What level macro? Choosing appropriate levels to assess how place influences population health

Theresa L. Osypuk, Sandro Galea

Research output: Chapter in Book/Report/Conference proceedingChapter

29 Citations (Scopus)

Abstract

It is increasingly recognized that characteristics of different spatial levels (e.g., neighborhoods, states, nations) are associated with population health and may present an opportunity for intervention and health promotion. However, it is often unclear which spatial level may be most suitable to pursue research questions concerned with the production of population health. In this paper we present a discussion about the key conceptual and methodologic considerations relevant to the choice of various spatial levels that may be helpful for ecologic or multilevel analysis that are concerned with understanding the production of health of populations. Although researchers often implicitly mean neighborhoods when discussing how ‘place’ affects health in the contemporary population health literature, we present historical origins and current definitions regarding a range of commonly-operationalized spatial levels including neighborhoods, cities, counties, metropolitan areas, states, and nations, along with a discussion of the strengths of the use of each level when considering the production of health. Reflecting the preponderance of literature in the area, we use U.S. based examples to illustrate the concepts. However, the concepts addressed here are meant to illuminate considerations about relevant spatial units in different national contexts. We also discuss the how the choice of unit affects methodological aspects of any particular study, including construct validity of measures, as well as internal validity, external validity, and statistical conclusion validity of the study. Although some methodological issues, such as causal inference from observational neighborhood studies, have been discussed in the literature with respect to place and health, other issues such as generalizability and policy relevance have received less attention. By articulating theoretical and empirical justifications for using alternate definitions of place, we strive to broaden the conceptualization of how place affects health that may be useful for future research.
Original languageEnglish (US)
Title of host publicationMacrosocial Determinants of Population Health
EditorsSandro Galea
Place of PublicationNew York, NY
PublisherSpringer
Pages399-435
Number of pages37
ISBN (Print)9780387708119
DOIs
StatePublished - 2007

Fingerprint

Health
Population
Multilevel Analysis
Health Promotion
Observational Studies
Research Personnel
Research

Cite this

Osypuk, T. L., & Galea, S. (2007). What level macro? Choosing appropriate levels to assess how place influences population health. In S. Galea (Ed.), Macrosocial Determinants of Population Health (pp. 399-435). New York, NY: Springer. https://doi.org/10.1007/978-0-387-70812-6_19

What level macro? Choosing appropriate levels to assess how place influences population health. / Osypuk, Theresa L.; Galea, Sandro.

Macrosocial Determinants of Population Health. ed. / Sandro Galea. New York, NY : Springer, 2007. p. 399-435.

Research output: Chapter in Book/Report/Conference proceedingChapter

Osypuk, TL & Galea, S 2007, What level macro? Choosing appropriate levels to assess how place influences population health. in S Galea (ed.), Macrosocial Determinants of Population Health. Springer, New York, NY, pp. 399-435. https://doi.org/10.1007/978-0-387-70812-6_19
Osypuk TL, Galea S. What level macro? Choosing appropriate levels to assess how place influences population health. In Galea S, editor, Macrosocial Determinants of Population Health. New York, NY: Springer. 2007. p. 399-435 https://doi.org/10.1007/978-0-387-70812-6_19
Osypuk, Theresa L. ; Galea, Sandro. / What level macro? Choosing appropriate levels to assess how place influences population health. Macrosocial Determinants of Population Health. editor / Sandro Galea. New York, NY : Springer, 2007. pp. 399-435
@inbook{eac3f87ec6da4d92857565187164f9a7,
title = "What level macro? Choosing appropriate levels to assess how place influences population health",
abstract = "It is increasingly recognized that characteristics of different spatial levels (e.g., neighborhoods, states, nations) are associated with population health and may present an opportunity for intervention and health promotion. However, it is often unclear which spatial level may be most suitable to pursue research questions concerned with the production of population health. In this paper we present a discussion about the key conceptual and methodologic considerations relevant to the choice of various spatial levels that may be helpful for ecologic or multilevel analysis that are concerned with understanding the production of health of populations. Although researchers often implicitly mean neighborhoods when discussing how ‘place’ affects health in the contemporary population health literature, we present historical origins and current definitions regarding a range of commonly-operationalized spatial levels including neighborhoods, cities, counties, metropolitan areas, states, and nations, along with a discussion of the strengths of the use of each level when considering the production of health. Reflecting the preponderance of literature in the area, we use U.S. based examples to illustrate the concepts. However, the concepts addressed here are meant to illuminate considerations about relevant spatial units in different national contexts. We also discuss the how the choice of unit affects methodological aspects of any particular study, including construct validity of measures, as well as internal validity, external validity, and statistical conclusion validity of the study. Although some methodological issues, such as causal inference from observational neighborhood studies, have been discussed in the literature with respect to place and health, other issues such as generalizability and policy relevance have received less attention. By articulating theoretical and empirical justifications for using alternate definitions of place, we strive to broaden the conceptualization of how place affects health that may be useful for future research.",
author = "Osypuk, {Theresa L.} and Sandro Galea",
year = "2007",
doi = "10.1007/978-0-387-70812-6_19",
language = "English (US)",
isbn = "9780387708119",
pages = "399--435",
editor = "Sandro Galea",
booktitle = "Macrosocial Determinants of Population Health",
publisher = "Springer",

