Improving longitudinal research in geospatial health: An agenda

All aspects of public health research require longitudinal analyses to fully capture the dynamics of outcomes and risk factors such as ageing, human mobility, non-communicable diseases (NCDs), climate change, and endemic, emerging, and re-emerging infectious diseases. Studies in geospatial health are often limited to spatial and temporal cross sections. This generates uncertainty in the exposures and behavior of study populations. We discuss a research agenda, including key challenges and opportunities of working with longitudinal geospatial health data. Examples include accounting for residential and human mobility, recruiting new birth cohorts, geoimputation, international and interdisciplinary collaborations, spatial lifecourse studies, and qualitative and mixed-methods approaches

Public Participation GIS for sustainable urban mobility planning: methods, applications and challenges

Sustainable mobility planning is a new approach to planning, and as such it requires new methods of public participation, data collection and data aggregation. In the article we present an overview of Public Participation GIS (PPGIS) methods with potential use in sustainable urban mobility planning. We present the methods using examples from two recent case studies conducted in Polish cities of Poznań and Łodź. Sustainable urban mobility planning is a cyclical process, and each stage has different data and participatory requirements. Consequently, we situate the PPGIS methods in appropriate stages of planning, based on potential benefits they may bring into the planning process. We discuss key issues related to participant recruitment and provide guidelines for planners interested in implementing methods presented in the paper. The article outlines future research directions stressing the need for systematic case study evaluation

Activity Spaces: Assessing Differences in Alcohol Exposures and Alcohol Use for Parents

This is a post-peer-review, pre-copyedit version of an article published in GeoJournal. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10708-019-10059-5.Parental alcohol use and alcohol outlet densities in residential areas are related to risk for child maltreatment. However, some parents spend significant time outside of their residential neighborhood. Thus, we may not be accurately assessing how alcohol environments are related to risks for problematic parenting. Here, we examine how residential environments and activity spaces are related to outlet density and whether drinking events in our sample of parents differ by location (e.g., routine vs. rare locations) and whether their children are present. We conducted semi-structured interviews with 60 parents living in four cities in the San Francisco Bay area who provided information on where they spent time, where they drank, and whether children were present. We constructed measures of activity spaces (e.g., convex hull polygons) and activity patterns (e.g., shortest network distance) and calculated outlet density in each. Density of alcohol outlets for residential Census tract was not related to density of the activity space and activity pattern measures. Alcohol use occurred more frequently (regardless of whether their children were present) inside activity spaces operationalized as convex hull polygons or two standard deviational ellipses. Measures that capture larger activity space areas (e.g., convex hull polygons, two standard deviational ellipses) may better model where people spend time, regardless of whether the location is routine or rare. By continuing to use activity spaces to explore relationships between outlet densities, drinking behaviors, and problems, we can start to ascertain those mechanisms by which outlets may affect local problems.National Institute on Alcohol Abuse and Alcoholism (P60-AA-006282

Beyond Residence: A Mobility-based Approach for Improved Evaluation of Human Exposure to Environmental Hazards

Evaluating human exposure to environmental hazards is crucial for identifying susceptible communities and devising targeted health policies. Standard environmental hazard exposure assessment methods have been primarily based on place of residence, an approach which neglect individuals hazard exposures due to the daily life activities and mobility outside home neighborhood. To address this limitation, this study proposes a novel mobility-based index for hazard exposure evaluation. Using large-scale and fine-grained human mobility data, we quantify the extent of population dwell time in high-environmental-hazard places in 239 U.S. counties for three major environmental hazards: air pollution, heat, and toxic sites. Subsequently we explore the extent to which human mobility extends the reach of environmental hazards and also lead to the emergence of latent exposure for populations living outside high hazard areas with relatively considerable dwell time in high hazard areas. The findings help quantify environmental hazard exposure more reliably, considering the role of human mobility and activities. The interplay of spatial clustering in high-hazard regions and human movement trends creates environmental hazard traps intensifying exposure. Poor and ethnic minority residents disproportionately face multiple types of environmental hazards, aggravating potential health impacts. This data-driven evidence supports the severity of these injustices. We also studied latent exposure arising from visits outside residents' home areas, revealing millions population having 5% to10% of daily activities occur in high-exposure zones. Despite living in perceived safe areas, human mobility could expose millions of residents to different hazards. These findings provide crucial insights for targeted policies to mitigate these severe environmental injustice

