When homogeneity meets heterogeneity: The geographically weighted regression with spatial lag approach to prenatal care utilisation

Carla Shoff, Vivian Yi Ju Chen, Tse Chuan Yang

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Using geographically weighted regression (GWR), a recent study by Shoff and colleagues (2012) investigated the place-specific risk factors for prenatal care utilisation in the United States of America (USA) and found that most of the relationships between late or no prenatal care and its determinants are spatially heterogeneous. However, the GWR approach may be subject to the confounding effect of spatial homogeneity. The goal of this study was to address this concern by including both spatial homogeneity and heterogeneity into the analysis. Specifically, we employed an analytic framework where a spatially lagged (SL) effect of the dependent variable is incorporated into the GWR model, which is called GWR-SL. Using this framework, we found evidence to argue that spatial homogeneity is neglected in the study by Shoff et al. (2012) and that the results change after considering the SL effect of prenatal care utilisation. The GWR-SL approach allowed us to gain a placespecific understanding of prenatal care utilisation in USA counties. In addition, we compared the GWR-SL results with the results of conventional approaches (i.e., ordinary least squares and spatial lag models) and found that GWR-SL is the preferred modelling approach. The new findings help us to better estimate how the predictors are associated with prenatal care utilisation across space, and determine whether and how the level of prenatal care utilisation in neighbouring counties matters.

Original languageEnglish (US)
Pages (from-to)557-568
Number of pages12
JournalGeospatial health
Volume8
Issue number2
DOIs
StatePublished - May 2014
Externally publishedYes

Keywords

  • Geographically weighted regression
  • Prenatal care
  • Spatial non-stationarity
  • United States of America

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Geography, Planning and Development
  • Health Policy

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