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The study
limitations included an unbalanced sample design of a relatively small sample of
individuals within each of 33 urban areas, which could have affected the robustness of
results. However, the significant contextual and interaction effects found with this
sample size provide further evidence for the relevancy of a multilevel profile of health
for public policy. The inferences from a sample restricted to the city of Moscow cannot be
generalized to other urban contexts. However, the sample frame included the complete
population of an urban community as a sampling point, in keeping with the WHO Healthy
Cities agenda, which enabled an in-depth examination of the micro-macro interactions
operating in Moscow of that period. This established a baseline for the longitudinal
comparison of changes in the health status of the sample cohort in follow-up studies. |
