Small-area methods for investigation of environment and health

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Title: Small-area methods for investigation of environment and health
Authors: Piel, F
Fecht, D
Hodgson, S
Blangiardo, M
Toledano, M
Hansell, A
Elliott, P
Item Type: Journal Article
Abstract: Small-area studies offer a powerful epidemiological approach to study disease patterns at the population level and assess health risks posed by environmental pollutants. They involve a public health investigation on a geographic scale (e.g. neighbourhood) with overlay of health, environmental, demographic and potential confounder data. Recent methodological advances, including Bayesian approaches, combined with fast growing computational capabilities permit more informative analyses than previously possible, including the incorporation of data at different scales, from satellites to individual-level survey information. Better data availability has widened the scope and utility of small-area studies, but also led to greater complexity, including choice of optimal study area size and extent, duration of study periods, range of covariates and confounders to be considered, and dealing with uncertainty. The availability of data from large, well-phenotyped cohorts such as UK Biobank enables the use of mixed-level study designs and the triangulation of evidence on environmental risks from small-area and individual-level studies, therefore improving causal inference, including use of linked biomarker and -omics data. As a result, there are now improved opportunities to investigate the impacts of environmental risk factors on human health, particularly for the surveillance and prevention of non-communicable diseases.
Issue Date: 1-Apr-2020
Date of Acceptance: 21-Jun-2019
DOI: 10.1093/ije/dyaa006
ISSN: 1464-3685
Publisher: Oxford University Press (OUP)
Start Page: 686
End Page: 699
Journal / Book Title: International Journal of Epidemiology
Volume: 49
Issue: 2
Copyright Statement: CThe Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permitsunrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: Public Health England
Medical Research Council (MRC)
Wellcome Trust
Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
Public Health England
National Institute for Health Research
Funder's Grant Number: 6509268
INS1324/P.O. 6319539
Keywords: Epidemiology
0104 Statistics
1117 Public Health and Health Services
Publication Status: Published
Online Publication Date: 2020-03-17
Appears in Collections:Faculty of Medicine
School of Public Health
Grantham Institute for Climate Change