Estimating Health over Space and Time: A Review of Spatial Microsimulation Applied to Public Health

There is an ongoing demand for data on population health, for reasons of resource allocation, future planning and crucially to address inequalities in health between people and between populations. Although there are regular sources of data at coarse spatial scales, such as countries or large sub-national units such as states, there is often a lack of good quality health data at the local level. One method to develop reliable estimates of population health outcomes is spatial microsimulation, an approach that has its roots in economic studies. Here, we share a review of this method for estimating health in populations, explaining the different approaches available and examples where the method is applied successfully for creating both static and dynamic populations. Recent notable advances in the method that allow uncertainty to be represented are highlighted, along with the evolving approaches to validation that are an ongoing challenge in small-area estimation. The summary serves as a primer for academics new to the area of research as well as an overview for non-academic researchers who consider using these models for policy evaluations.