Kaufman, Jay S. (2006). Socioeconomic Context. Epidemiology, 17(1)
In this issue, Stjärne et al describe socioeconomic gradients in the incidence of myocardial infarction (MI) using population-based data from Sweden. The authors estimate contextual effects, meaning effects attributable to the characteristics of communities rather than to the characteristics of people who live in these communities. This partitioning between individual-level and community-level effects is a long-standing strategy in social epidemiology and is pursued by adjusting for measured individual-level characteristics. Partial regression coefficients at the second level of the multilevel regression model are then viewed as representing purely contextual phenomena because their interpretation is conditional on the modeled individual factors. This strategy has been promoted on the grounds that substantial outcome variability from one place to another, conditional on measured individual factors, motivates public health intervention at the community level.
Kaufman, Jay S.