@article{ref1,
title="Explanatory models concerning the effects of small-area characteristics on individual health",
journal="International journal of public health",
year="2014",
author="Voigtländer, Sven and Vogt, Verena and Mielck, Andreas and Razum, Oliver",
volume="59",
number="3",
pages="427-438",
abstract="OBJECTIVES: Material and social living conditions at the small-area level are assumed to have an effect on individual health. We review existing explanatory models concerning the effects of small-area characteristics on health and describe the gaps future research should try to fill. <br><br>METHODS: Systematic literature search for, and analysis of, studies that propose an explanatory model of the relationship between small-area characteristics and health. <br><br>RESULTS: Fourteen studies met our inclusion criteria. Using various theoretical approaches, almost all of the models are based on a three-tier structure linking social inequalities (posited at the macro-level), small-area characteristics (posited at the meso-level) and individual health (micro-level). No study explicitly defines the geographical borders of the small-area context. The health impact of the small-area characteristics is explained by specific pathways involving mediating factors (psychological, behavioural, biological). These pathways tend to be seen as uni-directional; often, causality is implied. They may be modified by individual factors. <br><br>CONCLUSIONS: A number of issues need more attention in research on explanatory models concerning small-area effects on health. Among them are the (geographical) definition of the small-area context; the systematic description of pathways comprising small-area contextual as well as compositional factors; questions of direction of association and causality; and the integration of a time dimension.<p /> <p>Language: en</p>",
language="en",
issn="1661-8556",
doi="10.1007/s00038-014-0556-8",
url="http://dx.doi.org/10.1007/s00038-014-0556-8"
}