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Person: Philip Hurvitz

Stepping Towards Causation in Studies of Neighborhood and Environmental Effects: How Twin Research Can Overcome Problems of Selection and Reverse Causation

Duncan, Glen E.; Mills, Brianna; Strachan, Eric; Hurvitz, Philip; Huang, Ruizhu; Moudon, Anne Vernez; Turkheimer, Eric. (2014). Stepping Towards Causation in Studies of Neighborhood and Environmental Effects: How Twin Research Can Overcome Problems of Selection and Reverse Causation. Health & Place, 27, 106 – 111.

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Abstract

No causal evidence is available to translate associations between neighborhood characteristics and health outcomes into beneficial changes to built environments. Observed associations may be causal or result from uncontrolled confounds related to family upbringing. Twin designs can help neighborhood effects studies overcome selection and reverse causation problems in specifying causal mechanisms. Beyond quantifying genetic effects (i.e., heritability coefficients), we provide examples of innovative measures and analytic methods that use twins as quasi-experimental controls for confounding by environmental effects. We conclude that collaboration among investigators from multiple fields can move the field forward by designing studies that step toward causation. (C) 2014 Elsevier Ltd. All rights reserved,

Keywords

Residential Location; Methylation; Gene; Interplay; Obesity; Causality; Environment Design; Lifestyle Risk Reduction; Social And Built Environments; Twin Studies

Medical Facilities in the Neighborhood and Incidence of Sudden Cardiac Arrest

Goh, Charlene E.; Mooney, Stephen J.; Siscovick, David S.; Lemaitre, Rozenn N.; Hurvitz, Philip; Sotoodehnia, Nona; Kaufman, Tanya K.; Zulaika, Garazi; Lovasi, Gina S. (2018). Medical Facilities in the Neighborhood and Incidence of Sudden Cardiac Arrest. Resuscitation, 130, 118 – 123.

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Abstract

Background: Medical establishments in the neighborhood, such as pharmacies and primary care clinics, may play a role in improving access to preventive care and treatment and could explain previously reported neighborhood variations in sudden cardiac arrest (SCA) incidence and survival. Methods: The Cardiac Arrest Blood Study Repository is a population-based repository of data from adult cardiac arrest patients and population-based controls residing in King County, Washington. We examined the association between the availability of medical facilities near home with SCA risk, using adult (age 18-80) Seattle residents experiencing cardiac arrest (n = 446) and matched controls (n = 208) without a history of heart disease. We also analyzed the association of major medical centers near the event location with emergency medical service (EMS) response time and survival among adult cases (age 18+) presenting with ventricular fibrillation from throughout King County (n = 1537). The number of medical facilities per census tract was determined by geocoding business locations from the National Establishment Time-Series longitudinal database 1990-2010. Results: More pharmacies in the home census tract was unexpectedly associated with higher odds of SCA (OR: 1.28, 95% CI: 1.03, 1.59), and similar associations were observed for other medical facility types. The presence of a major medical center in the event census tract was associated with a faster EMS response time (-53 s, 95% CI: -84, -22), but not with short-term survival. Conclusions: We did not observe a protective association between medical facilities in the home census tract and SCA risk, orbetween major medical centers in the event census tract and survival.

Keywords

Cardiac Arrest; Medical Care; Emergency Medical Services; Ventricular Fibrillation; Heart Diseases; Patients; Medical Facilities; Neighborhood; Observational Study; Sudden Cardiac Arrest; Survival; Ambulance Response-times; Socioeconomic-status; Association; Care; Resuscitation; Disparities; Population; Provision; Disease

Within- and Between-Person Associations of Neighborhood Poverty with Alcohol Use and Consequences: A Monthly Study of Young Adults

Rhew, Isaac C.; Duckworth, Jennifer C.; Hurvitz, Philip M.; Lee, Christine M. (2020). Within- and Between-Person Associations of Neighborhood Poverty with Alcohol Use and Consequences: A Monthly Study of Young Adults. Drug & Alcohol Dependence, 212.

