Mooney, Stephen J.; Lemaitre, Rozenn N.; Siscovick, David S.; Hurvitz, Philip; Goh, Charlene E.; Kaufman, Tanya K.; Zulaika, Garazi; Sheehan, Daniel M.; Sotoodehnia, Nona; Lovasi, Gina S. (2018). Neighborhood Food Environment, Dietary Fatty Acid Biomarkers, and Cardiac Arrest Risk. Health & Place, 53, 128 – 134.
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Abstract
We explored links between food environments, dietary intake biomarkers, and sudden cardiac arrest in a population-based longitudinal study using cases and controls accruing between 1990 and 2010 in King County, WA. Surprisingly, presence of more unhealthy food sources near home was associated with a lower 18:1 trans-fatty acid concentration ( - 0.05% per standard deviation higher count of unhealthy food sources, 95% Confidence Interval [CI]: 0.01, 0.09). However, presence of more unhealthy food sources was associated with higher odds of cardiac arrest (Odds Ratio [OR]: 2.29, 95% CI: 1.19, 4.41 per standard deviation in unhealthy food outlets). While unhealthy food outlets were associated with higher cardiac arrest risk, circulating 18:1 trans fats did not explain the association.
Keywords
Fatty Acids; Biological Tags; Cardiac Arrest; Food Contamination; Standard Deviations; Food Supply; Out-of-hospital Cardiac Arrest; Residence Characteristics; Sudden Cardiac Death; Trans Fatty Acids; New-york-city; Acute Myocardial-infarction; Low Socioeconomic-status; United-states; Vascular Inflammation; Cardiovascular Health; Older-adults; Death; Epidemiology; Arrhythmias; Dietary Supplements; Biomarkers; Heart Attacks; Risk Factors; Diet; Heart; Healthy Food; Fats; Dietary Intake; Food Sources; Food; Confidence Intervals; Biological Markers; Myocardial Infarction; Population Studies; Food Intake; Correlation Analysis; Neighborhoods
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
Rhew, Isaac C.; Hurvitz, Philip M.; Lyles-riebli, Rose; Lee, Christine M. (2022). Geographic Ecological Momentary Assessment Methods to Examine Spatio-temporal Exposures Associated with Marijuana Use Among Young Adults: A Pilot Study. Spatial And Spatio-temporal Epidemiology, 41.
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Abstract
Background: This study demonstrates the use of geographic ecological momentary assessment (GEMA) methods among young adult marijuana users. Method: Participants were 14 current marijuana users ages 21-27 living in Greater Seattle, Washington. They completed brief surveys four times per day for 14 consecutive days, including measures of marijuana use and desire to use. They also carried a GPS data logger that tracked their spatial movements over time. Results: Participants completed 80.1% of possible EMA surveys. Using the GPS data, we calculated daily number of exposures to (i.e., within 100-m of) marijuana retail outlets (mean = 3.9 times per day; SD = 4.4) and time spent per day in high poverty census tracts (mean = 7.3 h per day in high poverty census tracts; SD = 5.1). Conclusions: GEMA may be a promising approach for studying the role spatio-temporal factors play in marijuana use and related factors.
Keywords
Geographic Ecological Momentary Assessment; Spatio-temporal Factors; Marijuana; Young Adults; Geographic Information System; Poverty; Substance Use; Alcohol; Tracking
Jiao, Junfeng; Moudon, Anne V.; Ulmer, Jared; Hurvitz, Philip M.; Drewnowski, Adam. (2012). How to Identify Food Deserts: Measuring Physical and Economic Access to Supermarkets in King County, Washington. American Journal Of Public Health, 102(10), E32 – E39.
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Abstract
Objectives. We explored new ways to identify food deserts. Methods. We estimated physical and economic access to supermarkets for 5 low-income groups in Seattle-King County, Washington. We used geographic information system data to measure physical access: service areas around each supermarket were delineated by ability to walk, bicycle, ride transit, or drive within 10 minutes. We assessed economic access by stratifying supermarkets into low, medium, and high cost. Combining income and access criteria generated multiple ways to estimate food deserts. Results. The 5 low-income group definitions yielded total vulnerable populations ranging from 4% to 33% of the county's population. Almost all of the vulnerable populations lived within a 10-minute drive or bus ride of a low-or medium-cost supermarket. Yet at most 34% of the vulnerable populations could walk to any supermarket, and as few as 3% could walk to a low-cost supermarket. Conclusions. The criteria used to define low-income status and access to supermarkets greatly affect estimates of populations living in food deserts. Measures of access to food must include travel duration and mode and supermarket food costs.
