Moudon, Anne Vernez; Drewnowski, Adam; Duncan, Glen E.; Hurvitz, Philip M.; Saelens, Brian E.; Scharnhorst, Eric. (2013). Characterizing the Food Environment: Pitfalls and Future Directions. Public Health Nutrition, 16(7), 1238 – 1243.
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Abstract
Objective: To assess a county population's exposure to different types of food sources reported to affect both diet quality and obesity rates. Design: Food permit records obtained from the local health department served to establish the full census of food stores and restaurants. Employing prior categorization schemes which classified the relative healthfulness of food sources based on establishment type (i.e. supermarkets v. convenience stores, or full-service v. fast-food restaurants), food establishments were assigned to the healthy, unhealthy or undetermined groups. Setting: King County, WA, USA. Subjects: Full census of food sources. Results: According to all categorization schemes, most food establishments in King County fell into the unhealthy and undetermined groups. Use of the food permit data showed that large stores, which included supermarkets as healthy food establishments, contained a sizeable number of bakery/delis, fish/meat, ethnic and standard quick-service restaurants and coffee shops, all food sources that, when housed in a separate venue or owned by a different business establishment, were classified as either unhealthy or of undetermined value to health. Conclusions: To fully assess the potential health effects of exposure to the extant food environment, future research would need to establish the health value of foods in many such common establishments as individually owned grocery stores and ethnic food stores and restaurants. Within-venue exposure to foods should also be investigated.
Keywords
Food Chemistry; Obesity; Health Boards; Dietary Supplements; Food Cooperatives; Restaurant Reviews; Coffee Shops; Food Consumption; Food Quality; Census Of Food Sources; Exposure; Health Value; Neighborhood Characteristics; Store Availability; Racial Composition; Physical-activity; Weight Status; Restaurants; Association; Proximity; Access; Business Enterprises; Fast Food Restaurants; Fish; Grocery Stores; Healthy Diet; Meat; Nutritional Adequacy; Supermarkets
James, Peter; Hart, Jaime E.; Hipp, J. Aaron; Mitchell, Jonathan A.; Kerr, Jacqueline; Hurvitz, Philip M.; Glanz, Karen; Laden, Francine. (2017). GPS-Based Exposure to Greenness and Walkability and Accelerometry-Based Physical Activity. Cancer Epidemiology Biomarkers & Prevention, 26(4), 525 – 532.
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Abstract
Background: Physical inactivity is a risk factor for cancer that may be influenced by environmental factors. Indeed, dense and well-connected built environments and environments with natural vegetation may create opportunities for higher routine physical activity. However, studies have focused primarily on residential environments to define exposure and self-reported methods to estimate physical activity. This study explores the momentary association between minute-level global positioning systems (GPS)-based greenness exposure and time-matched objectively measured physical activity. Methods: Adult women were recruited from sites across the United States. Participants wore a GPS device and accelerometer on the hip for 7 days to assess location and physical activity at minutelevel epochs. GPS records were linked to 250mresolution satellitebased vegetation data and Census Block Group-level U.S. Environmental Protection Agency (EPA) Smart Location Database walkability data. Minute-level generalized additive mixed models were conducted to test for associations between GPS measures and accelerometer count data, accounting for repeated measures within participant and allowing for deviations fromlinearity using splines. Results: Among 360 adult women (mean age of 55.3 +/- 10.2 years), we observed positive nonlinear relationships between physical activity and both greenness and walkability. In exploratory analyses, the relationships between environmental factors and physical activity were strongest among those who were white, had higher incomes, and who were middle-aged. Conclusions: Our results indicate that higher levels of physical activity occurred in areas with higher greenness and higher walkability. Impact: Findings suggest that planning and design policies should focus on these environments to optimize opportunities for physical activity. (C) 2017 AACR.
Keywords
Built Environments; Health Research; Breast-cancer; Obesity; Neighborhood; Validation; Validity; Walking; Risk; Energetics
Jones-Smith, Jessica C.; Walkinshaw, Lina Pinero; Oddo, Vanessa M.; Knox, Melissa; Neuhouser, Marian L.; Hurvitz, Philip M.; Saelens, Brian E.; Chan, Nadine. (2020). Impact of a Sweetened Beverage Tax on Beverage Prices in Seattle, WA. Economics & Human Biology, 39.
