Evaluating Geographic Health Disparities in Cancer Care: Example of the Modifiable Areal Unit Problem

Excerpt

As geographic information systems become more accessible to researchers, the role of geography in health research is becoming increasingly salient¹ and can lead to misapplication of important geographic concepts. One such example is the modifiable areal unit problem (MAUP), a type of ecologic fallacy that can lead to different results depending on the areal unit chosen for analysis.² This may have a disproportionate impact on rural areas versus urban areas, with the former suffering from highly variable rates for the same area due to lower population density. To truly understand how geography affects health outcomes, we must understand how the units of analysis we select influence our results. In this analysis, we demonstrated the differences in results stemming from our use of different areal units to evaluate disparities in late-stage presentation of patients with breast cancer. …