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Abstract

Background: Studies have shown associations between neighborhood disadvantage and alcohol misuse among adults. Less is known about the role of neighborhood context in young adults (YAs), who engage in more disordered forms of alcohol use compared to other age groups. Using data collected monthly, this study examined whether YAs reported more alcohol use and consequences when they were living in neighborhoods with greater concentration of poverty. Method: This study used data from 746 participants aged 18-23 years living in the Seattle, WA, region. Surveys were administered each month for 24 consecutive months. Measures included typical number of drinks per week and past month count of alcohol-related consequences. Residential addresses at each month were geocoded and linked to census-tract level percentage of households living at or below poverty threshold. Multilevel over-dispersed Poisson models were used to estimate associations between standardized monthly deviations in tract-level poverty from one's average and alcohol outcomes. Results: Across 14,247 monthly observations, the mean number of typical drinks per week was 4.8 (SD = 7.4) and the mean number of alcohol consequences was 2.1 (SD = 3.5). On months when they were living in neighborhoods with higher levels of poverty than their average, participants reported significantly higher levels of alcohol consequences (Count Ratio = 1.05; p = .045). Conclusion: YAs may engage in more problematic forms of drinking when they reside in neighborhoods with higher levels of disadvantage. During a time of frequent residential changes, YAs moving to more disadvantaged neighborhoods may benefit from additional supports.

Keywords

Alcohol Drinking; Young Adults; Neighborhoods; Age Groups; Poverty; Western Australia; Seattle (wash.); Alcohol; Neighborhood Context; Young Adulthood; Emergency-department Visits; Heavy Episodic Drinking; College-students; United-states; Substance Use; Use Disorders; Models; Health; Disorganization; Availability

How Far from Home? The Locations of Physical Activity in an Urban US Setting

Hurvitz, Philip M.; Moudon, Anne V.; Kang, Bumjoon; Fesinmeyer, Megan D.; Saelens, Brian E. (2014). How Far from Home? The Locations of Physical Activity in an Urban US Setting. Preventive Medicine, 69, 181 – 186.

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Abstract

Little is known about where physical activity (PA) occurs, or whether different demographic groups accumulate PA in different locations. Method. Objective data on PA and location from 611 adults over 7 days were collected in King County, WA in 2008-2009. The relative amounts of time spent in sedentary-to-low and moderate-to-vigorous PA (MVPA) were quantified at three locations: home (1666 m). Differences in MVPA by demographics and location were examined. The percent of daily time in MVPA was estimated using a mixed model adjusted for location, sex, age, race/ethnicity, employment, education, BMI, and income. Results. Most MVPA time occurred in nonhome locations, and disproportionately near home; this location was associated with 16.46% greater time in MVPA, compared to at-home activity (p< 0.001), whereas more time spent at away locations was associated with 3.74% greater time in MVPA (p< 0.001). Location was found to be a predictor of MVPA independent of demographic factors. Conclusion. A large proportion of MVPA time is spent at near locations, corresponding to the home neighborhood studied in previous PA research. Away locations also host time spent in MVPA and should be the focus of future research. (C) 2014 Elsevier Inc All rights reserved.

Keywords

Accelerometer Data; Built Environment; United-states; Neighborhood Walkability; Exercise Intensity; Time Use; Land-use; Walking; Health; Behavior; Physical Activity; Objective Measurement; Gps; Accelerometry; Gis

Increased Walking’s Additive and No Substitution Effect on Total Physical Activity

Kang, Bumjoon; Moudon, Anne V.; Hurvitz, Philip M.; Saelens, Brian E. (2018). Increased Walking’s Additive and No Substitution Effect on Total Physical Activity. Medicine & Science In Sports & Exercise, 50(3), 468 – 475.

