSION analysis; RESEARCH funding; SURVEYS; RESIDENTIAL patterns; SECONDARY analysis; HEALTH equity; EARLY detection of cancer; CLASSIFICATION
- Publication
American Journal of Epidemiology, 2014, Vol 179, Issue 10, p1255
- ISSN
0002-9262
- Publication type
Article
- DOI
10.1093/aje/kwu040