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Integrating national surveys to estimate small area variations in poor health and limiting long term illness in Great Britain

Integrating national surveys to estimate small area variations in poor health and limiting long term illness in Great Britain
Integrating national surveys to estimate small area variations in poor health and limiting long term illness in Great Britain
Objectives: This study aims to address, for the first time, the challenges of constructing small area estimates of health status using linked national surveys. The study also seeks to assess the concordance of these small area estimates with data from national censuses.

Setting: Population level health status in England, Scotland and Wales

Participants: A linked integrated dataset of 23,374 survey respondents (16+ years) from the 2011 waves of the Health Survey for England (n=8,603), the Scottish Health Survey (n=7,537) and the Welsh Health Survey (n=7,234)

Primary and secondary outcome measures: Population prevalence of poorer self-rated health and limiting long term illness. A multilevel small area estimation modelling approach was used to estimate prevalence of these outcomes for Middle Super Output Areas in England and Wales and Intermediate Zones in Scotland. The estimates were then compared to matched measures from the contemporaneous 2011 UK Census.

Results: There was a strong positive association between the small area estimates and matched Census measures for all three countries for both poorer self-rated health (r=0.828, 95% CI 0.821 - 0.834) and limiting long-term illness (r=0.831, 95% CI 0.824 to 0.837), although systematic differences were evident and small area estimation tended to indicate higher prevalences than Census data.

Conclusions: Despite strong concordance, variations in the small area prevalences of poorer self-rated health and limiting long-term illness evident in Census data cannot be replicated perfectly using small area estimation with linked national surveys. This reflects a lack of harmonisation between surveys over question wording and design. The nature of small area estimates as ‘expected values’ also needs to be better understood.
2044-6055
Moon, Graham
68cffc4d-72c1-41e9-b1fa-1570c5f3a0b4
Aitken, Grant
2a15aadb-1f20-4186-8588-759a4b0ab757
Taylor, Joanna
40b1395b-e282-4efa-9e4e-cb994987a496
Twigg, Liz
41a8c6df-488f-4c0f-b38d-e83b8b41728c
Moon, Graham
68cffc4d-72c1-41e9-b1fa-1570c5f3a0b4
Aitken, Grant
2a15aadb-1f20-4186-8588-759a4b0ab757
Taylor, Joanna
40b1395b-e282-4efa-9e4e-cb994987a496
Twigg, Liz
41a8c6df-488f-4c0f-b38d-e83b8b41728c

Moon, Graham, Aitken, Grant, Taylor, Joanna and Twigg, Liz (2017) Integrating national surveys to estimate small area variations in poor health and limiting long term illness in Great Britain. BMJ Open. (doi:10.1136/bmjopen-2017-016936).

Record type: Article

Abstract

Objectives: This study aims to address, for the first time, the challenges of constructing small area estimates of health status using linked national surveys. The study also seeks to assess the concordance of these small area estimates with data from national censuses.

Setting: Population level health status in England, Scotland and Wales

Participants: A linked integrated dataset of 23,374 survey respondents (16+ years) from the 2011 waves of the Health Survey for England (n=8,603), the Scottish Health Survey (n=7,537) and the Welsh Health Survey (n=7,234)

Primary and secondary outcome measures: Population prevalence of poorer self-rated health and limiting long term illness. A multilevel small area estimation modelling approach was used to estimate prevalence of these outcomes for Middle Super Output Areas in England and Wales and Intermediate Zones in Scotland. The estimates were then compared to matched measures from the contemporaneous 2011 UK Census.

Results: There was a strong positive association between the small area estimates and matched Census measures for all three countries for both poorer self-rated health (r=0.828, 95% CI 0.821 - 0.834) and limiting long-term illness (r=0.831, 95% CI 0.824 to 0.837), although systematic differences were evident and small area estimation tended to indicate higher prevalences than Census data.

Conclusions: Despite strong concordance, variations in the small area prevalences of poorer self-rated health and limiting long-term illness evident in Census data cannot be replicated perfectly using small area estimation with linked national surveys. This reflects a lack of harmonisation between surveys over question wording and design. The nature of small area estimates as ‘expected values’ also needs to be better understood.

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More information

Accepted/In Press date: 5 June 2017
e-pub ahead of print date: 28 August 2017
Published date: August 2017
Organisations: Southampton Marine & Maritime Institute, Population, Health & Wellbeing (PHeW), Faculty of Social, Human and Mathematical Sciences

Identifiers

Local EPrints ID: 411169
URI: http://eprints.soton.ac.uk/id/eprint/411169
ISSN: 2044-6055
PURE UUID: e2141ee5-a764-4787-a736-59cf7ae734f9
ORCID for Graham Moon: ORCID iD orcid.org/0000-0002-7256-8397

Catalogue record

Date deposited: 15 Jun 2017 16:31
Last modified: 17 Dec 2019 06:05

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