Most epidemiological air pollution studies focus on severe outcomes such as hospitalisations or deaths, but this underestimates the impact of air pollution by ignoring ill health treated in primary care. This paper quantifies the impact of air pollution on the rates of respiratory medication prescribed in primary care in Scotland, which is a proxy measure for the prevalence of less severe respiratory disease. A novel bivariate spatiotemporal process-convolution model is proposed, which: (i) has increased computational efficiency via a tapering function based on nearest neighbourhoods; and (ii) has locally adaptive weights that outperform traditional distance-decay kernels. The results show significant effects of particulate matter on respiratory prescription rates which are consistent with severe endpoint studies.
"A locally adaptive process-convolution model for estimating the health impact of air pollution." Ann. Appl. Stat. 12 (4) 2540 - 2558, December 2018. https://doi.org/10.1214/18-AOAS1167