Multi-level analysis in epidemiologic research on health behaviors and outcomes.
Individual-level health behaviors and outcomes have multi-level determinants (individual and environmental). Multi-level analysis seeks to explain individual outcomes in terms of both individual and environmental or aggregate variables. Ecologic fallacy (improper inference about individual-level associations based on associations measured only at the aggregate level) can result from confusion about the level of inference that is of ultimate interest. The perspective of multi-level analysis acknowledges the importance of both individual and environmental variables in determining health behaviors and outcomes at the level of the indivisible unit--the individual. The authors review concepts and methods of multi-level analysis and their application to epidemiologic research on health behavior and health outcomes.
Von Korff
M
M
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98101.
Koepsell
T
T
Curry
S
S
Diehr
P
P
D002908:Chronic Disease; D004812:Epidemiologic Methods; D015438:Health Behavior; D006801:Humans; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D012307:Risk Factors