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Environmental Epidemiology
Part 5. Ecological Studies.
Mark S. Goldberg
INRS-Institut Armand-Frappier,
University of Quebec, and
McGill University
July 2000
Ecological Studies
Definition: An investigation of the
distribution of health and its
determinants between groups of
individuals.
The degree to which studies are purely
ecological can vary considerably.
Measurement variables
Aggregated measures: summaries of
attributes calculated from data on
individuals for whole populations in
well-defined geographic regions
Types of studies
Individual level: Well defined target and
study populations and data available on
individuals for all (or most) covariates.
Case-control
Cohort and longitudinal
Cross-sectional
Time trend studies
Immigrant studies
Levels of Inference
Biologic inferences on populations
Individual-level studies
Ecologic-level studies
In individual-level studies,
inferences are made to the target
populations using data collected
from individuals
Ecological Fallacy
Assumptions:
1) that the effects estimated at the
individual level are the relevant ones
for making biological inferences
2) that the effects are a linear
function of the predictors; i.e. E[yi] =
+ xi
= G + W
AND
Region 1
Region 2
Region 3
Total
Smoking
Yes No
Yes No
Yes No
Yes No
No of cases
13
3
12
3.6
12 4.2
36 10.8
Population 100000.100000. 80000.120000. 60000. 140000. 240000.360000.
Rate/ 100.000
12
3
15
3
20
3
15
3
Rate ratio
4
5
6.7
5
Rate difference
9
12
17
12
Overall SMR
5 (Standardized to non-smokers; i.e.,no
noconfounging
confoundingby
bygroup
grou
0.5
7.5
0.4
7.8
0.3
8.1
Confounding by NonConfounders
Variable is not a confounder on the
individual level
may occur if background rates vary
by group
if rate differences between groups
not constant
Region 1
Region 2
Region 3
Smokers NonsmokersSmokers NonsmokersSmokers Nonsmoker
Radon level
Yes No Yes No Yes No Yes No Yes No Yes No
No of cases
52 74 5.2 7.4 56 52 8.4 7.8 60 30 14 7
Population
(in thousands) 26 74 26 74 28 52 42 78 30 30 70 70
Rate per 100,000 200 100 20 10 200 100 20 10 200 100 20 10
Rate by smoking level126
12.6
135
13.5
15
1.5
Rate ratio for smoking
10
10
10
Radon-smoking assocn.
1
1
1
Rate difference for radon
100
10
100
10
100
10
Rate ratio for radon
2
2
2
2
2
2
Region 1
Region 2
Region 3
Smokers NonsmokersSmokers NonsmokersSmokers Nonsmokers
Alcohol
Yes No Yes No Yes No Yes No Yes No Yes No
No of cases
13 2.5 1.5 0.7 14.7 1.1 1.1 1 15 0.6 1.9 0.9
Population
(in thousand50 50 30 70 58.8 21 21 98.8 60 12 38 90
Rate per 100,000 25 5 5 1 25 5 5 1 25 5 5 1
Rate by smoking level
15
2.2
19.7
1.8
21.7
2.2
RR: smoking
6.6
11
9.9
Alc-smk assocn.
2.3
12.1
11.8
Rate diff.: alcohol 20
4
20
4
20
4
RR: alcohol
5
5
5
5
5
5
Nondifferential Misclassification
of Exposure
For both linear and log-linear models
nondifferential misclassification of exposure
(binary variable) leads to an overestimation
of effect in ecological studies, even if there
are no other sources of ecological bias
Possible Solutions
Obtain detailed information on
covariates so that not just mean levels
are used in the analysis
Obtain joint distributions of covariates
and exposures
Use another analytic approach
(individual-level or semi-individuallevel studies)
tio s
O d d s r a tio s
1,8
1.8
1,6
1.6
1,4
1.4
1,2
1.2
1
0,8
0.8
0,6
0.6
0,4
0.4
0,2
0.2
0
0
50
100
150
200
Ecological
RR 95%CI
1 0.79-1.17
1 0.79-1.17
1.1 0.80-1.29
References
ECOLOGICAL STUDIES