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Related Experiment Videos

Place effects for areas defined by administrative boundaries.

M H Boyle1, J D Willms

  • 1Department of Psychiatry and Centre for Studies of Children Risk, McMaster University, Hamilton, Ontario, Canada.

American Journal of Epidemiology
|March 20, 1999
PubMed
Summary

Geographic place has minimal impact on health outcomes and family functioning. Even after accounting for individual factors, place effects remain small, questioning the utility of large regions for health assessments.

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Area of Science:

  • Public Health
  • Health Geography
  • Epidemiology

Background:

  • Understanding the influence of geographic location on population health is crucial for targeted interventions.
  • Previous research has yielded mixed results on the significance of place in health disparities.

Purpose of the Study:

  • To estimate the impact of place on health problems, quality of life, well-being, and family functioning.
  • To investigate how geographic scale and health indicators modify place effects.
  • To assess the influence of individual-level factors on place-based health variations.

Main Methods:

  • Utilized cross-sectional data from the 1990 Ontario Health Survey.
  • Analyzed health indicators across 42 public health units and smaller enumeration areas.

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  • Adjusted for demographic and socioeconomic factors (age, gender, education, income, etc.).

    • Main Results:

    • Place effects were generally small, varying by geographic scale and health indicator.
    • Less than 1% of health variations were explained at the public health region level.
    • At the enumeration area level, place explained up to 4.7% of health problems, reduced to 3.7% after adjustments.
    • Family functioning showed minimal place effects (0.2%–0.1%).

    Conclusions:

    • Large jurisdictional boundaries show limited evidence of place effects on health.
    • The findings question the effectiveness of health needs assessments in large regions.
    • Smaller geographic units provide more nuanced insights into place-based health variations.