Escalating concern about environmental influences on public health has led to an increasing need for scientists to quickly assemble accurate data for studies. More and more scientists are turning to spatial epidemiology to aid them in visualizing uncertainties across space and time. A series of articles, published in the August 2008 issue of Environmental Health Perspectives (EHP), explores applications of spatial epidemiology in identifying trends in the occurrence of diseases such as breast cancer as well as the ability of this rapidly evolving science to impact public health policy.

Spatial epidemiology combines epidemiology with statistics and geographic information systems, allowing scientists to more quickly and accurately identify and isolate the relationship between diseases and environmental hazards, as illustrated by one study in the series that examined multilevel modeling of breast cancer in Cape Cod, Massachusetts.

According to co-author Thomas Webster, of the Boston University School of Public Health, women living in higher socio-economic status (SES) communities on Cape Cod had an increased risk of breast cancer, independent of their individual SES. The findings suggest that some characteristics of higher SES communities may increase risk of breast cancer independent of individual-level risk factors.

"This study of breast cancer risk factors is just one strong example of the possible applications of spatial epidemiology," said Webster. "We were able to identify individual and community level risk factors over space and time - knowledge which could potentially help public health officials and health care providers identify and prevent disease."

The Webster study used individual and community SES information from the 1980 and 1990 censuses, as well as individual education information for study participants. The researchers then constructed controlled models of breast cancer risk, adjusting for individual risk factors other than education and SES. Study data were paired with census information from date of diagnosis and from 10 years prior to diagnosis to construct models for breast cancer risk. The multi-level measurement distinguished this study from other similar spatial epidemiology studies.

"Spatial epidemiology, although not without some limitations, allows scientists to study public health concerns related to environmental risks effectively and efficiently," said Linda Beale, of Imperial College London, lead author of another article in the series. "The method allows scientists to identify risk patterns and could be pivotal in the prevention of disease." According to Beale, spatial epidemiology is increasingly being used to assess health risks associated with environmental hazards. Risk patterns tend to have both temporal and spatial components.

The Beale article reviews methods that epidemiologists and public health practitioners can employ to overcome limitations of current efforts, and recommends tools to improve analyses of disease risk.

"These and other similar studies will have an important impact on our understanding of trends in disease prevalence among demographic groups and across geographic areas," said EHP editor-in-chief Hugh A. Tilson, PhD. "This growing field will continue to contribute to the understanding of environmental factors that pose health risks for the public and, ultimately, to guide and inform the design of prevention models for at risk populations."

Other authors for the Beale article included Juanjo Abellan, Susan Hodgson, and Lars Jarup. Other authors for Webster's study included Kate Hoffman, Janice Weinberg, Veronica Vieira, and Ann Aschengrau.

The complete series of articles is available free of charge at
-- ehponline/members/2008/10814/10814.html;
-- ehponline/members/2008/10815/10815.html;
-- ehponline/members/2008/10816/10816.html;
-- ehponline/members/2008/10817/10817.html;
-- ehponline/members/2008/10818.10818.html.

EHP is published by the National Institute of Environmental Health Sciences (NIEHS), part of the U.S. Department of Health and Human Services. EHP is an Open Access journal. More information is available online at ehponline/. Brogan & Partners Convergence Marketing handles marketing and public relations for the publication, and is responsible for creation and distribution of this press release.

Environmental Health Perspectives (EHP)

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