Drewnowski, Adam; Aggarwal, Anju; Tang, Wesley; Hurvitz, Philip M.; Scully, Jason; Stewart, Orion; Moudon, Anne Vernez. (2016). Obesity, Diet Quality, Physical Activity, and the Built Environment: The Need for Behavioral Pathways. BMC Public Health, 16.
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Abstract
Background: The built environment ( BE) is said to influence local obesity rates. Few studies have explored causal pathways between home-neighborhood BE variables and health outcomes such as obesity. Such pathways are likely to involve both physical activity and diet. Methods: The Seattle Obesity Study ( SOS II) was a longitudinal cohort of 440 adult residents of King Co, WA. Home addresses were geocoded. Home-neighborhood BE measures were framed as counts and densities of food sources and physical activity locations. Tax parcel property values were obtained from County tax assessor. Healthy Eating Index ( HEI 2010) scores were constructed using data from food frequency questionnaires. Physical activity ( PA) was obtained by self-report. Weights and heights were measured at baseline and following 12 months' exposure. Multivariable regressions examined the associations among BE measures at baseline, health behaviors ( HEI-2010 and physical activity) at baseline, and health outcome both cross-sectionally and longitudinally. Results: None of the conventional neighborhood BE metrics were associated either with diet quality, or with meeting PA guidelines. Only higher property values did predict better diets and more physical activity. Better diets and more physical activity were associated with lower obesity prevalence at baseline and 12 mo, but did not predict weight change. Conclusion: Any links between the BE and health outcomes critically depend on establishing appropriate behavioral pathways. In this study, home-centric BE measures, were not related to physical activity or to diet. Further studies will need to consider a broader range of BE attributes that may be related to diets and health.
Keywords
Body-mass Index; Local Food Environment; Residential Property-values; Supermarket Accessibility; Park Proximity; Neighborhood Walkability; Vegetable Consumption; Atherosclerosis Risk; Restaurant Food; Associations; Built Environment; Physical Activity; Obesity; Diet Quality
Chaix, Basile; Duncan, Dustin; Vallee, Julie; Vernez-moudon, Anne; Benmarhnia, Tarik; Kestens, Yan. (2017). The Residential Effect Fallacy in Neighborhood and Health Studies Formal Definition, Empirical Identification, and Correction. Epidemiology, 28(6), 789 – 797.
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Abstract
Background: Because of confounding from the urban/rural and socioeconomic organizations of territories and resulting correlation between residential and nonresidential exposures, classically estimated residential neighborhood-outcome associations capture nonresidential environment effects, overestimating residential intervention effects. Our study diagnosed and corrected this residential effect fallacy bias applicable to a large fraction of neighborhood and health studies. Methods: Our empirical application investigated the effect that hypothetical interventions raising the residential number of services would have on the probability that a trip is walked. Using global positioning systems tracking and mobility surveys over 7 days (227 participants and 7440 trips), we employed a multilevel linear probability model to estimate the trip-level association between residential number of services and walking to derive a naive intervention effect estimate and a corrected model accounting for numbers of services at the residence, trip origin, and trip destination to determine a corrected intervention effect estimate (true effect conditional on assumptions). Results: There was a strong correlation in service densities between the residential neighborhood and nonresidential places. From the naive model, hypothetical interventions raising the residential number of services to 200, 500, and 1000 were associated with an increase by 0.020, 0.055, and 0.109 of the probability of walking in the intervention groups. Corrected estimates were of 0.007, 0.019, and 0.039. Thus, naive estimates were overestimated by multiplicative factors of 3.0, 2.9, and 2.8. Conclusions: Commonly estimated residential intervention-outcome associations substantially overestimate true effects. Our somewhat paradoxical conclusion is that to estimate residential effects, investigators critically need information on nonresidential places visited.