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Abstract
Seattle's Sweetened Beverage Tax is an excise tax of 1.75 cents per ounce on sugar-sweetened beverages and is one of the highest beverage taxes in the U.S. This study examined the impact of Seattle's tax on the prices of beverages. We conducted audits of 407 retail food stores and eating places (quick service restaurants and coffee shops) before and 6 months after the tax was implemented in Seattle and in a comparison area. Ordinary least squares difference-in-differences models with store fixed effects were used to estimate the effect of the tax on prices, stratified by beverage type and store type. In secondary analyses, we assessed the effect of the tax on the price of non-taxed beverages and foods. Results from the adjusted difference-in-differences models indicated the tax was associated with an average increase of 1.58 cents per ounce among Seattle retailers, representing 90 % of the price of the tax. By store type, price increases were highest in smaller grocery stores and drug stores. By beverage type, price increases were highest for energy beverages and soda and lowest for bottled coffee and juice drinks. Prices of some nontaxed beverages also increased while the prices of select healthy foods generally did not. The sweetened beverage tax in Seattle is higher than beverage taxes in most other cities, and nearly the full cost of the tax is being passed through to consumers for many beverage types and stores types. (c) 2020 Published by Elsevier B.V.
Keywords
Soda Taxes; Food Policy; Health Policy; Beverage Taxes; Obesity
Aggarwal, Anju; Cook, Andrea J.; Jiao, Junfeng; Seguin, Rebecca A.; Moudon, Anne Vernez; Hurvitz, Philip M.; Drewnowski, Adam. (2014). Access to Supermarkets and Fruit and Vegetable Consumption. American Journal Of Public Health, 104(5), 917 – 923.
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Abstract
Objectives. We examined whether supermarket choice, conceptualized as a proxy for underlying personal factors, would better predict access to supermarkets and fruit and vegetable consumption than mere physical proximity. Methods. The Seattle Obesity Study geocoded respondents' home addresses and locations of their primary supermarkets. Primary supermarkets were stratified into low, medium, and high cost according to the market basket cost of 100 foods. Data on fruit and vegetable consumption were obtained during telephone surveys. Linear regressions examined associations between physical proximity to primary supermarkets, supermarket choice, and fruit and vegetable consumption. Descriptive analyses examined whether supermarket choice outweighed physical proximity among lower-income and vulnerable groups. Results. Only one third of the respondents shopped at their nearest supermarket for their primary food supply. Those who shopped at low-cost supermarkets were more likely to travel beyond their nearest supermarket. Fruit and vegetable consumption was not associated with physical distance but, with supermarket choice, after adjusting for covariates. Conclusions. Mere physical distance may not be the most salient variable to reflect access to supermarkets, particularly among those who shop by car. Studies on food environments need to focus beyond neighborhood geographic boundaries to capture actual food shopping behaviors.
Keywords
Confidence Intervals; Correlation (statistics); Fruit; Geographic Information Systems; Ingestion; Multivariate Analysis; Population Geography; Questionnaires; Regression Analysis; Research Funding; Sales Personnel; Shopping; Travel; Vegetables; Predictive Validity; Cross-sectional Method; Statistical Models; Descriptive Statistics; Null Hypothesis; Washington (state); Local Food Environment; Diet Quality; Socioeconomic Position; Atherosclerosis Risk; Stores; Associations; Obesity; Adults; Availability; Communities
Kang, Bumjoon; Moudon, Anne V.; Hurvitz, Philip M.; Saelens, Brian E. (2017). Differences in Behavior, Time, Location, and Built Environment between Objectively Measured Utilitarian and Recreational Walking. Transportation Research: Part D, 57, 185 – 194.
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Abstract
Objectives: Utilitarian and recreational walking both contribute to physical activity. Yet walking for these two purposes may be different behaviors. We sought to provide operational definitions of utilitarian and recreational walking and to objectively measure their behavioral, spatial, and temporal differences in order to inform transportation and public health policies and interventions. Methods: Data were collected 2008-2009 from 651 Seattle-King County residents, wearing an accelerometer and a GPS unit, and filling-in a travel diary for 7 days. Walking activity bouts were classified as utilitarian or recreational based on whether walking had a destination or not. Differences between the two walking purposes were analyzed, adjusting for the nested structure of walking activity within participants. Results: Of the 4905 observed walking bouts, 87.4% were utilitarian and 12.6% recreational walking. Utilitarian walking bouts were 45% shorter in duration (-12.1 min) and 9% faster in speed (+0.3 km/h) than recreational walking bouts. Recreational walking occurred more frequently in the home neighborhood and was not associated with recreational land uses. Utilitarian walking occurred in areas having higher residential, employment, and street density, lower residential property value, higher area percentage of mixed-use neighborhood destinations, lower percentage of parks/trails, and lower average topographic slope than recreational walking. Conclusion: Utilitarian and recreational walking are substantially different in terms of frequency, speed, duration, location, and related built environment. Policies that promote walking should adopt type-specific strategies. The high occurrence of recreational walking near home highlights the importance of the home neighborhood for this activity.
