Challenges and Methodological Issues Pertaining to Etiologic Research on Urban Health

Challenges in Studying Urban Health

Introduction
Focus on:
Methodological issues pertaining to etiologic research.

Challenges in Studying Urban Health
How to begin Etiologic research:
• What is the Research question?

How and why urban living may affect health?
•There are three reasons
challenging I doing research in urban health 

Challenges in Studying Urban Health
1. Urban health research literature associate  with other disciplines-
• Ex: demography and epidemiology

Role of urbanization

How people changing in cities

Migration and population growth affect distribution of diseases.

• But the study of urbanization in sociology  focus on social activities and social organization in cities. (population size / urban life styles)

2. Urban health research are not meaningful in isolation.
 It needs to combine with other factors
Racial segregation and poor health

3. Clear research questions?
Different perspectives on the Empiric study of urban health

• Published studies address three different questions on urban health:
1. Differences between rural and urban communities within countries.
2. Differences across cities within or between countries.
3. Examination of intra-urban differences of health. 

Different perspectives on the Empiric study of urban health
1. Differences between rural and urban communities within countries.
Most common form of urban research morbidity/mortality

Different perspectives on the Empiric study of urban health

2. Differences across cities within or between  countries.
•This research type on comparison between
cities – within/between countries Compare different cities promote or harm population health
Ex: studies – health systems in NYC, London, Paris etc.
Tried to show how mega cities in wealthy cities organize better health services.

•This approach limits the different impacts of urban characteristics on the health of urban residents.  Different perspectives on the Empiric study of urban health

3. Examination of intra-urban differences of health.
•This approach examines how specific features of cities are associates with the differential distribution of morbidity and mortality within cities.
•Using spatial grouping of individuals (neighborhoods)

Methods pertain to the study of Urban Health
Quantitative Methods
1. Correlation and Associations in Ecologic  analysis
• Associations between factors at a group or aggregate level
Ex: the association between average income and all-cause mortality rates across cities

• Generate hypothesis:
Role of relative income as a determinant of psychosocial stress in cities etc.
But, individual health neglected

Methods pertain to the study of Urban Health

2. Contextual Analysis
•Assess how urban living as an individual characteristic is associated with health.
•Mostly used to examine urban versus rural health
•Comparison studies
•Ex: comparing living in densely populated urban neighborhood and loving in ales densely populated neighborhood.

Qualitative Methods in Urban Health Studies
Three broad areas:
 1. Choice of study design
 2. Issues of variable specification
 3. Complex causal pathways Qualitative Methods Qualitative methods of data collection and analysis
•Useful for developing in-depth understanding
Description
Self-reflection
Discussion
Interpretation 

Qualitative Methods
Four common methods for gathering qualitative data:
 1. participant observation
 2. in-depth interviews
 3. focus group
 4. document review

Qualitative methods to study urban health Considerations for qualitative methods in urban research 
• Sampling –clearly define the target population
• ex; snowball sampling method a snowball sample is a non probability sampling technique that is appropriate to use in research when the members of a population are difficult to locate.

Qualitative methods to study urban health
• Ethnographic research
Describes human social systems in detail through the systematic collection and analysis of information. Researchers use:
•Document review
•Analysis of census data
•Vital statistics
•Participant observations etc