Keywords
Self-rated Health; Record Cohort; Physical-activity; Transportation Modes; Built Environment; Activity Spaces; Research Agenda; Risk-factors; Associations; Exposure
Chen, Peng; Sun, Feiyang; Wang, Zhenbo; Gao, Xu; Jiao, Junfeng; Tao, Zhimin. (2018). Built Environment Effects on Bike Crash Frequency and Risk in Beijing. Journal Of Safety Research, 64, 135 – 143.
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Abstract
Introduction: Building a safe biking environment is crucial to encouraging bicycle use. In developed areas with higher density and more mixed land use, the built environment factors that pose a crash risk may vary. This study investigates the connection between biking risk factors and the compact built environment, using data for Beijing. Method: In the context of China, this paper seeks to answer two research questions. First, what types of built environment factors are correlated with bike-automobile crash frequency and risk? Second, how do risk factors vary across different types of bikes? Poisson lognormal random effects models are employed to examine how land use and roadway design factors are associated with the bike-automobile crashes. Results: The main findings are: (1) bike-automobile crashes are more likely to occur in densely developed areas, which is characterized by higher population density, more mixed land use, denser roads and junctions, and more parking lots; (2) areas with greater ground transit are correlated with more bike-automobile crashes and higher risks of involving in collisions; (3) the percentages of wider streets show negative associations with bike crash frequency; (4) built environment factors cannot help explain factors contributing to motorcycle-automobile crashes. Practical Applications: In China's dense urban context, important policy implications for bicycle safety improvement drawn from this study include: prioritizing safety programs in urban centers, applying safety improvements to areas with more ground transit, placing bike-automobile crash countermeasures at road junctions, and improving bicycle safety on narrower streets. (C) 2018 National Safety Council and Elsevier Ltd. All rights
Keywords
Motorcycling Accidents; Built Environment; Motorcycling; Poisson Distribution; Safety; Beijing (china); Bike-automobile Crash; Frequency; Poisson Lognormal Random Effects Model; Risk; Signalized Intersections; Transportation Modes; Urban Intersections; Bicycle Crashes; Motor-vehicle; Riders; Infrastructure; China; Severity; Frequency Distribution; Risk Factors; Bicycles; Fatalities; Collisions; Traffic Accidents; Safety Programs; Urban Environments; Traffic Safety; Population Density; Crashes; Streets; Environmental Effects; Environmental Engineering; Roads; Land Use; Risk Analysis; Urban Areas; Road Design; Construction; Ecological Risk Assessment; Design Factors; Motorcycles; Urban Transportation; Studies; Safety Management; Beijing China
Ochsner, Jeffrey Karl. (2018). The Experience of Prospect and Refuge: Frank Lloyd Wright’s Houses as Holding Environments. American Imago, 75(2), 179 – 211.
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Keywords
Reverie
Nkyekyer, Esi W.; Dannenberg, Andrew L. (2019). Use and Effectiveness of Health Impact Assessment in the Energy and Natural Resources Sector in the United States, 2007 – 2016. Impact Assessment & Project Appraisal, 37(1), 17 – 32.
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Abstract
Decisions made in the energy and natural resources sector can affect public health. This report reviews the characteristics and assesses the effectiveness of health impact assessments (HIAs) conducted in this sector. A total of 30 HIAs conducted in 14 states in the United States were identified using a targeted literature search. Five HIAs illustrative of the different source and sub-sector categories, and with identifiable impacts on decision-making processes were selected for review. An existing conceptual framework (Wismar) was used to assess the effectiveness of the five selected HIAs on decision-making related to non-renewable energy, renewable energy, mining, and energy conservation. The 30 HIAs were performed for a variety of projects and assessed health impacts ranging from metabolic disorders to community livability. Eight of the 30 reports were incorporated into environmental impact assessments. All five selected HIAs were generally effective and raised awareness of the health effects of the projects being assessed; four were directly effective and led to changes in final project decisions. Their variable effectiveness may be related to the extent of community engagement and consideration of equity issues, differences in the details and quality of monitoring and evaluation plans devised as part of the HIA process, and whether the outcomes of monitoring and evaluation are reported.
