Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Gregory Tce, Fortitude Valley, Australia.
Int J Health Geogr. 2011 Jan 24;10:9. doi: 10.1186/1476-072X-10-9.
Achieving health equity has been identified as a major challenge, both internationally and within Australia. Inequalities in cancer outcomes are well documented, and must be quantified before they can be addressed. One method of portraying geographical variation in data uses maps. Recently we have produced thematic maps showing the geographical variation in cancer incidence and survival across Queensland, Australia. This article documents the decisions and rationale used in producing these maps, with the aim to assist others in producing chronic disease atlases.
Bayesian hierarchical models were used to produce the estimates. Justification for the cancers chosen, geographical areas used, modelling method, outcome measures mapped, production of the adjacency matrix, assessment of convergence, sensitivity analyses performed and determination of significant geographical variation is provided.
Although careful consideration of many issues is required, chronic disease atlases are a useful tool for assessing and quantifying geographical inequalities. In addition they help focus research efforts to investigate why the observed inequalities exist, which in turn inform advocacy, policy, support and education programs designed to reduce these inequalities.
在国际和澳大利亚国内,实现健康公平都被认为是一个重大挑战。癌症结局的不平等现象已有充分记录,在解决之前必须对其进行量化。一种描述数据地理差异的方法是使用地图。最近,我们制作了专题地图,展示了澳大利亚昆士兰州癌症发病率和生存率的地理差异。本文记录了制作这些地图所使用的决策和基本原理,旨在帮助其他人制作慢性病地图集。
使用贝叶斯层次模型来生成估计值。选择癌症的理由、使用的地理区域、建模方法、映射的结果测量、邻接矩阵的生成、收敛性评估、进行敏感性分析以及确定显著的地理差异都提供了依据。
尽管需要仔细考虑许多问题,但慢性病地图集是评估和量化地理不平等的有用工具。此外,它们还有助于集中研究努力,以调查观察到的不平等现象存在的原因,这反过来又为旨在减少这些不平等现象的宣传、政策、支持和教育计划提供了信息。