189064 Role of multilevel analysis in exploring environmental health disparities

Tuesday, October 28, 2008: 9:30 AM

Russell Lopez, MCRP ScD , School of Public Health, Boston University, Boston, MA
Multilevel modeling is a tool that can assist in exploring how the built, physical and social environment can perpetuate environmental injustices and create racial disparities in health. By combining individual level characteristics such as age, race/ethnicity, education, etc. with neighborhood level factors such as presence of liquor stores, absence of supermarkets, etc., the effects of levels of effects can be assessed and variance between levels estimated. Multilevel modeling makes it possible to study the effects of racial residential segregation, income inequality, disparate exposure and other factors that operate on a level greater than that of any individual's experience.

Multilevel modeling is becoming popular and is possible to perform using standard statistical programs including SAS, STATA and HLM. But multilevel analysis is more than just plugging in numbers and commands into the software.

A critical issue is the selection of what levels beyond the individual should be included in the analysis. Under best circumstances, level selection should be guided by an analysis of the factors being studied and the conceptual model driving the hypotheses being tested. Too often, level choice is opportunistically driven by the available data, which can result in inappropriate or misleading conclusions. A major related issue is how to define “neighborhood”. Researchers have used census block group, census tract, zip code and other metrics to parse out neighborhoods. Each has its advantages and disadvantages.

Used properly, multilevel modeling is a robust tool for furthering the science of environmental justice.

Learning Objectives:
Understand the uses and limits of multilevel modeling Discuss the issue of level identification and the problems of defining neighborhood and other levels of effect. Outline the steps that should go into the design of a multilevel study. Identify the range of issues that can be explored using multilevel modeling.

Keywords: Environmental Justice, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published several articles using multilevel modeling to explore environmental justice and health disparities issues.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.