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Abstract

Purpose We assessed the associations between a change in time spent walking and a change in total physical activity (PA) time within an urban living adult sample to test for additive or substitution effects. Methods Participants living in the greater Seattle area were assessed in 2008-2009 and again 1-2 yr later (2010-2011). At each time point, they wore accelerometers and GPS units and recorded trips and locations in a travel diary for seven consecutive days. These data streams were combined to derive a more objective estimate of walking and total PA. Participants also completed the International Physical Activity Questionnaire to provide self-reported estimates of walking and total PA. Regression analyses assessed the associations between within-participant changes in objective and self-reported walking and total PA. Results Data came from 437 participants. On average, a 1-min increase in total walking was associated with an increase in total PA of 1 min, measured by objective data, and 1.2-min, measured by self-reported data. A similar additive effect was consistently found with utilitarian, transportation, or job-related walking, measured by both objective and self-reported data. For recreational walking, the effect of change was mixed between objective and self-reported results. Conclusion Both objective and self-reported data confirmed an additive effect of utilitarian and total walking on PA.

Keywords

Accelerometers; Global Positioning System; Metropolitan Areas; Questionnaires; Recreation; Self-evaluation; Time; Walking; Physical Activity; Accelerometer; Gps; Ipaq; Longitudinal Study; Self-reported Measures; Light-rail Construction; Built Environment; Accelerometer Data; Older-adults; Urban Form; Transit Use; Travel; Neighborhood; Interventions; Calibration

Associations between Neighborhood Greenspace and Brain Imaging Measures in Non-Demented Older Adults: The Cardiovascular Health Study

Besser, Lilah M.; Lovasi, Gina S.; Michael, Yvonne L.; Garg, Parveen; Hirsch, Jana A.; Siscovick, David; Hurvitz, Phil; Biggs, Mary L.; Galvin, James E.; Bartz, Traci M.; Longstreth, W. T. (2021). Associations between Neighborhood Greenspace and Brain Imaging Measures in Non-Demented Older Adults: The Cardiovascular Health Study. Social Psychiatry And Psychiatric Epidemiology, 56(9), 1575 – 1585.

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Abstract

Purpose Greater neighborhood greenspace has been associated with brain health, including better cognition and lower odds of Alzheimer's disease in older adults. We investigated associations between neighborhood greenspace and brain-based magnetic resonance imaging (MRI) measures and potential effect modification by sex or apolipoprotein E genotype (APOE), a risk factor for Alzheimer's disease. Methods We obtained a sample of non-demented participants 65 years or older (n = 1125) from the longitudinal, population-based Cardiovascular Health Study (CHS). Greenspace data were derived from the National Land Cover Dataset. Adjusted multivariable linear regression estimated associations between neighborhood greenspace five years prior to the MRI and left and right hippocampal volume and 10-point grades of ventricular size and burden of white matter hyperintensity. Interaction terms tested effect modification by APOE genotype and sex. CHS data (1989-1999) were obtained/analyzed in 2020. Results Participants were on average 79 years old [standard deviation (SD) = 4], 58% were female, and 11% were non-white race. Mean neighborhood greenspace was 38% (SD = 28%). Greater proportion of greenspace in the neighborhood five years before MRI was borderline associated with lower ventricle grade (estimate: - 0.30; 95% confidence interval: - 0.61, 0.00). We observed no associations between greenspace and the other MRI outcome measures and no evidence of effect modification by APOE genotype and sex. Conclusion This study suggests a possible association between greater greenspace and less ventricular enlargement, a measure reflecting global brain atrophy. If confirmed in other longitudinal cohort studies, interventions and policies to improve community greenspaces may help to maintain brain health in older age.

Keywords

Mild Cognitive Impairment; Ventricular Enlargement; Residential Greenness; Hippocampal Atrophy; Volume; Disease; Environment; Progression; Symptoms; Dementia; Neighborhood; Green Space; Mri; Brain Volume; Hippocampal; White Matter

Relation between Higher Physical Activity and Public Transit Use

Saelens, Brian E.; Moudon, Anne Vernez; Kang, Bumjoon; Hurvitz, Philip M.; Zhou, Chuan. (2014). Relation between Higher Physical Activity and Public Transit Use. American Journal Of Public Health, 104(5), 854 – 859.

