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• 1. A comparison of approaches to modelling health and environment Archived

  Articles and reports: 11-522-X20020016719

  Description:

  This study takes a look at the modelling methods used for public health data. Public health has a renewed interest in the impact of the environment on health. Ecological or contextual studies ideally investigate these relationships using public health data augmented with environmental characteristics in multilevel or hierarchical models. In these models, individual respondents in health data are the first level and community data are the second level. Most public health data use complex sample survey designs, which require analyses accounting for the clustering, nonresponse, and poststratification to obtain representative estimates of prevalence of health risk behaviours.

  This study uses the Behavioral Risk Factor Surveillance System (BRFSS), a state-specific US health risk factor surveillance system conducted by the Center for Disease Control and Prevention, which assesses health risk factors in over 200,000 adults annually. BRFSS data are now available at the metropolitan statistical area (MSA) level and provide quality health information for studies of environmental effects. MSA-level analyses combining health and environmental data are further complicated by joint requirements of the survey sample design and the multilevel analyses.

  We compare three modelling methods in a study of physical activity and selected environmental factors using BRFSS 2000 data. Each of the methods described here is a valid way to analyse complex sample survey data augmented with environmental information, although each accounts for the survey design and multilevel data structure in a different manner and is thus appropriate for slightly different research questions.

  Release date: 2004-09-13

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• 1. A comparison of approaches to modelling health and environment Archived

  Articles and reports: 11-522-X20020016719

  Description:

  This study takes a look at the modelling methods used for public health data. Public health has a renewed interest in the impact of the environment on health. Ecological or contextual studies ideally investigate these relationships using public health data augmented with environmental characteristics in multilevel or hierarchical models. In these models, individual respondents in health data are the first level and community data are the second level. Most public health data use complex sample survey designs, which require analyses accounting for the clustering, nonresponse, and poststratification to obtain representative estimates of prevalence of health risk behaviours.

  This study uses the Behavioral Risk Factor Surveillance System (BRFSS), a state-specific US health risk factor surveillance system conducted by the Center for Disease Control and Prevention, which assesses health risk factors in over 200,000 adults annually. BRFSS data are now available at the metropolitan statistical area (MSA) level and provide quality health information for studies of environmental effects. MSA-level analyses combining health and environmental data are further complicated by joint requirements of the survey sample design and the multilevel analyses.

  We compare three modelling methods in a study of physical activity and selected environmental factors using BRFSS 2000 data. Each of the methods described here is a valid way to analyse complex sample survey data augmented with environmental information, although each accounts for the survey design and multilevel data structure in a different manner and is thus appropriate for slightly different research questions.

  Release date: 2004-09-13

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