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International Journal of Public Health

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01-06-2014 | Review

Explanatory models concerning the effects of small-area characteristics on individual health

Authors: Sven Voigtländer, Verena Vogt, Andreas Mielck, Oliver Razum

Published in: International Journal of Public Health | Issue 3/2014

Abstract

Objectives

Material and social living conditions at the small-area level are assumed to have an effect on individual health. We review existing explanatory models concerning the effects of small-area characteristics on health and describe the gaps future research should try to fill.

Methods

Systematic literature search for, and analysis of, studies that propose an explanatory model of the relationship between small-area characteristics and health.

Results

Fourteen studies met our inclusion criteria. Using various theoretical approaches, almost all of the models are based on a three-tier structure linking social inequalities (posited at the macro-level), small-area characteristics (posited at the meso-level) and individual health (micro-level). No study explicitly defines the geographical borders of the small-area context. The health impact of the small-area characteristics is explained by specific pathways involving mediating factors (psychological, behavioural, biological). These pathways tend to be seen as uni-directional; often, causality is implied. They may be modified by individual factors.

Conclusions

A number of issues need more attention in research on explanatory models concerning small-area effects on health. Among them are the (geographical) definition of the small-area context; the systematic description of pathways comprising small-area contextual as well as compositional factors; questions of direction of association and causality; and the integration of a time dimension.

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Title: Explanatory models concerning the effects of small-area characteristics on individual health
Authors: Sven Voigtländer
Verena Vogt
Andreas Mielck
Oliver Razum
Publication date: 01-06-2014
Publisher: Springer Basel
Published in: International Journal of Public Health / Issue 3/2014
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-014-0556-8

At a glance: The STEP trials

Springer Medicine

Explanatory models concerning the effects of small-area characteristics on individual health

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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