title: Does population mixing measure infectious exposure in children at the community level?
abstract: Epidemiological studies focusing on the etiology of childhood chronic diseases have used population mixing as a proxy for the level of infection circulating in a community. We compared different measures of population mixing (based on residential migration and commuting) and other demographic variables, derived from the United Kingdom Census, with hospital inpatient data on infections from two Government Office Regions in England (Eastern and the West Midlands) to inform the development of an infectious disease proxy for future epidemiological studies. The association between rates of infection and the population mixing measures was assessed, using incidence rate ratios across census areas, from negative binomial regression. Commuting distance demonstrated the most consistent association with admissions for infections across the two regions; areas with a higher median distance travelled by commuters leaving the area having a lower rate of hospital admissions for infections. Deprived areas and densely populated areas had a raised rate of admissions for infections. Assuming hospital admissions are a reliable indicator of common infection rates, the results from this study suggest that commuting distance is a consistent measure of population mixing in relation to infectious disease and deprivation and population density are reliable demographic proxies for infectious exposure. Areas that exhibit high levels of population mixing do not necessarily possess raised rates of hospital admissions for infectious disease.
authors.affiliation: Paediatric Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK. j.c.taylor@leeds.ac.uk
authors.forename: John C
authors.initials: JC
authors.lastname: Taylor
authors.forename: Graham R
authors.initials: GR
authors.lastname: Law
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Boyle
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Feng
authors.forename: Mark S
authors.initials: MS
authors.lastname: Gilthorpe
authors.forename: Roger C
authors.initials: RC
authors.lastname: Parslow
authors.forename: Gavin
authors.initials: G
authors.lastname: Rudge
authors.forename: Richard G
authors.initials: RG
authors.lastname: Feltbower
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003141:Communicable Diseases / Q000453:epidemiology*; D015986:Confounding Factors, Epidemiologic; D004739:England / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011156:Population Density; D020379:Risk Adjustment; D012959:Socioeconomic Factors; D014186:Transportation / Q000706:statistics & numerical data; D055815:Young Adult