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Abstract

Objectives. We isolated physical activity attributable to transit use to examine issues of substitution between types of physical activity and potential confounding of transit-related walking with other walking. Methods. Physical activity and transit use data were collected in 2008 to 2009 from 693 Travel Assessment and Community study participants from King County, Washington, equipped with an accelerometer, a portable Global Positioning System, and a 7-day travel log. Physical activity was classified into transit-and non-transit-related walking and nonwalking time. Analyses compared physical activity by type between transit users and nonusers, between less and more frequent transit users, and between transit and nontransit days for transit users. Results. Transit users had more daily overall physical activity and more total walking than did nontransit users but did not differ on either non-transit-related walking or nonwalking physical activity. Most frequent transit users had more walking time than least frequent transit users. Higher physical activity levels for transit users were observed only on transit days, with 14.6 minutes (12.4 minutes when adjusted for demographics) of daily physical activity directly linked with transit use. Conclusions. Because transit use was directly related to higher physical activity, future research should examine whether substantive increases in transit access and use lead to more physical activity and related health improvements.

Keywords

Transportation; Analysis Of Covariance; Analysis Of Variance; Chi-squared Test; Comparative Studies; Confidence Intervals; Geographic Information Systems; Research Funding; Statistics; Walking; Data Analysis; Accelerometry; Cross-sectional Method; Exercise Intensity; Physical Activity; Diary (literary Form); Descriptive Statistics; Washington (state); Work; Car; Impact

Capturing Fine-Scale Travel Behaviors: A Comparative Analysis between Personal Activity Location Measurement System (PALMS) and Travel Diary

Kang, Mingyu; Moudon, Anne V.; Hurvitz, Philip M.; Saelens, Brian E. (2018). Capturing Fine-Scale Travel Behaviors: A Comparative Analysis between Personal Activity Location Measurement System (PALMS) and Travel Diary. International Journal Of Health Geographics, 17(1).

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Abstract

BackgroundDevice-collected data from GPS and accelerometers for identifying active travel behaviors have dramatically changed research methods in transportation planning and public health. Automated algorithms have helped researchers to process large datasets with likely fewer errors than found in other collection methods (e.g., self-report travel diary). In this study, we compared travel modes identified by a commonly used automated algorithm (PALMS) that integrates GPS and accelerometer data with those obtained from travel diary estimates.MethodsSixty participants, who made 2100 trips during seven consecutive days of data collection, were selected from among the baseline sample of a project examining the travel behavior impact of a new light rail system in the greater Seattle, WA (USA) area. GPS point level analyses were first conducted to compare trip/place and travel mode detection results using contingency tables. Trip level analyses were then performed to investigate the effect of proportions of time overlap between travel logs and device-collected data on agreement rates. Global performance (with all subjects' data combined) and subject-level performance of the algorithm were compared at the trip level.ResultsAt the GPS point level, the overall agreement rate of travel mode detection was 77.4% between PALMS and the travel diary. The agreement rate for vehicular trip detection (84.5%) was higher than for bicycling (53.5%) and walking (58.2%). At the trip level, the global performance and subject-level performance of the PALMS algorithm were 46.4% and 42.4%, respectively. Vehicular trip detection showed highest agreement rates in all analyses. Study participants' primary travel mode and car ownership were significantly related to the subject-level mode agreement rates.ConclusionsThe PALMS algorithm showed moderate identification power at the GPS point level. However, trip level analyses found lower agreement rates between PALMS and travel diary data, especially for active transportation. Testing different PALMS parameter settings may serve to improve the detection of active travel and help expand PALMS's applicability in geographically different urbanized areas with a variety of travel modes.

Keywords

Transportation Planning; Public Health; Accelerometers; Global Positioning System; Voyages & Travels; Cycling; Algorithms; Accelerometer; Automated Algorithm; Gis; Gps; Places; Trips; Global Positioning Systems; Physical-activity; Data-collection; Health Research; Gps Data; Accelerometry; Validity

Does the Built Environment Have Independent Obesogenic Power? Urban Form and Trajectories of Weight Gain

Buszkiewicz, James H.; Bobb, Jennifer F.; Hurvitz, Philip M.; Arterburn, David; Moudon, Anne Vernez; Cook, Andrea; Mooney, Stephen J.; Cruz, Maricela; Gupta, Shilpi; Lozano, Paula; Rosenberg, Dori E.; Theis, Mary Kay; Anau, Jane; Drewnowski, Adam. (2021). Does the Built Environment Have Independent Obesogenic Power? Urban Form and Trajectories of Weight Gain. International Journal Of Obesity, 45(9), 1914 – 1924.

