Spatio-temporal modelling of rates for the construction of disease maps

There have been significant developments in disease mapping in the past few decades. The continual development of statistical methodology in this area is responsible for the growing popularity of disease mapping because of its potential usefulness in regional health planning, disease surveillance and intervention, and allocating health funding. Here we review the area of disease mapping where relative risks pertain to an event such as incidence or mortality over space and time. In particular we briefly discuss the use of generalized additive mixed models, an additive extension of generalized linear mixed models, for spatio-temporal analysis of disease rates. To illustrate the procedures, we present an in-depth analysis of infant mortality data in the province of British Columbia, Canada. The goals of the analysis are to produce more reliable small-area estimates of mortality rates, assess spatial patterns over time, and examine risk trends at both global (provincial) and local (local health area) levels.