Modelling the impact of socioeconomic structure on spatial health outcomes

A factor analytic model is proposed for the impact of spatially defined latent social constructs on area health outcomes (e.g. mortality or hospitalisation counts). The model has two components or sub-models. The first component is a social indicator measurement model using socioeconomic variables (e.g. from population censuses) as indicators of latent social constructs. The other sub-model considers variations in spatial health outcomes in terms both of the latent social constructs and of residual common factors — the latter have only the health variation component as their measurement model. The two sets of latent variables can be mutually correlated and latent scores can be correlated over areas, though the extent of the spatial dependence in the scores on any particular latent variable is determined by the data. A case study application considers the impact of two latent social constructs (denoted as social deprivation and social fragmentation) on four types of psychiatric hospitalisation in 33 local authorities in London, England.