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Author Notes:

David C. Wheeler, Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, U.S.A. dcwheel@sph.emory.edu

We would like to thank Dr Mercedes Jacobson, Director of the Temple University Comprehensive Epilepsy Center, for her support in the acquisition of the patient data utilized in this research.

Subjects:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Physical Sciences
  • Mathematical & Computational Biology
  • Public, Environmental & Occupational Health
  • Medical Informatics
  • Medicine, Research & Experimental
  • Statistics & Probability
  • Research & Experimental Medicine
  • Mathematics
  • hierarchical Bayesian regression
  • health disparities
  • spatial epidemiology
  • MCMC
  • spatial statistics
  • HEALTH
  • POPULATION
  • PREVALENCE
  • SEIZURES

Modeling epilepsy disparities among ethnic groups in Philadelphia, PA

Tools:

Journal Title:

Statistics in Medicine

Volume:

Volume 27, Number 20

Publisher:

, Pages 4069-4085

Type of Work:

Article | Post-print: After Peer Review

Abstract:

The Centers for Disease Control and Prevention defined epilepsy as an emerging public health issue in a recent report and emphasized the importance of epilepsy studies in minorities and people of low socioeconomic status. Previous research has suggested that the incidence rate for epilepsy is positively associated with various measures of social and economic disadvantage. In response, we utilize hierarchical Bayesian models to analyze health disparities in epilepsy and seizure risks among multiple ethnicities in the city of Philadelphia, Pennsylvania. The goals of the analysis are to highlight any overall significant disparities in epilepsy risks between the populations of Caucasians, African Americans, and Hispanics in the study area during the years 2002-2004 and to visualize the spatial pattern of epilepsy risks by ethnicity to indicate where certain ethnic populations were most adversely affected by epilepsy within the study area. Results of the Bayesian model indicate that Hispanics have the highest epilepsy risk overall, followed by African Americans, and then Caucasians. There are significant increases in relative risk for both African Americans and Hispanics when compared with Caucasians, as indicated by the posterior mean estimates of 2.09 with a 95 per cent credible interval of (1.67, 2.62) for African Americans and 2.97 with a 95 per cent credible interval of (2.37, 3.71) for Hispanics. Results also demonstrate that using a Bayesian analysis in combination with geographic information system (GIS) technology can reveal spatial patterns in patient data and highlight areas of disparity in epilepsy risk among subgroups of the population.

Copyright information:

Copyright © 2008 John Wiley & Sons, Ltd.

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