Measures of Sprawl Applied to Urban and Rural Areas, and Cardiovascular Disease Mortality: A Bayesian Spatial Analysis

Gerald Shoultz, ASPH Fellow, National Center for Health Statistics

Recent studies indicate a potential association between urban sprawl and obesity, with residual effects for such health conditions diseases as hypertension, cardiovascular disease, etc. This research addresses two important issues in the study of sprawl: (1) measurement - how is urban sprawl/effect measured, and (2) impact - how does urban sprawl/effect relate to mortality rates of Cardiovascular Disease (CVD). 1990 and 2000 Census data on population, housing counts, and socioeconomic status, are used to develop county-level indices of urban sprawl/effect and socioeconomic deprivation for 1990 and also changes in sprawl and socioeconomic deprivation from 1990 to 2000; these indices are used as covariates to model CVD Mortality data for white males age 35 and over in the 1999-2001 period using Bayesian and Spatial methods. Chloropleth maps of mean CVD rates are presented. Spatial and other patterns in the age-specific maps are related to urban sprawl/effect and other pertinent covariates.