Characteristics of Walkable Built Environments and BMI z-Scores in Children: Evidence from a Large Electronic Health Record Database

Background: Childhood obesity remains a prominent public health problem. Walkable built environments may prevent excess weight gain. Objectives: We examined the association of walkable built environment characteristics with body mass index (BMI) z-score among a large sample of children and adolescents. Methods: We used geocoded residential address data from electronic health records of 49,770 children and adolescents 4 to < 19 years of age seen at the 14 pediatric practices of Harvard Vanguard Medical Associates from August 2011 through August 2012. We used eight geographic information system (GIS) variables to characterize walkable built environments. Outcomes were BMI z-score at the most recent visit and BMI z-score change from the earliest available (2008–2011) to the most recent (2011–2012) visit. Multivariable models were adjusted for child age, sex, race/ethnicity, and neighborhood median household income. Results: In multivariable cross-sectional models, living in closer proximity to recreational open space was associated with lower BMI z-score. For example, children who lived in closest proximity (quartile 1) to the nearest recreational open space had a lower BMI z-score (β = –0.06; 95% CI: –0.08, –0.03) compared with those living farthest away (quartile 4; reference). Living in neighborhoods with fewer recreational open spaces and less residential density, traffic density, sidewalk completeness, and intersection density were associated with higher cross-sectional BMI z-score and with an increase in BMI z-score over time. Conclusions: Overall, built environment characteristics that may increase walkability were associated with lower BMI z-scores in a large sample of children. Modifying existing built environments to make them more walkable may reduce childhood obesity. Citation: Duncan DT, Sharifi M, Melly SJ, Marshall R, Sequist TD, Rifas-Shiman SL, Taveras EM. 2014. Characteristics of walkable built environments and BMI z-scores in children: evidence from a large electronic health record database. Environ Health Perspect 122:1359–1365; http://dx.doi.org/10.1289/ehp.130770

Destinations That Older Adults Experience Within Their GPS Activity Spaces: Relation to Objectively Measured Physical Activity

Identifying the relevant geography is an ongoing obstacle to effectively evaluate the influence of neighborhood built environment on physical activity. We characterized density and diversity of destinations that 77 older adults experienced within individually representative GPS activity spaces and traditional residential buffers and assessed their associations with accelerometry-measured physical activity. Traditional residential buffers had lower destination density and diversity than activity spaces. Activity spaces based only on pedestrian and bicycling trips had higher destination densities than all-mode activity spaces. Regardless of neighborhood definition, adjusted associations between destinations and physical activity generally failed to reach statistical significance. However, within pedestrian and bicycling-based activity spaces each additional destination type was associated with 243.3 more steps/day (95% confidence interval (CI) 36.0, 450.7). Traditional buffers may not accurately portray the geographic space or neighborhood resources experienced by older adults. Pedestrian and bicycling activity spaces elucidate the importance of destinations for facilitating active transportation

How GIS can help address the uncertain geographic context problem in social science research

The uncertain geographic context problem (UGCoP), first articulated by Kwan (2012; The uncertain geographic context problem. Annals of the Association of American Geographers, 102 (5), 958–968), refers to the problem that findings about the effects of area-based contextual variables on individual behaviors or outcomes may be affected by how contextual units (e.g., neighborhoods) are geographically delineated and the extent to which these areal units deviate from the true geographic context. It is a significant methodological problem because it means that analytical results can differ for different delineations of contextual units even if everything else is the same. Drawing upon Kwan (2012) and recent social science studies (especially environmental health and neighborhood effects research), this article further elaborates on the nature of the UGCoP and explores how recent advances in geographical information system (GIS) and geospatial technologies can help address the problem. It discusses possible means for mitigating the UGCoP, especially with regard to the collection of detailed individual space–time data with global positioning systems, construction of individual activity spaces, and the use of qualitative and web-based GIS to capture people’s activity locations and everyday experiences. It also discusses the challenges for future research that seeks to address the UGCoP

