Assessing the influence of the modifiable areal unit problem on Bayesian disease mapping in Queensland, Australia

Background Spatial data are often aggregated by area to protect the confidentiality of individuals and aid the calculation of pertinent risks and rates. However, the analysis of spatially aggregated data is susceptible to the modifiable areal unit problem (MAUP), which arises when inference varies with boundary or aggregation changes. While the impact of the MAUP has been examined previously, typically these studies have focused on well-populated areas. Understanding how the MAUP behaves when data are sparse is particularly important for countries with less populated areas, such as Australia. This study aims to assess different geographical regions' vulnerability to the MAUP when data are relatively sparse to inform researchers' choice of aggregation level for fitting spatial models. Methods To understand the impact of the MAUP in Queensland, Australia, the present study investigates inference from simulated lung cancer incidence data using the five levels of spatial aggregation defined by the Australian Statistical Geography Standard. To this end, Bayesian spatial BYM models with and without covariates were fitted. Results and Conclusion The MAUP impacted inference in the analysis of cancer counts for data aggregated to coarsest areal structures. However, area structures with moderate resolution were not greatly impacted by the MAUP, and offer advantages in terms of data sparsity, computational intensity and availability of data sets.