In this talk I will describe four types of spatial epidemiological study that may be summarized as: disease mapping; clustering and cluster detection; point/line source studies; ecological studies. A basic aim is to quantify and isolate sources of variability in disease rates; the latter often to gain clues to disease aetiology. I have been involved in a number of studies carried out by the Small Area Health Statistics Unit in the United Kingdom; an independent government-sponsored unit part of whose remit is to investigate, using routinely-collected data, the link between putative sources of environmental pollution and disease risk.
In studies with which I have been involved it has been vital to adjust for some measure of socio-economic status since this has been shown to be a powerful predictor of a range of health outcomes. I will describe the area-level indices utilized, and the rationale behind their use, including discussion of the complex relationship between health, environmental pollution and socio-economic status.