Keywords
Health Impact Assessment; Health Equity; Natural Resources; Environmental Impact Analysis; Power Resources; U.s. States; Energy Conservation; United States; Decision-making Effectiveness; Energy And Natural Resources; Wismar Framework; Horizon Oil-spill; Wind Turbine Noise; Quality-of-life; Environmental-health; Gas Development; Mental-health; Exposure; Vicinity; Hazards; Sleep; Environmental Assessment; Public Health; Metabolic Disorders; Renewable Energy; Monitoring; Decision Making; Evaluation; Environmental Impact; Community Involvement; Environmental Impact Assessment; Renewable Resources; Decisions; Impact Analysis; Mining; United States--us
Kuriyama, Naoko; Maly, Elizabeth; Leon, Jorge; Abramson, Daniel; Nguyen, Lan T.; Bostrom, Ann. (2020). Towards a Comparative Framework of Adaptive Planning and Anticipatory Action Regimes in Chile, Japan, and the US: An Exploration of Multiple Contexts Informing Tsunami Risk-based Planning and Relocation. Journal Of Disaster Research, 15(7), 878 – 889.
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Abstract
Coastal regions around the Pacific Ring of Fire share the risk of massive earthquakes and tsunamis. Along with their own political-economic, cultural and biophysical contexts, each region has their own history and experiences of tsunami disasters. Coastal areas of Washington State in the U.S. are currently at risk of experiencing a tsunami following a massive Magnitude 9 (M9) earthquake anticipated in the Cascadia Subduction Zone (CSZ). Looking ahead to consider adaptive planning in advance of a tsunami following this M9 event, this paper explores how lessons from recent megaquake- and tsunami-related experiences of risk-based planning and relocation in coastal areas of Japan and Chile could inform anticipatory action in coastal Washington State. Based on a comparison of earthquake and tsunami hazards, social factors, and the roles of government, this paper outlines a framework to compare policy contexts of tsunami risk-based planning and relocation in three Ring of Fire countries, including factors shaping the possible transfer of approaches between them. Findings suggest some aspects of comparative significance and commonalities shared across coastal communities in the three countries and at the same time highlight numerous differences in governance and policies related to planning and relocation. Although there are limitations to the transferability of lessons in disaster adaptive planning and anticipatory action from one national/regional context to another, we believe there is much more that Washington and the Pacific Northwest can learn from Japanese and Chilean experiences. In any context, risk reduction policies and actions need to garner political support in order to be implemented. Additional case study research and detailed analysis is still needed to understand specific lessons that may be applied to detailed risk-based planning and relocation programs across these different national contexts.
Keywords
Great Earthquake Recurrence; Land-use; Statistical-analyses; Subduction Zone; New-zealand; Community; Recovery; Management; Cascadia; Policies; Risk-based Planning; Earthquake; Tsunami; Disaster Governance; Residential Relocation
Berrigan, David; Dannenberg, Andrew L.; Lee, Michelle; Rodgers, Kelly; Wojcik, Janet R.; Wali, Behram; Tribby, Calvin P.; Buehler, Ralph; Sallis, James F.; Roberts, Jennifer D.; Steedly, Ann; Peng, Binbin; Eisenberg, Yochai; Rodriguez, Daniel A. (2021). The 2019 Conference on Health and Active Transportation: Research Needs and Opportunities. International Journal Of Environmental Research And Public Health, 18(22).
