A cross-sectional study is useful for highlighting the extent of a problem in a community, identifying the need for services, or describing the burden of a condition within a population (Das-Munshi et al., 2020).  For example, cross-sectional studies can be used to measure the prevalence of depression within a group of university students. They can also be used to compare experiences of an event or topic of interest among different populations. For instance, you can compare experiences with community engagement between groups of students with and without depression.

To put it in a nutshell, Keyes and Galea (2014) state: “any study that simply hits the pause button and samples a population at a single moment in time, counting cases of disease and potential causes at that point in time, is termed a cross-sectional study”. Such studies vary in their generalisability. According to Das-Munshi et al. (2020), findings from cross-sectional surveys “can be generalized to the base population for that survey and, to some extent, to other populations with similar characteristics” (p. 127).

Usually, cross-sectional studies are conducted using a questionnaire or survey, like the one below.

(University of Guelph, 2016)

To illustrate the use of cross-sectional surveys further, let’s use a fun example: say you want to understand the relationship between eating pizza regularly and mental health. To do so, you could use a questionnaire to ask people how often they eat pizza and if they have good mental health. This means you will use the same survey to measure the exposure (pizza) and the outcome (having good mental health) at the same point in time. Using data from this cross-sectional survey you will provide the researcher with an understanding of:

  • How many people eat pizza regularly, usually measured as a proportion or percentage
  • How many people have good mental health, usually measured as a proportion of percentage
  • The ‘association’, or relationship, between eating pizza and having good mental health

Cross-sectional studies have a limitation, however, which you may have already noticed above: because all data is collected at the same time, it is not possible to determine the ‘directionality’ of the relationship. Using the above study, for example, you will not be able to determine whether eating pizza regularly makes people more likely to have good mental health or if the relationship is the other way around. It may be that having good mental health means people have more energy to go pick up a pizza, and so they eat it more regularly!

Other advantages and disadvantages of cross-sectional studies include:

Advantage Disadvantage
Cheaper and less time consuming than other types of research Difficult to establish cause-and-effect
Can collect data from a larger pool of participants Cannot be used to analyse behaviour over a long period time
Capture or identify the health needs of a population at a specific moment in time Timing of the cross-sectional snapshot may not represent the behaviour of the group as a whole
Can examine (cross-sectional) associations between exposures and outcomes

(Thomas, 2022)

(Authors: Madison Wempe and Sam Davis)

What is it?

Videos:

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10.3 Cross sectional studies by Andrew Wills (2015)

This ten-minute video introduces cross-sectional studies, the information which they can be used to get, and their strengths and weaknesses. It uses several examples to aid understanding.

(Academic reference: Wills, A. (2015, September 16). 10.3 Cross sectional studies [Video]. YouTube. https://www.youtube.com/watch?v=ulRIqmJ9FiY&t=6s)

Articles:

Methodology series module 3: cross-sectional studies by Maninder Singh Setia (2016)

This article describes the uses, strengths, and weaknesses of cross-sectional studies.

(Academic reference: Setia, M. S. (2016). Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology, 61(3), 261—264. https://doi.org/10.4103/0019-5154.182410)

Cross-sectional studies: strengths, weaknesses, and recommendations by Xiaofeng Wang and Zhenshun Cheng (2020)

This resource outlines the strengths and weaknesses of cross-sectional studies. It also gives recommendations for their design and analysis.

(Academic reference: Wang, X. & Cheng, Z. (2020). Cross-sectional studies: Strengths, weaknesses, and recommendations. Chest, 158(1), S65—S71. https://doi.org/10.1016/j.chest.2020.03.012)

Books:

Cross-sectional surveys by Martin Prince and Jayati Das-Munshi (2020)

This resource is the ninth chapter of an epidemiology methods book for psychiatric epidemiology. It begins by describing cross-sectional studies and their use and then applies specific examples to these concepts.

(Academic reference: Prince, M. & Das-Munshi, J. (2020). Cross-sectional surveys. In Das-Munshi, J., Ford, T., Hotopf, M., Prince, M., & Stewart, R.  (Eds.), Practical psychiatric epidemiology (2nd ed., pp. 127-143). Oxford University Press)

Epidemiology matters: A New introduction to methodological foundations by Katherine Keyes and Sandro Galea (2014)

This textbook introduces the methodological foundations of epidemiology and population health research.

(Academic reference: Keyes, K. & Galea, S. (2014). Epidemiology matters: A new introduction to methodological foundations. Oxford University Press)

Online Course:

Epidemiology: the basic science of public health by the University of North Carolina Chapel Hill (2023)

This is a free online course which users can complete in their own time. Study designs, including cross-sectional studies, are discussed in week 3.

(Academic reference: The University of North Carolina Chapel Hill (2023).

Epidemiology: The basic science of public health. Retrieved March 10, 2023, from https://gb.coursera.org/learn/epidemiology)

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Week 5: Cross-sectional studies by Data Learner (2013)

This is a 15-minute videoed lecture at the Harvard School of Public Health on cross-sectional studies. It provides an understanding of cross-sectional studies and their relation to measures like incidence and prevalence.

(Academic reference: Data Learner. (2013, August 24). Week 5: Cross-sectional studies [Video]. YouTube. https://www.youtube.com/watch?v=uuhZSfYcygY)

Books:

Cross-sectional surveys by Martin Prince and Jayati Das-Munshi (2020)

This resource is the ninth chapter of an epidemiology methods book for psychiatric epidemiology. It begins by describing cross-sectional studies and their use and then applies specific examples to these concepts.

(Academic reference: Prince, M. & Das-Munshi, J. (2020). Cross-sectional surveys. In Das-Munshi, J., Ford, T., Hotopf, M., Prince, M., & Stewart, R.  (Eds.), Practical psychiatric epidemiology (2nd ed., pp. 127-143). Oxford University Press)

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