Bringing the individual back to small-area variation studies: A multilevel analysis of all-cause mortality in Andalusia, Spain

Similarity of Perceived Health Between Household Members: The “Mutual Influences” Hypothesis

“…Conversely, in a family where nutrition style is unbalanced in favor of consumption of fatty foods, members will be more exposed to the risk of being obese, and in turn exposed to an increased risks of cardiovascular diseases. This kind of result has been consistently illustrated in the epidemiological literature (Johnson et al 1965;Monden 2007;Merlo et al 2012).…”

“…Such a comparison is not easy, as to date only a handful of studies have looked at the issue of households influences on health, and across these studies the health outcome, the target population, and the country characteristics vary largely. Working on all-cause mortality in Sweden, Merlo et al (2012) reported 18.6% of variability at the household level. Subramanian et al (2003) found a very large effect of households on poor self-rated health in Chile (VPC of 47%), however they made use solely of the binary indicator (SRH).…”

Revisiting causal neighborhood effects on individual ischemic heart disease risk: A quasi-experimental multilevel analysis among Swedish siblings

“…As we have discussed elsewhere (Merlo J, 2011;Merlo J et al, 2012;Merlo et al, 2009;Subramanian SV et al, 2007), from both an epidemiological and a public health policy viewpoint we need to consider two aspects in the investigation of neighborhood effects on health: (i) the validity of the association between neighborhood characteristics and individual IHD risk (i.e., specific contextual effects) and (ii) the relevance of the neighborhood boundaries −like those defining the Swedish SAMS− for understanding individual health disparities (i.e., general contextual effects)…”

“…General contextual effects are assessed by measures of variance and clustering rather than by measures of association (Merlo, 2003;Merlo J et al, 2012;Merlo et al, 2009;Merlo et al, 2001;Petronis & Anthony, 2003;Subramanian SV et al, 2007). We aimed to quantify the extent to which the SAMS we use for delimiting the neighborhood context conditioned individual IHD risk without specifying any contextual characteristic other than the very boundaries we used for defining the SAMS' context .…”

“…Moreover the conventional study of specific contextual effects described above (i.e., the analysis of the association between specific neighborhood level variables and individual outcomes), we also intended to investigate general contextual effects that are estimated by measures of variance and clustering rather than by measures of association (Merlo, 2003;Merlo J et al, 2012;Merlo et al, 2009;Merlo et al, 2001;Petronis & Anthony, 2003;Subramanian SV et al, 2007). The study of general contextual effects shows the extent to which the geographical constructs we use for delimiting the neighborhood context (i.e., parishes, Swedish small-area market statistics, blocks, postal code areas, census tracts, etc.)…”