Department of Economic and Legal Studies, University of Naples "Parthenope", Italy.
Soc Sci Med. 2018 May;204:67-83. doi: 10.1016/j.socscimed.2018.03.027. Epub 2018 Mar 21.
The present study analyses the spatial distribution of cancer mortality rates in Campania (an Italian region with the highest population density), in which residents in several areas are exposed to major environmental health hazards. The paper has the methodological aims of verifying the existence, or otherwise, of a spatial correlation between mortality from different types of cancer and the occurrence of some specific area characteristics, using both Bayesian statistics and spatial econometrics. We show that the use of the Spatial Empirical Bayes Smoothed Rate, instead of the more commonly used Raw Rate, allows a more comprehensive analysis of the mortality rate, highlighting the existence of different cluster sizes throughout the region, according to the type of cancer mortality rate analysed. By using a Spatial Durbin model we verify that cancer mortality rates are related to the environmental characteristics of specific areas with spatial spillover effects. Our results validate the hypothesis that living along the coast by Mt Vesuvius and, to a lesser extent, along the Domitio-Flegreo coast NW of Naples and in more urbanised municipalities, increases the risk of dying of cancer. By contrast, living in less urbanised municipalities, with the presence of natural and historical attractions, has a positive effect on the residents' health, reducing their risk of disease. In both cases significant spillover effects (negative and positive) are found in municipalities close to the areas in question. Despite a number of reasonable limitations, our findings may provide useful information support for policy makers to foster knowledge, awareness and informed participation of citizens.
本研究分析了癌症死亡率在坎帕尼亚（意大利人口密度最高的地区之一）的空间分布，该地区的几个地区的居民面临着重大的环境健康危害。本文的方法学目的是验证不同类型癌症死亡率与某些特定区域特征之间是否存在空间相关性，使用了贝叶斯统计和空间计量经济学。我们表明，使用空间经验贝叶斯平滑率（Spatial Empirical Bayes Smoothed Rate）而不是更常用的原始率（Raw Rate），可以更全面地分析死亡率，突出了根据分析的癌症死亡率类型，整个地区存在不同大小的聚类。通过使用空间杜宾模型，我们验证了癌症死亡率与具有空间溢出效应的特定区域的环境特征有关。我们的结果验证了这样一个假设，即在维苏威火山沿岸以及在那不勒斯西北部的多米蒂奥-弗莱格雷奥（Domitio-Flegreo）海岸和城市化程度较高的市镇生活，会增加癌症死亡的风险。相比之下，生活在城市化程度较低、有自然和历史景点的市镇，对居民的健康有积极影响，降低了他们患病的风险。在这两种情况下，都发现了与相关地区相邻的市镇存在显著的溢出效应（负向和正向）。尽管存在一些合理的限制，但我们的研究结果可能为决策者提供有用的信息支持，以促进知识、意识和公民的知情参与。
