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Background  Neighbourhood is a complex structure but of high relevance for health. Its operationalisation remains however a challenge.The aim of this work is to present a new application of the use of semi-variograms as an approach for the evaluation of spatial effects on health. For this, we propose to estimate two parameters providing a measure of an average neighbourhood or spatial effect at city level without having to predefine any notion of physical neighbourhood.    Methods  We present the statistical method to estimate the parameters of this correlation neighbourhood by fitting an exponential model to the empirical semi-variogram at short distances. With a simulation study, we show for which sample size and sampling density the method performs well and illustrate how to use the method with data from a birth cohort using the outcome birthweight.    Results  For small sample sizes (500) the method provides reliable estimates if the density of observations is high. For larger sample sizes other parameters influencing the quality of estimates are the maximal distance at which the semi-variograms are estimated.    Conclusions  Given the complexity of spatial scales relative to neighbourhood spatial processes, our approach offers the possibility to incorporate existing approaches to the operationalisation of neighbourhood in quantitative analyses while providing a measure of the part of health inequalities which could be possibly due to unmeasured spatial exposure as well as a measure of their spatial scale.

bmc medical research methodology

An ego-centred approach for the evaluation of spatial effects on health in urban areas based on parametric semi-variogram models: concept and validation