During the past decade, there has been growing research
interest in the impact of neighborhood of residence on
health (1). Most studies have used the multilevel modeling
technique (2). With this approach, standard errors for the
measures of association between neighborhood factors and
health are corrected for the nonindependence of individuals
within neighborhoods (3, 4), and measures of variation
based on random effects (e.g., neighborhood-level variance)
allow quantifying the magnitude of variations in outcomes
among neighborhoods (5–8). However, our hypothesis was
that the multilevel approach may provide only limited information
on the spatial distribution of outcomes, both when