The stationarity bias in research on the environmental determinants of health.

An implicit assumption often made in research on the environmental determinants of health is that the relationships between environmental factors and their health effects are stable over space and time. This is the assumption of stationarity. The health impacts of environmental factors, however, may vary not only over space and time but also over the value ranges of the environmental factors under investigation. Few studies to date have examined how often the stationarity assumption is violated and when violated, to what extent findings might be misleading. Using selected studies as examples, this paper explores how the stationarity assumption can lead to misleading conclusions about health-environment relationships that may in turn have serious health consequences or policy implications. It encourages researchers to embrace nonstationarity and recognize its meaning because it helps direct our attention to the ignored factors or processes that may enhance our understanding of the phenomena under investigation.