Keywords
Walking; Utilitarianism; Recreation; Behavioral Assessment; Built Environment; Physical Activity Measurement; Accelerometer; Active Transportation; Gps; Home And Non-home Based Walking; Pedestrian; Physical-activity; Us Adults; Accelerometer Data; Trip Purpose; Urban Form; Travel; Neighborhood; Distance; System
Mooney, Stephen J.; Bobb, Jennifer F.; Hurvitz, Philip M.; Anau, Jane; Theis, Mary Kay; Drewnowski, Adam; Aggarwal, Anju; Gupta, Shilpi; Rosenberg, Dori E.; Cook, Andrea J.; Shi, Xiao; Lozano, Paula; Moudon, Anne Vernez; Arterburn, David. (2020). Impact of Built Environments on Body Weight (The Moving to Health Study): Protocol for a Retrospective Longitudinal Observational Study. Jmir Research Protocols, 9(5).
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Abstract
Background: Studies assessing the impact of built environments on body weight are often limited by modest power to detect residential effects that are small for individuals but may nonetheless comprise large attributable risks. Objective: We used data extracted from electronic health records to construct a large retrospective cohort of patients. This cohort will be used to explore both the impact of moving between environments and the long-term impact of changing neighborhood environments. Methods: We identified members with at least 12 months of Kaiser Permanente Washington (KPWA) membership and at least one weight measurement in their records during a period between January 2005 and April 2017 in which they lived in King County, Washington. Information on member demographics, address history, diagnoses, and clinical visits data (including weight) was extracted. This paper describes the characteristics of the adult (aged 18-89 years) cohort constructed from these data. Results: We identified 229,755 adults representing nearly 1.2 million person-years of follow-up. The mean age at baseline was 45 years, and 58.0% (133,326/229,755) were female. Nearly one-fourth of people (55,150/229,755) moved within King County at least once during the follow-up, representing 84,698 total moves. Members tended to move to new neighborhoods matching their origin neighborhoods on residential density and property values. Conclusions: Data were available in the KPWA database to construct a very large cohort based in King County, Washington. Future analyses will directly examine associations between neighborhood conditions and longitudinal changes in body weight and diabetes as well as other health conditions.
Keywords
Residential Location Choice; Physical-activity; Risk-factors; Food Desert; Neighborhood; Obesity; Association; Outcomes; Bmi; Accelerometer; Electronic Health Records; Built Environment; Washington; Geography; Longitudinal Studies
Doescher, Mark P.; Lee, Chanam; Berke, Ethan M.; Adachi-mejia, Anna M.; Lee, Chun-kuen; Stewart, Orion; Patterson, Davis G.; Hurvitz, Philip M.; Carlos, Heather A.; Duncan, Glen E.; Moudon, Anne Vernez. (2014). The Built Environment and Utilitarian Walking in Small U.S. Towns. Preventive Medicine, 69, 80 – 86.
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Abstract
Objectives. The role of the built environment on walking in rural United States (U.S.) locations is not well characterized. We examined self-reported and measured built environment correlates of walking for utilitarian purposes among adult residents of small rural towns. Methods. In 2011-12, we collected telephone survey and geographic data from 2152 adults in 9 small towns from three U.S. regions. We performed mixed-effects logistic regression modeling to examine relationships between built environment measures and utilitarian walking (any versus none; high [>= 150 min per week] versus low [<150 min per week]) to retail, employment and public transit destinations. Results. Walking levels were lower than those reported for populations living in larger metropolitan areas. Environmental factors significantly (p < 0.05) associated with higher odds of utilitarian walking in both models included self-reported presence of crosswalks and pedestrian signals and availability of park/natural recreational areas in the neighborhood, and also objectively measured manufacturing land use. Conclusions. Environmental factors associated with utilitarian walking in cities and suburbs were important in small rural towns. Moreover, manufacturing land use was associated with utilitarian walking. Modifying the built environment of small towns could lead to increased walking in a sizeable segment of the U.S. population. (C) 2014 Elsevier Inc. All rights reserved.
Keywords
Cities & Towns -- Environmental Conditions; Walking; Telephone Surveys; Logistic Regression Analysis; Public Transit; Cities & Towns; Rural Conditions; United States; Exercise/physical Activity; Health Promotion; Physical Environment; Prevention; Rural Health; Social Environment; Physical-activity; Postmenopausal Women; Adults; Health; Risk; Transportation; Associations; Neighborhood; Travel; Determinants
Quistberg, D. Alex; Howard, Eric J.; Hurvitz, Philip M.; Moudon, Anne V.; Ebel, Beth E.; Rivara, Frederick P.; Saelens, Brian E. (2017). The Relationship between Objectively Measured Walking and Risk of Pedestrian–Motor Vehicle Collision. American Journal Of Epidemiology, 185(9), 810 – 821.
