The rate of neural tube defects (NTDs) in Shanxi Province is the highest world widely. Both human and environmental factors can induce NTDs, but various studies ignored contextual effects. This research examines whether there are significant soil type contextual effects on the rate of NTDs. A spatial two-level regression model is used to quantify the magnitude of contextual effects. Spatial autocorrelated errors structure is used to control autocorrelation of residuals. The results suggest that the spatial multilevel model fit the data better than non-spatial multilevel models. Our findings indicate that there are significant soil type contextual effects on the rate of NTDs, even after taking into account of fertilizer and net income. More attentions should be focused on how characteristics of each soil type may affect the rates of NTDs in further studies, which is a relevant issue for understanding etiology of NTDs.

原文链接：http://link.springer.com/article/10.1007%2Fs00477-013-0707-0