}

TY - CHAP

T1 - What level macro? Choosing appropriate levels to assess how place influences population health

AU - Osypuk, Theresa L.

AU - Galea, Sandro

PY - 2007

Y1 - 2007

N2 - It is increasingly recognized that characteristics of different spatial levels (e.g., neighborhoods, states, nations) are associated with population health and may present an opportunity for intervention and health promotion. However, it is often unclear which spatial level may be most suitable to pursue research questions concerned with the production of population health. In this paper we present a discussion about the key conceptual and methodologic considerations relevant to the choice of various spatial levels that may be helpful for ecologic or multilevel analysis that are concerned with understanding the production of health of populations. Although researchers often implicitly mean neighborhoods when discussing how ‘place’ affects health in the contemporary population health literature, we present historical origins and current definitions regarding a range of commonly-operationalized spatial levels including neighborhoods, cities, counties, metropolitan areas, states, and nations, along with a discussion of the strengths of the use of each level when considering the production of health. Reflecting the preponderance of literature in the area, we use U.S. based examples to illustrate the concepts. However, the concepts addressed here are meant to illuminate considerations about relevant spatial units in different national contexts. We also discuss the how the choice of unit affects methodological aspects of any particular study, including construct validity of measures, as well as internal validity, external validity, and statistical conclusion validity of the study. Although some methodological issues, such as causal inference from observational neighborhood studies, have been discussed in the literature with respect to place and health, other issues such as generalizability and policy relevance have received less attention. By articulating theoretical and empirical justifications for using alternate definitions of place, we strive to broaden the conceptualization of how place affects health that may be useful for future research.

AB - It is increasingly recognized that characteristics of different spatial levels (e.g., neighborhoods, states, nations) are associated with population health and may present an opportunity for intervention and health promotion. However, it is often unclear which spatial level may be most suitable to pursue research questions concerned with the production of population health. In this paper we present a discussion about the key conceptual and methodologic considerations relevant to the choice of various spatial levels that may be helpful for ecologic or multilevel analysis that are concerned with understanding the production of health of populations. Although researchers often implicitly mean neighborhoods when discussing how ‘place’ affects health in the contemporary population health literature, we present historical origins and current definitions regarding a range of commonly-operationalized spatial levels including neighborhoods, cities, counties, metropolitan areas, states, and nations, along with a discussion of the strengths of the use of each level when considering the production of health. Reflecting the preponderance of literature in the area, we use U.S. based examples to illustrate the concepts. However, the concepts addressed here are meant to illuminate considerations about relevant spatial units in different national contexts. We also discuss the how the choice of unit affects methodological aspects of any particular study, including construct validity of measures, as well as internal validity, external validity, and statistical conclusion validity of the study. Although some methodological issues, such as causal inference from observational neighborhood studies, have been discussed in the literature with respect to place and health, other issues such as generalizability and policy relevance have received less attention. By articulating theoretical and empirical justifications for using alternate definitions of place, we strive to broaden the conceptualization of how place affects health that may be useful for future research.

UR - http://www.scopus.com/inward/record.url?scp=84892784627&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892784627&partnerID=8YFLogxK

U2 - 10.1007/978-0-387-70812-6_19

DO - 10.1007/978-0-387-70812-6_19

M3 - Chapter

AN - SCOPUS:84892784627

SN - 9780387708119

SP - 399

EP - 435

BT - Macrosocial Determinants of Population Health

A2 - Galea, Sandro

PB - Springer

CY - New York, NY

ER -