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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

Professional Judgement in Clinical Practice (Part 3): A Better Alternative to Strong Evidence-Based Medicine

Mugerauer, Robert. (2021). Professional Judgement in Clinical Practice (Part 3): A Better Alternative to Strong Evidence-Based Medicine. Journal Of Evaluation In Clinical Practice, 27(3), 612 – 623.

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Abstract

Parts 1 and 2 in this series of three articles have shown that and how strong evidence-based medicine has neither a coherent theoretical foundation nor creditable application to clinical practice. Because of its core commitment to the discredited positivist tradition it holds both a false concept of scientific knowledge and misunderstandings concerning clinical decision-making. Strong EBM continues attempts to use flawed adjustments to recover from the unsalvageable base view. Paper three argues that a promising solution is at hand if we can manage several modes of inclusion. A modified original, moderate version of EBM continues though usually overshadowed. As definitively laid out by Sackett in the 1990s, clinical decision making is intended to be person-centered, recognizing and integrating multiple modes of evidence and knowledge that have been marginalized: professional experience, illness narratives, and individual patients' values and preferences. Complementary resources are at hand: interpretative understanding and practice, such as philosophical anthropology, hermeneutical phenomenology, complexity theory, and phronetic practices respond to the major problems and open new possibilities. Phronesis is especially important in regard to public decision making. Within part 3 an additional tone necessarily occurs. While most of papers 1, 2, and 3 are written in the classical mode of contrasting the theoretical-logical and empirical evidence offered by contending positions bearing on the decision making and judgement in clinical practice, a shift occurs when considerations move beyond what is possible for clinical practitioners to accomplish. A different, discontinuous level of power operates in the trans-personal realm of instrumental policy, insurance, and hospital management practices. In this social-economic-political-ethical realm what happens in clinical practice today increasingly becomes a matter of what is done unto clinical practitioners, of what hampers their professional action and thus care of individual patients and clients.

Keywords

Medical Policy; Judgment (psychology); Professions; Evidence-based Medicine; Patient-centered Care; Phenomenology; Decision Making In Clinical Medicine; Casuistry; Decision Making; Evidence‚Äêbased Medicine; Phronƒìsis; 2009 Cancer-control; Integrating Evidence; Decision-making; Health-care; G. H.; Mental-health; Tonelli; Challenge; Knowledge; Evidence‐ Based Medicine; Phronē Sis

How Does Ride-Hailing Influence Individual Mode Choice? An Examination Using Longitudinal Trip Data from the Seattle Region

Wang, Yiyuan; Moudon, Anne Vernez; Shen, Qing. (2022). How Does Ride-Hailing Influence Individual Mode Choice? An Examination Using Longitudinal Trip Data from the Seattle Region. Transportation Research Record, 2676(3), 621 – 633.

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Abstract

This study investigates the impacts of ride-hailing, which we define as mobility services consisting of both conventional taxis and app-based services offered by transportation network companies, on individual mode choice. We examine whether ride-hailing substitutes for or complements travel by driving, public transit, or walking and biking. The study overcomes some of the limitations of convenience samples or cross-sectional surveys used in past research by employing a longitudinal dataset of individual travel behavior and socio-demographic information. The data include three waves of travel log data collected between 2012 and 2018 in transit-rich areas of the Seattle region. We conducted individual-level panel data modeling, estimating independently pooled models and fixed-effect models of average daily trip count and duration for each mode, while controlling for various factors that affect travel behavior. The results provide evidence of substitution effects of ride-hailing on driving. We found that cross-sectionally, participants who used more ride-hailing tended to drive less, and that longitudinally, an increase in ride-hailing usage was associated with fewer driving trips. No significant associations were found between ride-hailing and public transit usage or walking and biking. Based on detailed travel data of a large population in a major U.S. metropolitan area, the study highlights the value of collecting and analyzing longitudinal data to understand the impacts of new mobility services.

Keywords

Shared Mobility; Ride-hailing; Longitudinal Data; Substitution Between Travel Modes; Complementarity Between Travel Modes; Services; Uber

Carbon Consequences of Land Cover Change and Expansion of Urban Lands: A Case Study in the Seattle Metropolitan Region

Hutyra, Lucy R.; Yoon, Byungman; Hepinstall-Cymerman, Jeffrey; Alberti, Marina. (2011). Carbon Consequences of Land Cover Change and Expansion of Urban Lands: A Case Study in the Seattle Metropolitan Region. Landscape And Urban Planning, 103(1), 83 – 93.