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Abstract

Objective To determine whether selected features of the built environment can predict weight gain in a large longitudinal cohort of adults. Methods Weight trajectories over a 5-year period were obtained from electronic health records for 115,260 insured patients aged 18-64 years in the Kaiser Permanente Washington health care system. Home addresses were geocoded using ArcGIS. Built environment variables were population, residential unit, and road intersection densities captured using Euclidean-based SmartMaps at 800-m buffers. Counts of area supermarkets and fast food restaurants were obtained using network-based SmartMaps at 1600, and 5000-m buffers. Property values were a measure of socioeconomic status. Linear mixed effects models tested whether built environment variables at baseline were associated with long-term weight gain, adjusting for sex, age, race/ethnicity, Medicaid insurance, body weight, and residential property values. Results Built environment variables at baseline were associated with differences in baseline obesity prevalence and body mass index but had limited impact on weight trajectories. Mean weight gain for the full cohort was 0.06 kg at 1 year (95% CI: 0.03, 0.10); 0.64 kg at 3 years (95% CI: 0.59, 0.68), and 0.95 kg at 5 years (95% CI: 0.90, 1.00). In adjusted regression models, the top tertile of density metrics and frequency counts were associated with lower weight gain at 5-years follow-up compared to the bottom tertiles, though the mean differences in weight change for each follow-up year (1, 3, and 5) did not exceed 0.5 kg. Conclusions Built environment variables that were associated with higher obesity prevalence at baseline had limited independent obesogenic power with respect to weight gain over time. Residential unit density had the strongest negative association with weight gain. Future work on the influence of built environment variables on health should also examine social context, including residential segregation and residential mobility.

Keywords

Body-mass Index; Physical-activity; Food Environment; Structural Racism; Obesity; Neighborhoods; Associations; Health; Walkability; Exposure; Environment Models; Minority & Ethnic Groups; Urban Environments; Regression Analysis; Regression Models; Residential Density; Body Mass Index; Property Values; Body Weight Gain; Government Programs; Body Weight; Electronic Medical Records; Electronic Health Records; Fast Food; Buffers; Real Estate; Body Mass; Body Size; Socioeconomics; Health Care

Geospatial and Contextual Approaches to Energy Balance and Health

Berrigan, David; Hipp, J. Aaron; Hurvitz, Philip M.; James, Peter; Jankowska, Marta M.; Kerr, Jacqueline; Laden, Francine; Leonard, Tammy; Mckinnon, Robin A.; Powell-wiley, Tiffany M.; Tarlov, Elizabeth; Zenk, Shannon N.; The Trec Spatial And Contextual Measures And Modeling Work Group. (2015). Geospatial and Contextual Approaches to Energy Balance and Health. Annals Of Gis, 21(2), 157 – 168.

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Abstract

In the past 15 years, a major research enterprise has emerged that is aimed at understanding associations between geographic and contextual features of the environment (especially the built environment) and elements of human energy balance, including diet, weight and physical activity. Here we highlight aspects of this research area with a particular focus on research and opportunities in the United States as an example. We address four main areas: (1) the importance of valid and comparable data concerning behaviour across geographies; (2) the ongoing need to identify and explore new environmental variables; (3) the challenge of identifying the causally relevant context; and (4) the pressing need for stronger study designs and analytical methods. Additionally, we discuss existing sources of geo-referenced health data which might be exploited by interdisciplinary research teams, personnel challenges and some aspects of funding for geospatial research by the US National Institutes of Health in the past decade, including funding for international collaboration and training opportunities. [ABSTRACT FROM AUTHOR]; Copyright of Annals of GIS is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Keywords

Bioenergetics; Geospatial Data; Contextual Analysis; Physical Activity; Obesity; Contextual; Energy Balance; Geospatial; Spatial