Ecological studies, which consider patient groups rather than individuals, are common in health policy research. The ‘ecological fallacy’ is a well-recognised methodological concern, but in this perspectives paper, we focus on less often appreciated but equally important limitations of such studies. In particular, we consider reliability and power as they apply to ecological studies, and make r...

Laypeople's perceptions of health and safety risks have been widely studied, but only a few studies have addressed perceptions of ecological hazards. We assembled a list of 39 attributes of ecological hazards from the literatures on comparative risk assessment, ecological health, environmental conservation and management, environmental psychology, and risk perception. In Study 1, 125 laypeople ...

Childhood obesity has reached epidemic levels in the developed world. Recent research and commentary suggest that an ecological approach is required to address childhood obesity, given the multidimensional nature of the problem. We propose a Canadian prototype, the Child Health Ecological Surveillance System, for a regional health authority to address the growing obesity epidemic. This prototyp...

BACKGROUND Drug-resistant tuberculosis (DR-TB) is a major public health problem caused by various factors. It is essential to systematically investigate the epidemiological and, in particular, the ecological factors of DR-TB for its prevention and control. Studies of the ecological factors can provide information on etiology, and assist in the effective prevention and control of disease. So it ...

Clinical assessment in psychiatry is commonly based on findings from brief, regularly scheduled in-person appointments. Although critically important, this approach reduces assessment to cross-sectional observations that miss essential information about disease course. The mental health provider makes all medical decisions based on this limited information. Thanks to recent technological advanc...

BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) resulting from various factors has raised serious public health concerns worldwide. Identifying the ecological risk factors associated with MDR-TB is critical to its prevention and control. This study aimed to explore the association between the development of MDR-TB and the risk factors at the group-level (ecological risk factors) in China. ...

BACKGROUND For health promotion to be effective in Aboriginal and Torres Strait Islander Communities, interventions (and their evaluation) need to work within a complex social environment and respect Indigenous knowledge, culture and social systems. At present, there is a lack of culturally appropriate evaluation methods available to practitioners that are capable of capturing this complexity. ...

Using an ecological study design, Gordon et al. (Isr J Health Policy Res 6:39, 2017) demonstrate variations in mortality patterns across districts and sub-districts of Israel during 2008-2013. Unlike other epidemiological study designs, the units of analysis in ecological studies are groups of people, often defined geographically, and the exposures and outcomes are aggregated, and often known o...

In coupled social–ecological systems, the same driving forces can result in combined social and environmental health inequities, hazards, and impacts. Policies that decrease social inequities and improve social cohesion, however, also have the potential to improve health outcomes and to minimize and offset the drivers of ecosystem change. Actions that address both biophysical and social environ...