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
Scully, Jason Y.; Moudon, Anne Vernez; Hurvitz, Philip M.; Aggarwal, Anju; Drewnowski, Adam. (2017). GPS or Travel Diary: Comparing Spatial and Temporal Characteristics of Visits to Fast Food Restaurants and Supermarkets. Plos One, 12(4).
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Abstract
To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health Seattle King County, addresses from food permit data were matched to King County tax assessor parcels in a GIS. A three-step process was used to verify travel-diary reported visits using GPS records: (1) GPS records were temporally matched if their timestamps were within the time window created by the arrival and departure times reported in the travel diary; (2) the temporally matched GPS records were then spatially matched if they were located in a food establishment parcel of the same type reported in the diary; (3) the travel diary visit was then GPS-sensed if the name of food establishment in the parcel matched the one reported in the travel diary. To account for errors in reporting arrival and departure times, GPS records were temporally matched to three time windows: the exact time, +/-10 minutes, and +/-30 minutes. One third of the participants reported 273 visits to fast food restaurants; 88% reported 1,102 visits to supermarkets. Of these, 77.3 percent of the fast food and 78.6 percent supermarket visits were GPS-sensed using the +/-10-minute time window. At this time window, the mean travel-diary reported fast food visit duration was 14.5 minutes (SD 20.2), 1.7 minutes longer than the GPS-sensed visit. For supermarkets, the reported visit duration was 23.7 minutes (SD 18.9), 3.4 minutes longer than the GPS-sensed visit. Travel diaries provide reasonably accurate information on the locations and brand names of fast food restaurants and supermarkets participants report visiting.
Keywords
Global Positioning System; Fast Food Restaurants; Self-evaluation; Public Health; Supermarkets; Geoinformatics; Comparative Studies; Biology And Life Sciences; Computer And Information Sciences; Diet; Earth Sciences; Eating; Engineering And Technology; Food; Food Consumption; Geographic Information Systems; Geography; Medicine And Health Sciences; Nutrition; Physiological Processes; Physiology; Public And Occupational Health; Research And Analysis Methods; Research Article; Research Design; Survey Research; Surveys; Transportation; Global Positioning Systems; Environment; Neighborhood; Exposure; Health; Consumption; Tracking; Adults; Associations; Dietary
Muni, Kennedy; Kobusingye, Olive; Mock, Charles; Hughes, James P.; Hurvitz, Philip M.; Guthrie, Brandon. (2020). Motorcycle Taxi Programme Increases Safe Riding Behaviours Among Its Drivers In Kampala, Uganda. Injury Prevention, 26(1), 5 – 11.
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Abstract
Background SafeBoda is a motorcycle taxi company that provides road safety training and helmets to its drivers in Kampala, Uganda. We sought to determine whether SafeBoda drivers are more likely to engage in safe riding behaviours than regular drivers (motorcycle taxi drivers not part of SafeBoda). Methods We measured riding behaviours in SafeBoda and regular drivers through: (1) computer-assisted personal interview (CAPI), where 400 drivers were asked about their riding behaviours (eg, helmet and mobile phone use) and (2) roadside observation, where riding behaviours were observed in 3000 boda-boda drivers and their passengers along major roads in Kampala. Results Across the two cross-sectional studies, a higher proportion of SafeBoda drivers than regular drivers engaged in safe riding behaviours. For instance, helmet use among SafeBoda compared with regular drivers was 21% points higher (95% CI 0.15 to 0.27; p<0.001) based on the CAPI and 45% points higher (95% CI 0.43 to 0.47; p<0.001) based on roadside observation. Furthermore, compared with regular drivers, SafeBoda drivers were more likely to report having a driver's license (66.3% vs 33.5 %; p<0.001) and a reflective jacket (99.5% vs 50.5 %; p<0.001) and were less likely to report driving towards oncoming traffic (4% vs 45.7 %; p<0.001) in the past 30 days. Conclusion The SafeBoda programme is associated with increased safe riding behaviours among motorcycle taxi drivers in Kampala. Therefore, the promotion and expansion of such programmes may lead to a reduction in morbidity and mortality due to road injuries.
Keywords
Multiple-imputation; Helmet Use; Knowledge; Injuries; Riders
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
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
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
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