ArticleInternational journal of environmental research and public health2013
Modeling the cumulative effects of social exposures on health: moving beyond disease-specific models.
Article in International journal of environmental research and public health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Assessing the effect of race on machine learning models predicting hospital admissions from emergency department.JAMIA open · 2026Article
- Neighborhood playability and early childhood development: a population-based birth cohort study.Environmental research · 2026Article
- Effects of household and neighbourhood attributes on four definitions of multimorbidity: a comparative multilevel analysis of linked clinical and census data of Wales.BMJ public health · 2026Article
- Prevalence of multimorbidity and its relationship with socioeconomic status among Chinese older adults over time.PloS one · 2025Article
- Disparities in self-reported mental health, physical health, and substance use across sexual orientations in Canada.PloS one · 2025Article
- Recent Prevalence of and Factors Associated With Chronic Obstructive Pulmonary Disease in a Rapidly Aging Society: Korea National Health and Nutrition Examination Survey 2015-2019.Journal of Korean medical science · 2023Observational
- Social determinants of multimorbidity and multiple functional limitations among the ageing population of England, 2002-2015.SSM - population health · 2019Article
- Childhood Conditions and Multimorbidity Among Older Adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2016Article
- Physical health and gender as risk factors for usage of services for mental illness.Journal of epidemiology and community health · 2014Article
- Mental health status and gender as risk factors for onset of physical illness over 10 years.Journal of epidemiology and community health · 2014Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The traditional explanatory models used in epidemiology are "disease specific", identifying risk factors for specific health conditions. Yet social exposures lead to a generalized, cumulative health impact which may not be specific to one illness. Disease-specific models may therefore misestimate social factors' effects on health. Using data from the Canadian Community Health Survey and Canada 2001 Census we construct and compare "disease-specific" and "generalized health impact" (GHI) models to gauge the negative health effects of one social exposure: socioeconomic position (SEP). We use logistic and multinomial multilevel modeling with neighbourhood-level material deprivation, individual-level education and household income to compare and contrast the two approaches. In disease-specific models, the social determinants under study were each associated with the health conditions of interest. However, larger effect sizes were apparent when outcomes were modeled as compound health problems (0, 1, 2, or 3+ conditions) using the GHI approach. To more accurately estimate social exposures' impacts on population health, researchers should consider a GHI framework.
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