Journal article
Incorporating small-area estimation into mediation analyses with areal datasets
Spatial and spatio-temporal epidemiology, Vol.54, 100735
08/2025
DOI: 10.1016/j.sste.2025.100735
PMCID: PMC12513566
PMID: 40935499
Abstract
Various methods have been employed in the medical literature to conduct mediation analyses with areal datasets. These analyses are typically performed to understand why age-adjusted incidence or mortality rates vary by county or ZIP code-level characteristics. Two primary approaches are commonly used: the “Calculation before mediation” (C-BM) approach, where age-adjusted rates are calculated from the raw data for each areal unit and used as the outcome in the mediation analysis, and the “Small-area estimation before mediation” (SAE-BM) approach, which uses pre-existing small-area estimates as the outcome in the mediation analysis. However, these approaches have significant limitations that can impact the inferences around mediation effects and the overall conclusions of a mediation analysis. In this paper, we propose a new method, the “Small-area estimation within mediation” (SAE-WM) approach, for conducting mediation analyses with areal datasets. This method integrates Bayesian small-area estimation techniques into the mediation analysis outcome model, allowing for precise estimation of mediation effects with areal datasets. We conduct a simulation study to demonstrate the advantages of the SAE-WM method for estimating mediation effects with areal datasets, while highlighting the pitfalls and potential problems with the C-BM and SAE-BM methods. We also illustrate an application of the SAE-WM method to assess whether healthcare access mediates the relationship between ZIP code-level socioeconomic environment and age-adjusted colorectal cancer incidence rates in Iowa.
Details
- Title: Subtitle
- Incorporating small-area estimation into mediation analyses with areal datasets
- Creators
- Melissa J. SmithEmily K. RobertsMary E. CharltonJacob J. Oleson
- Resource Type
- Journal article
- Publication Details
- Spatial and spatio-temporal epidemiology, Vol.54, 100735
- DOI
- 10.1016/j.sste.2025.100735
- PMID
- 40935499
- PMCID
- PMC12513566
- NLM abbreviation
- Spat Spatiotemporal Epidemiol
- ISSN
- 1877-5845
- eISSN
- 1877-5853
- Publisher
- ELSEVIER SCI LTD
- Grant note
- National Science Foundation Graduate Research Fellowship Program: 000390183 National Institute of Environmental Health Sciences through the University of Iowa Environmental Health Sciences Research Center: NIH/NIEHS P30 ES005605 National Institutes of Health/National Cancer Institute [NIH/NCI]: U01CA 258400, P30 CA086862, HHSN261201800012I/HHSN26100001
We gratefully acknowledge the referees for their time and thoughtful suggestions which have strengthened our paper. This work was supported by the National Science Foundation Graduate Research Fellowship Program [grant number 000390183] , the National Institute of Environmental Health Sciences through the University of Iowa Environmental Health Sciences Research Center [grant number NIH/NIEHS P30 ES005605] , and the National Institutes of Health/National Cancer Institute [NIH/NCI grant numbers U01CA 258400, P30 CA086862, and contract number HHSN261201800012I/HHSN26100001] . Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Institutes of Health or the National Science Foundation.
- Language
- English
- Date published
- 08/2025
- Academic Unit
- Epidemiology; Biostatistics; Otolaryngology
- Record Identifier
- 9984865440602771
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