Tobacco Retail Environment and Smoking: A Systematic Review of Geographic Exposure Measures and Implications for Future Studies

Introduction: To review the geographic exposure measures used to characterize the tobacco environment in terms of density of tobacco outlets and proximity to tobacco outlets, and its association with smoking-related outcomes. Methods: We used PubMed and Google Scholar to find articles published until December 2019. The search was restricted to studies that (1) measured the density of and/or proximity to tobacco outlets and (2) included associations with smoking outcomes. The extraction was coordinated by several observers. We gathered data on the place of exposure, methodological approaches, and smoking outcomes. Results: Forty articles were eligible out of 3002 screened papers. Different density and proximity measures were described. 47.4% density calculations were based on simple counts (number of outlets within an area). Kernel density estimations and other measures weighted by the size of the area (outlets per square kilometer), population, and road length were identified. 81.3% of the articles which assessed proximity to tobacco outlets used length distances estimated through the street network. Higher density values were mostly associated with higher smoking prevalence (76.2%), greater tobacco use and smoking initiation (64.3%), and lower cessation outcomes (84.6%). Proximity measures were not associated with any smoking outcome except with cessation (62.5%). Conclusion: Associations between the density of tobacco outlets and smoking outcomes were found regardless of the exposure measure applied. Further research is warranted to better understand how proximity to tobacco outlets may influence the smoking outcomes. This systematic review discusses methodological gaps in the literature and provides insights for future studies exploring the tobacco environment. Implications: Our findings pose some methodological lessons to improve the exposure measures on the tobacco outlet environment. Solving these methodological gaps is crucial to understand the influence of the tobacco environment on the smoking outcomes. Activity spaces should be considered in further analyses because individuals are exposed to tobacco beyond their residence or school neighborhood. Further studies in this research area demand density estimations weighted by the size of the area, population, or road length, or measured using Kernel density estimations. Proximity calculations should be measured through the street network and should consider travel times apart from the length distance

How GIS can help address the uncertain geographic context problem in social science research

The uncertain geographic context problem (UGCoP), first articulated by Kwan (2012; The uncertain geographic context problem. Annals of the Association of American Geographers, 102 (5), 958–968), refers to the problem that findings about the effects of area-based contextual variables on individual behaviors or outcomes may be affected by how contextual units (e.g., neighborhoods) are geographically delineated and the extent to which these areal units deviate from the true geographic context. It is a significant methodological problem because it means that analytical results can differ for different delineations of contextual units even if everything else is the same. Drawing upon Kwan (2012) and recent social science studies (especially environmental health and neighborhood effects research), this article further elaborates on the nature of the UGCoP and explores how recent advances in geographical information system (GIS) and geospatial technologies can help address the problem. It discusses possible means for mitigating the UGCoP, especially with regard to the collection of detailed individual space–time data with global positioning systems, construction of individual activity spaces, and the use of qualitative and web-based GIS to capture people’s activity locations and everyday experiences. It also discusses the challenges for future research that seeks to address the UGCoP

UK Biobank Urban Morphometric Platform (UKBUMP): a nationwide resource for evidence-based healthy city planning and public health interventions

The built environment (BE) has emerged as one of the ‘first causes’ of chronic disease, capable of explaining its socio-spatial variation. There is an increasing need for objective, detailed and precise measurements of attributes of BE that may influence our lifestyle, behaviour and hence physical and mental health. In this paper, we report the UK Biobank Urban Morphometric Platform (UKBUMP), the first ever very large sample size high resolution spatial database of urban morphological metrics (morphometrics), being developed for half-a-million participants of the UK Biobank Prospective study spatially distributed across 22 UK cities. Large-scale objective assessment of the BE was conducted employing state-of-the-art spatial and network analyses upon multiple national-level spatial data-sets. Prospective large-scale objective assessment of the BE enables the development of BE-health modelling studies that have the potential to identify causal pathways from specific attributes of the BE to various complex chronic health outcomes as well as well-being. The UKBUMP will act as a national resource, providing a platform for evidence-based healthy city planning and interventions for the first half of the twenty-first century.postprin