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An ego-centred approach for the evaluation of health inequalities in urban areas

  • Background: Neighbourhood possesses attributes, structural, physical and social, for which pathways to health inequalities could be hypothesized. Hence, neighbourhood is a complex mixture of factors which cannot be simply defined by a delineation on a map, making common definitions of neighbourhood (e.g. administrative borders) problematic. We present a new concept for the evaluation of contextual health inequalities in an urban setting. Methods: An ego-centred approach to neighbourhood effects on health allows to establish to what degree the health outcomes of a person are on average correlated to the health outcomes of his/her neighbours. This approach does not necessitate the definition of what a neighbourhood is, or of its boundaries. Using data from the BaBi birth cohort following up 958 mother-child pairs in Bielefeld/Germany we illustrate how the method provides information about the spatial structure of a possible association between unmeasured neighbourhood factors and birthweight. Spatially correlated birthweightBackground: Neighbourhood possesses attributes, structural, physical and social, for which pathways to health inequalities could be hypothesized. Hence, neighbourhood is a complex mixture of factors which cannot be simply defined by a delineation on a map, making common definitions of neighbourhood (e.g. administrative borders) problematic. We present a new concept for the evaluation of contextual health inequalities in an urban setting. Methods: An ego-centred approach to neighbourhood effects on health allows to establish to what degree the health outcomes of a person are on average correlated to the health outcomes of his/her neighbours. This approach does not necessitate the definition of what a neighbourhood is, or of its boundaries. Using data from the BaBi birth cohort following up 958 mother-child pairs in Bielefeld/Germany we illustrate how the method provides information about the spatial structure of a possible association between unmeasured neighbourhood factors and birthweight. Spatially correlated birthweight indicates a neighbourhood effect on maternal health. Results: A parametric model of the correlation structure gives two indicators: a distance after which health outcomes are no longer correlated (practical range), and the strength of correlation (RSV). We modelled birthweight directly and residuals after controlling for (spatially correlated) covariates. After adjusting for the mother’s demographics and neighbourhood characteristics, birthweights remained spatially correlated with RSV of 11% and a practical range of 128 m. Conclusions: Modelling the spatial correlation of a health outcome provides a measure of the degree of health correlation, thus offering new evidence on the production of health inequalities while incorporating current modelling approaches. Moreover, it measures heterogeneity in a city. This could be used as an indicator for policy makers or town planners to identify areas in need of socioeconomic investment.show moreshow less

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Author: Odile Sauzet, Kim Alexandra Zolitschka, Jacob SpallekORCiDGND, Jürgen Breckenkamp, Oliver RazumGND
DOI:https://doi.org/10.1093/eurpub/ckz186.243
ISSN:1101-1262
ISSN:1464-360X
Title of the source (English):European Journal of Public Health
Document Type:Conference publication peer-reviewed
Language:English
Year of publication:2019
Tag:Germany; birth weight; child; demography; ego; health disparity; health inequalities; maternal health; socioeconomic factors; towns; urban
Volume/Year:29
Issue number:4
Number of pages:1
Article number:ckz186.243
Faculty/Chair:Fakultät 4 Humanwissenschaften (bis 2023 Soziale Arbeit, Gesundheit und Musik) / FG Gesundheitswissenschaften
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