Investigating spatial clustering of chronic diseases at governorate level in Iraq-2007

Abstract

Although, many studes examinedthe existence of spatial pattern of Chronic Diseases (CDs) problem in many developed and some developing countries, in improving health status and reducing inequalities between areas of such country, there is still much work to be done. Some of these studies were found spatial pattern for CDs using different statistical techmques and geographical mapping. Question is raised whether the spatial pattern of CDs rate is existed in Iraq? The objective of this study was to investigate the spatial structure of CDs rate across governorates, showing visual picture for health status and to provide implications for policy makers. Both descriptive and inference analysis were done. Study design was a cross-sectional census data for 18 governorates conducted in 2007. Mapping was used as a first step to conduct visual inspection for CDs using qualtiles. Two statistics of spatial autocorrelation, based on sharing boundary neighbours, known as global Moran's I and local Moran's L, were carried out for examining global clustering and local clusters, respectively. Global Moran statistic I = 0.06 wasn't found significant with z = 0.91, p = 0.365 andpemutationp = 0.175 Three local Moranstatistics (I 1= 1.40, I 5= 0.71 and I 7 = 0.38) were found significant with p-values (0.019, 0.020 and 0.058), respectively. In conclusion, high inequality in CDs was concentrated in eastern-northern and western-southern governorates based on visual impection of mapping. Global clustering was not found in CDs but local clusters were found. Out of 18, three governorates were found as local clusters in CDs Further research is needed to understand mechanisms underlying the influence of neighbourhood context.