Keywords
Neighborhood Characteristics; Store Availability; Accessibility; Consumption; Disparities; Environment; Location; Fruit; Pay
Stewart, Orion Theodore; Moudon, Anne Vernez. (2014). Using the Built Environment to Oversample Walk, Transit, and Bicycle Travel. Transportation Research: Part D, 32, 15 – 23.
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Abstract
Characteristics of the built environment (BE) have been associated with walk, transit, and bicycle travel. These BE characteristics can be used by transportation researchers to oversample households from areas where walk, transit, or bicycle travel is more likely, resulting in more observations of these uncommon travel behaviors. Little guidance, however, is available on the effectiveness of such built environment oversampling strategies. This article presents measures that can be used to assess the effectiveness of BE oversampling strategies and inform future efforts to oversample households with uncommon travel behaviors. The measures are sensitivity and specificity, positive likelihood ratio (LR+), and positive predictive value (PPV). To illustrate these measures, they were calculated for 10 BE-defined oversampling strata applied post-hoc to a Seattle area household travel survey. Strata with an average block size of <10 acres within a 1/4 mile of household residences held the single greatest potential for oversampling households that walk, use transit, and/or bicycle. (C) 2014 Elsevier Ltd. All rights reserved.
Keywords
Cycling; Transportation; Observation (scientific Method); Strategic Planning; Public Transit; Land Use; Bicycle; Household Travel Survey; Non-motorized Travel; Sampling; Screening Tests; Transit; Walk; Land-use; North-america; Renaissance; Policies; Choice; Trends
Stewart, Orion T.; Carlos, Heather A.; Lee, Chanam; Berke, Ethan M.; Hurvitz, Philip M.; Li, Li; Moudon, Anne Vernez; Doescher, Mark P. (2016). Secondary GIS Built Environment Data for Health Research: Guidance for Data Development. Journal Of Transport & Health, 3(4), 529 – 539.
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Abstract
Built environment (BE) data in geographic information system (GIS) format are increasingly available from public agencies and private providers. These data can provide objective, low-cost BE data over large regions and are often used in public health research and surveillance. Yet challenges exist in repurposing GIS data for health research. The GIS data do not always capture desired constructs; the data can be of varying quality and completeness; and the data definitions, structures, and spatial representations are often inconsistent across sources. Using the Small Town Walkability study as an illustration, we describe (a) the range of BE characteristics measurable in a GIS that may be associated with active living, (b) the availability of these data across nine U.S. small towns, (c) inconsistencies in the GIS BE data that were available, and (d) strategies for developing accurate, complete, and consistent GIS BE data appropriate for research. Based on a conceptual framework and existing literature, objectively measurable characteristics of the BE potentially related to active living were classified under nine domains: generalized land uses, morphology, density, destinations, transportation system, traffic conditions, neighborhood behavioral conditions, economic environment, and regional location. At least some secondary GIS data were available across all nine towns for seven of the 9 BE domains. Data representing high-resolution or behavioral aspects of the BE were often not available. Available GIS BE data - especially tax parcel data often contained varying attributes and levels of detail across sources. When GIS BE data were available from multiple sources, the accuracy, completeness, and consistency of the data could be reasonable ensured for use in research. But this required careful attention to the definition and spatial representation of the BE characteristic of interest. Manipulation of the secondary source data was often required, which was facilitated through protocols. (C) 2015 Elsevier Ltd. All rights reserved.
Keywords
Geographic Information-systems; Physical-activity; Land-use; Walking; Neighborhood; Associations; Density; Design; Adults; Travel; Active Travel; Pedestrian; Urban Design; Community Health; Rural
Stewart, Orion T.; Moudon, Anne Vernez; Littman, Alyson J.; Seto, Edmund; Saelens, Brian E. (2018). The Association between Park Facilities and Duration of Physical Activity During Active Park Visits. Journal Of Urban Health, 95(6), 869 – 880.
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Abstract
Public parks provide places for urban residents to obtain physical activity (PA), which is associated with numerous health benefits. Adding facilities to existing parks could be a cost-effective approach to increase the duration of PA that occurs during park visits. Using objectively measured PA and comprehensively measured park visit data among an urban community-dwelling sample of adults, we tested the association between the variety of park facilities that directly support PA and the duration of PA during park visits where any PA occurred. Cross-classified multilevel models were used to account for the clustering of park visits (n=1553) within individuals (n=372) and parks (n=233). Each additional different PA facility at a park was independently associated with a 6.8% longer duration of PA bouts that included light-intensity activity, and an 8.7% longer duration of moderate to vigorous PA time. Findings from this study are consistent with the hypothesis that more PA facilities increase the amount of PA that visitors obtain while already active at a park.
