[Geographic differences of bronchopulmonary cancer mortality in France and spatial scales of analysis: significance of scale change in health geography].

BACKGROUND

It is important to choose a valid spatial scale to study health differences in a geographical perspective. Many scales can be valid and a combination is required to understand the spatial distribution of a given health problem. Geographic distribution of lung cancer was studied in France using different scales to illustrate the importance of changing scales in health geography.

METHODS

Standardized rates (direct method) for lung cancer were calculated for the period 1988-92 and mapped at different scales.

RESULTS

Original spatial structure was observed for each scale. This proved that different interactions occur at each scale between environmental and social factors. Changing the scale allowed a better understanding of variations in the spatial distribution of lung cancer.

CONCLUSIONS

The validity of a regional scale to study health geographical distributions is questioned. Changing the scale would allow proposing action to improve health promotion.