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Abstract

Understanding the role humans play in modifying ecosystems through changing land cover is central to addressing our current and emerging environmental challenges. In particular, the consequences of urban growth and land cover change on terrestrial carbon budgets is a growing issue for our rapidly urbanizing planet. Using the lowland Seattle Statistical Metropolitan Area (MSA) region as a case study, this paper explores the consequences of the past land cover changes on vegetative carbon stocks with a combination of direct field measurements and a time series of remote sensing data. Between 1986 and 2007, the amount of urban land cover within the lowland Seattle MSA more than doubled, from 1316 km(2) to 2798 km(2), respectively. Virtually all of the urban expansion was at the expense of forests with the forested area declining from 4472 km(2) in 1986 to 2878 km(2) in 2007. The annual mean rate of urban land cover expansion was 1 +/- 0.6% year(-1). We estimate that the impact of these regional land cover changes on aboveground carbon stocks was an average loss of 1.2 Mg C ha(-1) yr(-1) in vegetative carbon stocks. These carbon losses from urban expansion correspond to nearly 15% of the lowland regional fossil fuel emissions making it an important, albeit typically overlooked, term in regional carbon emissions budgets. As we plan for future urban growth and strive for more ecologically sustainable cities, it is critical that we understand the past patterns and consequences of urban development to inform future land development and conservation strategies. (C) 2011 Elsevier B.V. All rights reserved.

Keywords

Sprawl; Growth; Carbon Cycle; Emissions; Land Cover; Urbanization; Seattle; Vegetation; Carbon; Carbon Sinks; Case Studies; Cities; Ecosystems; Forests; Fossil Fuels; Humans; Land Use; Planning; Remote Sensing; Time Series Analysis

The Economic Value of Walkable Neighborhoods

Sohn, Dong Wook; Moudon, Anne Vernez; Lee, Jeasun. (2012). The Economic Value of Walkable Neighborhoods. Urban Design International, 17(2), 115 – 128.

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Abstract

This study investigated how the benefits of a walkable neighborhood were reflected in the American real estate market by examining the economic values of urban environmental factors supporting walking activities. Property values were used as a proxy measure for economic value and analyzed in relation to land use characteristics that have been known to correlate with walking at the neighborhood scale. Four aspects of the built environment supporting walking were included in the analyses: development density, land use mix, public open space and pedestrian infrastructure. Hedonic models were employed where the property value was regressed on the measures of the four sets of correlates of walking in a neighborhood. Models were estimated for four land use types - single-family residential, rental multi-family residential, commercial and office. The findings did not support previous arguments that increasing density weakens the quality of a neighborhood. To the contrary, the positive association of higher development density with the value of single-family residential properties detected in King County suggested that high development density might increase surrounding property values. The pedestrian infrastructure and land use mix significantly contributed to increases in rental multi-family residential property values. Higher development density with higher street and sidewalk coverage were also favored by retail service uses. In relation to land use mix, mixing retail service uses and rental multi-family residential uses helped make rental housings more attractive. URBAN DESIGN International (2012) 17, 115-128. doi:10.1057/udi.2012.1; published online 4 April 2012

Keywords

Land-use; Physical-activity; Travel Behavior; Smart Growth; Mode Choice; Urban Form; Walking; Gis; Transportation; Accessibility; Mixed Land Use; Neighborhood; Urban Design

Use of Health Impact Assessment for Transportation Planning Importance of Transportation Agency Involvement in the Process

Dannenberg, Andrew L.; Ricklin, Anna; Ross, Catherine L.; Schwartz, Michael; West, Julie; White, Steve; Wier, Megan L. (2014). Use of Health Impact Assessment for Transportation Planning Importance of Transportation Agency Involvement in the Process. Transportation Research Record, 2452, 71 – 80.

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Abstract

A health impact assessment (HIA) is a tool that can be used to inform transportation planners of the potential health consequences of their decisions. Although dozens of transportation-related HIAs have been completed in the United States, the characteristics of these HIAs and the interactions between public health professionals and transportation decision makers in these HIM have not been documented. A master list of completed HIAs was used to identify transportation-related HIAs. Seventy-three transportation-related HIAs conducted in 22 states between 2004 and 2013 were identified. The HIAs were conducted for projects such as road redevelopments, bridge replacements, and development of trails and public transit. Policies such as road pricing, transit service levels, speed limits, complete streets, and safe routes to schools were also assessed. Five HIAs in which substantial interactions between public health and transportation professionals took place during and after the HIA were examined in detail and included HIAs of the road pricing policy in San Francisco, California; a bridge replacement in Seattle, Washington; new transit lines in Baltimore, Maryland, and Portland, Oregon; and the BeltLine transit, trails, and parks project in Atlanta, Georgia. Recommendations from the HIAs led to changes in decisions in some cases and helped to raise awareness of health issues by transportation decision makers in all cases. HIAs are now used for many topics in transportation. The range of involvement of transportation decision makers in the conduct of HIAs varies. These case studies may serve as models for the conduct of future transportation-related HIAs, because the involvement of transportation agencies may increase the likelihood that an HIA will influence subsequent decisions.

Keywords

Policy; Inequalities; Benefits; Justice; Oregon

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

Measuring Pedestrian Exposure to PM-2.5: Case of the Seattle, Washington, International District

Bae, Chang-hee Christine; Sinha, Debmalya. (2016). Measuring Pedestrian Exposure to PM-2.5: Case of the Seattle, Washington, International District. Transportation Research Record, 2570, 139 – 147.