Keywords
Park Facilities; Physical Activity; Park Use; Recreation; Built Environment; Global Positioning System; Accelerometer; Gis; Gps; Accelerometer Data; United-states; Adults; Proximity; Features; Walking; Size; Attractiveness; Improvements; Environment; Parks & Recreation Areas; Parks; Luminous Intensity; Clustering; Urban Areas
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
Rehm, Colin D.; Moudon, Anne V.; Hurvitz, Philip M.; Drewnowski, Adam. (2012). Residential Property Values are Associated with Obesity among Women in King County, WA, USA. Social Science & Medicine, 75(3), 491 – 495.
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Abstract
Studies of social determinants of weight and health in the US have typically relied on self-reported education and incomes as the two primary measures of socioeconomic status (SES). The assessed value of one's home, an important component of wealth, may be a better measure of the underlying SES construct and a better predictor of obesity. The Seattle Obesity Study (SOS), conducted in 2008-9, was a cross-sectional random digit dial telephone survey of 2001 adults in King County, Washington State, US. Participants' addresses were geocoded and residential property values for each tax parcel were obtained from the county tax assessor's database. Prevalence ratios of obesity by property values, education, and household income were estimated separately for women and men, after adjusting for age, race/ethnicity, household size, employment status and home ownership. Among women, the inverse association between property values and obesity was very strong and independent of other SES factors. Women in the bottom quartile of property values were 3.4 times more likely to be obese than women in the top quartile. No association between property values and obesity was observed for men. The present data strengthen the evidence for a social gradient in obesity among women. Property values may represent a novel and objective measure of SES at the individual level in the US. Measures based on tax assessment data will provide a valuable resource for future health studies. (C) 2012 Elsevier Ltd. All rights reserved.
Keywords
Communities; Employment; Income; Obesity; Poisson Distribution; Probability Theory; Research Funding; Self-evaluation; Sex Distribution; Social Classes; Statistics; Surveys; Data Analysis; Educational Attainment; Cross-sectional Method; Data Analysis Software; Descriptive Statistics; Washington (state); Health Status Disparities; Health Surveys; Social Class; Socioeconomic Factors; Usa; Women; Body-mass Index; Socioeconomic-status; Aged Men; Health; Weight; Disparities; Overweight; Disease; Poverty; Height
Stewart, Orion; Moudon, Anne Vernez; Claybrooke, Charlotte. (2014). Multistate Evaluation of Safe Routes to School Programs. American Journal Of Health Promotion, 28, S89 – S96.
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Abstract
Purpose. State Safe Routes to School (SRTS) programs provide competitive grants to local projects that support safe walking, bicycling, and other modes of active school travel (AST). This study assessed changes in rates of AST after implementation of SRTS projects at multiple sites across four states. Design. One-group pretest and posttest. Setting. Florida, Mississippi, Washington, and Wisconsin. Subjects. Convenience sample of 48 completed SRTS projects and 53 schools affected by a completed SRTS project. Intervention. State-funded SRTS project. Measures. AST was measured as the percentage of students walking, bicycling, or using any AST mode. SRTS project characteristics were measured at the project, school, and school neighborhood levels. Analysis. Paired-samples t-tests were used to assess changes in AST. Bivariate analysis was used to identify SRTS project characteristics associated with increases in AST. Data were analyzed separately at the project (n = 48) and school (n = 53) levels. Results. Statistically significant increases in AST were observed across projects in all four states. All AST modes increased from 12.9% to 17.6%; walking from 9.8% to 14.2%; and bicycling from 2.5% to 3.0%. Increases in rates of bicycling were negatively correlated with baseline rates of bicycling. Conclusion. State-funded SRTS projects are achieving one of the primary program goals of increasing rates of AST. They may be particularly effective at introducing bicycling to communities where it is rare. The evaluation framework introduced in this study can be used to continue tracking the effect of state SRTS programs as more projects are completed.
Keywords
Transportation Of School Children; Physical Activity Measurement; Health Promotion; Cycling; Walking; School Children -- United States; Bicycling; Children; Commuting; Health Focus: Fitness/physical Activity; Manuscript Format: Research; Outcome Measure: Behavioral; Prevention Research; Research Purpose: Program Evaluation; Schools; Setting: School; Strategy: Skill Building/behavior Change, Built Environment; Study Design: Quasi-experimental; Target Population Age: Youth; Target Population Circumstances: Geographic Location; Physical-activity; Mental-health; Travel; Association; Validity; Mode; Bus