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Abstract
Active transportation (AT) is widely viewed as an important target for increasing participation in aerobic physical activity and improving health, while simultaneously addressing pollution and climate change through reductions in motor vehicular emissions. In recent years, progress in increasing AT has stalled in some countries and, furthermore, the coronavirus (COVID-19) pandemic has created new AT opportunities while also exposing the barriers and health inequities related to AT for some populations. This paper describes the results of the December 2019 Conference on Health and Active Transportation (CHAT) which brought together leaders from the transportation and health disciplines. Attendees charted a course for the future around three themes: Reflecting on Innovative Practices, Building Strategic Institutional Relationships, and Identifying Research Needs and Opportunities. This paper focuses on conclusions of the Research Needs and Opportunities theme. We present a conceptual model derived from the conference sessions that considers how economic and systems analysis, evaluation of emerging technologies and policies, efforts to address inclusivity, disparities and equity along with renewed attention to messaging and communication could contribute to overcoming barriers to development and use of AT infrastructure. Specific research gaps concerning these themes are presented. We further discuss the relevance of these themes considering the pandemic. Renewed efforts at research, dissemination and implementation are needed to achieve the potential health and environmental benefits of AT and to preserve positive changes associated with the pandemic while mitigating negative ones.
Keywords
Improving Arterial Roads; Physical-activity; Cost-effectiveness; Built Environment; Autonomous Vehicles; Walking; Behavior; Impact; Active Transportation; Covid-19; Climate Change; Physical Activity; Public Health; Pandemics; Public Transportation; Collaboration; Transportation; Economic Models; Environmental Impact; Outdoor Air Quality; Vehicle Emissions; Coronaviruses; Hispanic Americans; Fatalities; Systems Analysis; African Americans; Infrastructure; Medical Research; Committees; Land Use; Economic Analysis; New Technology; United States--us
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
Wang, Yiyuan; Shen, Qing; Abu Ashour, Lamis; Dannenberg, Andrew L. (2022). Ensuring Equitable Transportation For The Disadvantaged: Paratransit Usage By Persons With Disabilities During The Covid-19 Pandemic. Transportation Research Part A: Policy & Practice, 159, 84 – 95.
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Abstract
Paratransit services developed under the Americans with Disabilities Act are a critical transportation means for persons with disabilities to meet their basic needs, but the COVID-19 pandemic posed an unprecedented challenge to service providers. To safeguard transportation equity, this study used complete records of service trips and riders obtained from the Access Transportation Program in the Seattle region for an empirical analysis aimed at answering two research questions. First, how did the ridership and trip purposes of paratransit change after the outbreak of COVID-19? Second, what factors explained the users' changing levels of service usage in response to the pandemic? Statistical methods, including a Hurdle model, were employed as the analytical tools. The results show that paratransit ridership dramatically decreased during 2020 with the most substantial reductions of working and non-essential personal trips, and that most of the remaining trips were for medical purposes. The results also indicate that riders' service usage during the pandemic was associated with their sociodemographic characteristics, disability conditions, and pre-pandemic travel demand. When controlling for other factors, riders who lived in neighborhoods with lower income and lower access to personal vehicles were more dependent on the service. Based on the empirical findings, we recommend that when developing plans for future disruptive events, public transit agencies should promptly implement safety measures, identify and prioritize neighborhoods that are most in need of mobility services, and actively pursue collaboration with other organizations for innovative service delivery options.
Keywords
Covid-19 Pandemic; Public Transit; People With Disabilities; Americans With Disabilities Act Of 1990; Public Transit Ridership; Paratransit Services; Seattle (wash.); Americans With Disabilities Act (ada); Hurdle Model; Paratransit; Transportation Equity; Mobility; Justice
Berke, Ethan M.; Vernez-Moudon, Anne. (2014). Built Environment Change: A Framework to Support Health-Enhancing Behaviour through Environmental Policy and Health Research. Journal Of Epidemiology And Community Health, 68(6), 586 – 590.
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Abstract
As research examining the effect of the built environment on health accelerates, it is critical for health and planning researchers to conduct studies and make recommendations in the context of a robust theoretical framework. We propose a framework for built environment change (BEC) related to improving health. BEC consists of elements of the built environment, how people are exposed to and interact with them perceptually and functionally, and how this exposure may affect health-related behaviours. Integrated into this framework are the legal and regulatory mechanisms and instruments that are commonly used to effect change in the built environment. This framework would be applicable to medical research as well as to issues of policy and community planning.
Keywords
Geographic Information-systems; Physical-activity; Obesity; Place; Associations; Walkability; Risk; Care