Alette Willis

Doing Epidemiology As if Space and Place Mattered: Accounting for Spatial Processes in a Cohort Study Alette Willis

All too often, epidemiological studies are conducted as if people lived in a featureless abstract space. Even those studies examining the health effects of exposure to environmental contaminants in specific places often proceed as if those places are just points on a sheet of otherwise empty graph paper. This book explores what an epidemiological study might look like if people were truly conceived of as living in particular places within geographic space. In particular, it highlights the issues of place-based determinants of health, spatial autocorrelation and the importance of the scale of data acquisition, aggregation and analysis. Multi-level analyses, filtering and the inclusion of place-specific ecological covariates are offered as ways of taking into account spatial processes. Through an extensive reanalysis of the influential American Cancer Society study of the health effects of particulate air pollution, the book demonstrates that taking place and space into account can change what we know about human health and the environment.