Multivariate spatiotemporal modeling of age-specific stroke mortality

DOI10.1214/17-AOAS1068MaRDI QIDQ1697386zbMATH OpenOpenAlexFDO

Authors Harrison Quick, Lance A. Waller, Michele Casper

Publication date 19 February 2018

Published in The Annals of Applied Statistics (Search for Journal in Brave)

Full work available at URL https://arxiv.org/abs/1602.04528, https://projecteuclid.org/euclid.aoas/1514430281

zbMATH Keywords

Bayesian methodsnonseparable modelsage disparities in healthgeographic disparities in healthsmall area analysis

Mathematics Subject Classification ID

Bayesian inference (62F15) Time series, auto-correlation, regression, etc. in statistics (GARCH) (62M10) Inference from spatial processes (62M30) Applications of statistics to biology and medical sciences; meta analysis (62P10) Sampling theory, sample surveys (62D05)

Abstract: Geographic patterns in stroke mortality have been studied as far back as the 1960s, when a region of the southeastern United States became known as the "stroke belt" due to its unusually high rates of stroke mortality. While stroke mortality rates are known to increase exponentially with age, an investigation of spatiotemporal trends by age group at the county-level is daunting due to the preponderance of small population sizes and/or few stroke events by age group. Here, we harness the power of a complex, nonseparable multivariate space-time model which borrows strength across space, time, and age group to obtain reliable estimates of yearly county-level mortality rates from US counties between 1973 and 2013 for those aged 65+. Furthermore, we propose an alternative metric for measuring changes in event rates over time which accounts for the full trajectory of a county's event rates, as opposed to simply comparing the rates at the beginning and end of the study period. In our analysis of the stroke data, we identify differing spatiotemporal trends in mortality rates across age groups, shed light on the gains achieved in the Deep South, and provide evidence that a separable model is inappropriate for these data.

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Cited in

(3)

• Selection of a stroke risk model based on transcranial Doppler ultrasound velocity
• Improved inference for areal unit count data using graph-based optimisation
• Assessing the evolution of territorial disparities in health

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