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Abstract
Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian-motor vehicle collision is unknown. We examined associations between individuals' walking bouts and walking risk, measured as mean exposure to the risk of pedestrian-vehicle collision. Walking bouts were ascertained through integrated accelerometry and global positioning system data and from individual travel-diary data obtained from adults in the Travel Assessment and Community Study (King County, Washington) in 2008-2009. Walking patterns were superimposed onto maps of the historical probabilities of pedestrian-vehicle collisions for intersections and midblock segments within Seattle, Washington. Mean risk of pedestrian-vehicle collision in specific walking locations was assessed according to walking exposure (duration, distance, and intensity) and participant demographic characteristics in linear mixed models. Participants typically walked in areas with low pedestrian collision risk when walking for recreation, walking at a faster pace, or taking longer-duration walks. Mean daily walking duration and distance were not associated with collision risk. Males walked in areas with higher collision risk compared with females, while vehicle owners, residents of single-family homes, and parents of young children walked in areas with lower collision risk. These findings may suggest that pedestrians moderate collision risk by using lower-risk routes.
Keywords
Traffic Accidents; Confidence Intervals; Geographic Information Systems; Health Promotion; Maps; Research Funding; Walking; Accelerometry; Physical Activity; Data Analysis Software; Diary (literary Form); Descriptive Statistics; Risk Factors; Washington (state); Accidents; Environment Design; Global Positioning Systems; Pedestrians; Risk Assessment; Traffic; Physical-activity; Built Environment; Traffic Safety; Accident Risk; Injury Rates; Route-choice; Exposure; Gps; Travel; Accidents, Traffic
Mooney, Stephen J.; Hurvitz, Philip M.; Moudon, Anne Vernez; Zhou, Chuan; Dalmat, Ronit; Saelens, Brian E. (2020). Residential Neighborhood Features Associated with Objectively Measured Walking Near Home: Revisiting Walkability Using the Automatic Context Measurement Tool (ACMT). Health & Place, 63.
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Abstract
Many distinct characteristics of the social, natural, and built neighborhood environment have been included in walkability measures, and it is unclear which measures best describe the features of a place that support walking. We developed the Automatic Context Measurement Tool, which measures neighborhood environment characteristics from public data for any point location in the United States. We explored these characteristics in home neighborhood environments in relation to walking identified from integrated GPS, accelerometer, and travel log data from 681 residents of King Country, WA. Of 146 neighborhood characteristics, 92 (63%) were associated with walking bout counts after adjustment for individual characteristics and correction for false discovery. The strongest built environment predictor of walking bout count was housing unit count. Models using data-driven and a priori defined walkability measures exhibited similar fit statistics. Walkability measures consisting of different neighborhood characteristic measurements may capture the same underlying variation in neighborhood conditions.
Keywords
Built-environment; Physical-activity; Transit; Density; Obesity; Weight; Time; Gps; American Community Survey; Epa Walkability Index; Neighborhood Environment-wide Association; Study; Walking Bouts
Drewnowski, Adam; Aggarwal, Anju; Rehm, Colin D.; Cohen-Cline, Hannah; Hurvitz, Philip M.; Moudon, Anne V. (2014). Environments Perceived as Obesogenic Have Lower Residential Property Values. American Journal Of Preventive Medicine, 47(3), 260 – 274.
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Abstract
Background: Studies have tried to link obesity rates and physical activity with multiple aspects of the built environment. Purpose: To determine the relation between residential property values and multiple perceived (self-reported) measures of the obesogenic environment. Methods: The Seattle Obesity Study (SOS) used a telephone survey of a representative, geographically distributed sample Of 2,001 King County adults, collected in 2008-2009 and analyzed in 2012-2013. Home addresses were geocoded. Residential property values at the tax parcel level were obtained from the King County tax assessor. Mean residential property values within a 10-minute walk (833-m buffer) were calculated for each respondent. Data on multiple perceived measures of the obesogenic environment were collected by self-report. Correlations and multi-variable linear regression analyses, stratified by residential density, were used to examine the associations among perceived environmental measures, property values, and BMI. Results: Perceived measures of the environment such as crime, heavy traffic, and proximity to bars, liquor stores, and fast food were all associated with lower property values. By contrast, living in neighborhoods that were perceived as safe, quiet, clean, and attractive was associated with higher property values. Higher property values were associated, in turn, with lower BMIs among women. The observed associations between perceived environment measures and BMI were largely attenuated after accounting for residential property values. Conclusions: Environments perceived as obesogenic are associated with lower property values. Studies in additional locations need to explore to what extent other perceived environment measures can be reflected in residential property values. (C) 2014 American Journal of Preventive Medicine
Keywords
Body-mass Index; Physical-activity; Objective Measures; Childhood Obesity; Food Stores; Neighborhood Disorder; Atherosclerosis Risk; Collective Efficacy; Racial Composition; Built Environment