Health selection into neighborhoods among patients enrolled in a clinical trial.
Health selection into neighborhoods may contribute to geographic health disparities. We demonstrate the potential for clinical trial data to help clarify the causal role of health on locational attainment. We used data from the 20-year United Kingdom Prospective Diabetes Study (UKPDS) to explore whe...
Main Authors: | , , , , |
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Format: | Journal article |
Language: | English |
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Elsevier
2017
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_version_ | 1797070150147506176 |
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author | Arcaya, M Coleman, R Razak, F Alva, M Holman, R |
author_facet | Arcaya, M Coleman, R Razak, F Alva, M Holman, R |
author_sort | Arcaya, M |
collection | OXFORD |
description | Health selection into neighborhoods may contribute to geographic health disparities. We demonstrate the potential for clinical trial data to help clarify the causal role of health on locational attainment. We used data from the 20-year United Kingdom Prospective Diabetes Study (UKPDS) to explore whether random assignment to intensive blood-glucose control therapy, which improved long-term health outcomes after median 10 years follow-up, subsequently affected what neighborhoods patients lived in. We extracted postcode-level deprivation indices for the 2710 surviving participants of UKPDS living in England at study end in 1996/1997. We observed small neighborhood advantages in the intensive versus conventional therapy group, although these differences were not statistically significant. This analysis failed to show conclusive evidence of health selection into neighborhoods, but data suggest the hypothesis may be worthy of exploration in other clinical trials or in a meta-analysis. |
first_indexed | 2024-03-06T22:34:52Z |
format | Journal article |
id | oxford-uuid:598aebf0-2d62-4cec-ba41-19f281587ce4 |
institution | University of Oxford |
language | English |
last_indexed | 2024-03-06T22:34:52Z |
publishDate | 2017 |
publisher | Elsevier |
record_format | dspace |
spelling | oxford-uuid:598aebf0-2d62-4cec-ba41-19f281587ce42022-03-26T17:10:21ZHealth selection into neighborhoods among patients enrolled in a clinical trial.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:598aebf0-2d62-4cec-ba41-19f281587ce4EnglishSymplectic Elements at OxfordElsevier2017Arcaya, MColeman, RRazak, FAlva, MHolman, RHealth selection into neighborhoods may contribute to geographic health disparities. We demonstrate the potential for clinical trial data to help clarify the causal role of health on locational attainment. We used data from the 20-year United Kingdom Prospective Diabetes Study (UKPDS) to explore whether random assignment to intensive blood-glucose control therapy, which improved long-term health outcomes after median 10 years follow-up, subsequently affected what neighborhoods patients lived in. We extracted postcode-level deprivation indices for the 2710 surviving participants of UKPDS living in England at study end in 1996/1997. We observed small neighborhood advantages in the intensive versus conventional therapy group, although these differences were not statistically significant. This analysis failed to show conclusive evidence of health selection into neighborhoods, but data suggest the hypothesis may be worthy of exploration in other clinical trials or in a meta-analysis. |
spellingShingle | Arcaya, M Coleman, R Razak, F Alva, M Holman, R Health selection into neighborhoods among patients enrolled in a clinical trial. |
title | Health selection into neighborhoods among patients enrolled in a clinical trial. |
title_full | Health selection into neighborhoods among patients enrolled in a clinical trial. |
title_fullStr | Health selection into neighborhoods among patients enrolled in a clinical trial. |
title_full_unstemmed | Health selection into neighborhoods among patients enrolled in a clinical trial. |
title_short | Health selection into neighborhoods among patients enrolled in a clinical trial. |
title_sort | health selection into neighborhoods among patients enrolled in a clinical trial |
work_keys_str_mv | AT arcayam healthselectionintoneighborhoodsamongpatientsenrolledinaclinicaltrial AT colemanr healthselectionintoneighborhoodsamongpatientsenrolledinaclinicaltrial AT razakf healthselectionintoneighborhoodsamongpatientsenrolledinaclinicaltrial AT alvam healthselectionintoneighborhoodsamongpatientsenrolledinaclinicaltrial AT holmanr healthselectionintoneighborhoodsamongpatientsenrolledinaclinicaltrial |