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Voigtländer, S.* ; Vogt, V.* ; Mielck, A. ; Razum, O.*

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

Int. J. Public Health 59, 427-438 (2014)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
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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Publication type Article: Journal article
Document type Review
Corresponding Author
Keywords Small-area Context ; Health ; Explanatory Models ; Health Inequalities ; Environmental Health; Coronary-heart-disease; Social-inequality; Physical-activity; Neighborhood; Deprivation; Determinants; Mortality; Impact; Place; Disparities
ISSN (print) / ISBN 0303-8408
e-ISSN 1420-911X
Journal International Journal of Public Health
Quellenangaben Volume: 59, Issue: 3, Pages: 427-438 Article Number: , Supplement: ,
Publisher Springer
Publishing Place Basel
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Health Economics and Health Care Management (IGM)