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Int. J. Environ. Res. Public Health 2010, 7(1), 164-177;

Estimating Prevalence of Coronary Heart Disease for Small Areas Using Collateral Indicators of Morbidity

Department of Geography and Centre for Statistics, Queen Mary University of London, Mile End Rd, London E1 4NS, UK
Received: 20 November 2009 / Accepted: 14 January 2010 / Published: 18 January 2010
(This article belongs to the Special Issue Cardiovascular Diseases and Public Health)
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Different indicators of morbidity for chronic disease may not necessarily be available at a disaggregated spatial scale (e.g., for small areas with populations under 10 thousand). Instead certain indicators may only be available at a more highly aggregated spatial scale; for example, deaths may be recorded for small areas, but disease prevalence only at a considerably higher spatial scale. Nevertheless prevalence estimates at small area level are important for assessing health need. An instance is provided by England where deaths and hospital admissions for coronary heart disease are available for small areas known as wards, but prevalence is only available for relatively large health authority areas. To estimate CHD prevalence at small area level in such a situation, a shared random effect method is proposed that pools information regarding spatial morbidity contrasts over different indicators (deaths, hospitalizations, prevalence). The shared random effect approach also incorporates differences between small areas in known risk factors (e.g., income, ethnic structure). A Poisson-multinomial equivalence may be used to ensure small area prevalence estimates sum to the known higher area total. An illustration is provided by data for London using hospital admissions and CHD deaths at ward level, together with CHD prevalence totals for considerably larger local health authority areas. The shared random effect involved a spatially correlated common factor, that accounts for clustering in latent risk factors, and also provides a summary measure of small area CHD morbidity. View Full-Text
Keywords: Prevalence; common factor; spatial correlation; coronary heart disease; Bayesian Prevalence; common factor; spatial correlation; coronary heart disease; Bayesian
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Congdon, P. Estimating Prevalence of Coronary Heart Disease for Small Areas Using Collateral Indicators of Morbidity. Int. J. Environ. Res. Public Health 2010, 7, 164-177.

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