Estimating the changing nature of Scotland's health inequalities by using a multivariate spatiotemporal model

J R Stat Soc Ser A Stat Soc. 2019 Jun;182(3):1061-1080. doi: 10.1111/rssa.12447. Epub 2019 Apr 9.

Abstract

Health inequalities are the unfair and avoidable differences in people's health between different social groups. These inequalities have a huge influence on people's lives, particularly those who live at the poorer end of the socio-economic spectrum, as they result in prolonged ill health and shorter lives. Most studies estimate health inequalities for a single disease, but this will give an incomplete picture of the overall inequality in population health. Here we propose a novel multivariate spatiotemporal model for quantifying health inequalities in Scotland across multiple diseases, which will enable us to understand better how these inequalities vary across disease and have changed over time. In developing this model we are interested in estimating health inequalities between Scotland's 14 regional health boards, who are responsible for the protection and improvement of their population's health. The methodology is applied to hospital admissions data for cerebrovascular disease, coronary heart disease and respiratory disease, which are three of the leading causes of death, from 2003 to 2012 across Scotland.

Keywords: Bayesian modelling; Disease mapping; Health inequalities; Multivariate spatiotemporal correlation.