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Does population mixing measure infectious exposure in children at the community level?

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Abstract

Epidemiological studies focusing on the etiology of childhood chronic diseases have used population mixing as a proxy for the level of infection circulating in a community. We compared different measures of population mixing (based on residential migration and commuting) and other demographic variables, derived from the United Kingdom Census, with hospital inpatient data on infections from two Government Office Regions in England (Eastern and the West Midlands) to inform the development of an infectious disease proxy for future epidemiological studies. The association between rates of infection and the population mixing measures was assessed, using incidence rate ratios across census areas, from negative binomial regression. Commuting distance demonstrated the most consistent association with admissions for infections across the two regions; areas with a higher median distance travelled by commuters leaving the area having a lower rate of hospital admissions for infections. Deprived areas and densely populated areas had a raised rate of admissions for infections. Assuming hospital admissions are a reliable indicator of common infection rates, the results from this study suggest that commuting distance is a consistent measure of population mixing in relation to infectious disease and deprivation and population density are reliable demographic proxies for infectious exposure. Areas that exhibit high levels of population mixing do not necessarily possess raised rates of hospital admissions for infectious disease.

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Abbreviations

HES:

Hospital episode statistics

ICD:

International classification of diseases

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Acknowledgements

The grant for the study of population mixing was provided by CHILDREN with LEUKAEMIA. The 2001 census data were made available through ESRC/JISC Census Program, Census Dissemination Unit and Census Interaction Data Services, Crown Copy Right. The Eastern HES data were provided by Paul Smith, Eastern Region Public Health Observatory.

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Authors and Affiliations

  1. Paediatric Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK

    John C. Taylor, Roger C. Parslow & Richard G. Feltbower

  2. Section of Epidemiology and Biostatistics, Leeds Institute of Molecular Medicine, St. James’s University Hospital, Leeds, LS9 7TF, UK

    John C. Taylor

  3. Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK

    Graham R. Law & Mark S. Gilthorpe

  4. School of Geography and Geosciences, University of St. Andrews, Fife, UK

    Paul J. Boyle & Zhiqiang Feng

  5. Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK

    Gavin Rudge

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  1. John C. Taylor
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  2. Graham R. Law
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Correspondence to John C. Taylor.

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Taylor, J.C., Law, G.R., Boyle, P.J. et al. Does population mixing measure infectious exposure in children at the community level?. Eur J Epidemiol 23, 593–600 (2008). https://doi.org/10.1007/s10654-008-9272-0

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