A hierarchically adaptable spatial regression model to link aggregated health data and environmental data

Robust inference and optimal prediction over geographical space and at different spatial aggregation levels are studied by simulated data sets. The spatial associations at different spatial supports are largely different, but can be efficiently inferred when prior knowledge of the associations is available. The model is applied to study hand, foot and mouth disease (HFMD) in Da Nang city, Viet Nam.

Decrease in vegetated areas corresponds with elevated HFMD risks. A study to the identifiability of the parameters shows a strong need for a highly informative prior distribution. We conclude that the model is robust to the underlying aggregation levels of the calibrating data for association inference and it is ready for application in health geography.