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Abstract

Traffic-related air pollution is dangerous to human health. Although transportation and land use planning policies often focus on making walking more attractive, there is a lack of research on pedestrian exposure to air pollution levels. This research focused on pedestrian exposure to particulate matter with a diameter of 2.5 mu m or less (PM-2.5) in the International District (ID) adjacent to downtown Seattle, Washington. Several types of equipment were used: (a) a portable nephelometer (Radiance Research M903) mounted on a backpack (arranged by the Puget Sound Clean Air Agency); (b) an AirCasting mobile application (by Habitmap) in a cell phone to record the researcher's location and exposure levels while walking; and (c) a GoPro Hero camera to record visual images of the surrounding built environment, traffic volume, and other activities. The field data were collected three times a day (morning, midday, and evening) for one week in winter (December 31, 2014-January 9, 2015) and one week in spring (March 21-30, 2015) on selected routes in the ID. The study found seasonal and time-of-day variability of exposure levels: there were higher PM-2.5 concentration levels during the winter (57.77 mu g/m(3)) than in the spring (6.99 mu g/m(3)), and higher levels in the morning (25 mu g/m(3)) than in the evening (17 mu g/m(3)). Also, the average PM-2.5 levels of ID data were slightly higher (20.7 mu g/m(3)) than those at the nearest U.S. Environmental Protection Agency monitoring station (19.0 mu g/m(3)). The researchers concluded that the key contributors of pedestrian exposure to air pollution are traffic, construction activities, and smokers on sidewalks.

Keywords

Particulate Air-pollution; Long-term Exposure; Particle Number; Fine; Quality; Health; Pm2.5; Risk; Road

Advancing Urban Ecology toward a Science of Cities

McPhearson, Timon; Pickett, Steward T. A.; Grimm, Nancy B.; Niemela, Jari; Alberti, Marina; Elmqvist, Thomas; Weber, Christiane; Haase, Dagmar; Breuste, Juergen; Qureshi, Salman. (2016). Advancing Urban Ecology toward a Science of Cities. Bioscience, 66(3), 198 – 212.

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Abstract

Urban ecology is a field encompassing multiple disciplines and practical applications and has grown rapidly. However, the field is heterogeneous as a global inquiry with multiple theoretical and conceptual frameworks, variable research approaches, and a lack of coordination among multiple schools of thought and research foci. Here, we present an international consensus on how urban ecology can advance along multiple research directions. There is potential for the field to mature as a holistic, integrated science of urban systems. Such an integrated science could better inform decisionmakers who need increased understanding of complex relationships among social, ecological, economic, and built infrastructure systems. To advance the field requires conceptual synthesis, knowledge and data sharing; cross-city comparative research, new intellectual networks, and engagement with additional disciplines. We consider challenges and opportunities for understanding dynamics of urban systems. We suggest pathways for advancing urban ecology research to support the goals of improving urban sustainability and resilience, conserving urban biodiversity, and promoting human well-being on an urbanizing planet.

Keywords

Urban Ecology (biology); Urban Biodiversity; Urbanization & The Environment; Life Sciences; Medical Sciences; Comparative Research; Complexity; Conceptual Frameworks; Urban Ecology; Urban Systems; Ecosystem Services; Green Spaces; Resilience; Framework; Systems; Design; Water; Tree

Understanding the Motivations of Coastal Residents to Voluntarily Purchase Federal Flood Insurance

Brody, Samuel D.; Highfield, Wesley E.; Wilson, Morgan; Lindell, Michael K.; Blessing, Russell. (2017). Understanding the Motivations of Coastal Residents to Voluntarily Purchase Federal Flood Insurance. Journal Of Risk Research, 20(6), 760 – 775.

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Abstract

Federally-backed flood insurance is the primary mechanism by which residents in the United States (US) prepare for and recover from floods. While there is a growing literature on the general uptake of flood insurance, little work has been done to address the factors motivating residents to voluntarily buy and maintain federally-based insurance policies. We address this issue by conducting a survey of coastal residents in four localities in Texas and Florida. Based on survey responses, we quantitatively examine the factors influencing whether residents located outside of the 100-year floodplain obtain insurance policies when it is not required. Using two-sample t-tests and binary logistic regression analysis to control for multiple contextual and psychological variables, we statistically isolate the factors contributing most to the decision to purchase insurance. Our findings indicate that a resident located outside the 100-year floodplain who has voluntarily purchased federal flood insurance can be characterized, on average, as more highly educated, living in relatively expensive homes, and a long-time resident who thinks about flood hazard relatively infrequently but who, nonetheless, thinks flood insurance is relatively affordable. Unexpectedly, the physical proximity of a respondent to flood hazard areas makes little or no discernible difference in the decision to obtain flood insurance.

Keywords

Action Decision-model; Hazard Adjustments; Risk; Perceptions; Adoption; Florida; Losses; Determinants; Preferences; Responses; Insurance; Floodplain; Purchase Decision; Texas