Measuring Neighborhood Environment

1. Measuring Neighborhood Environment TICR Epi 222 Irene Yen Department of Medicine May 1,, 2008

2. Outline of today’s lecture Neighborhood-Health overviews Administrative Data Survey assessment of perceived neighborhood Direct observation Geographic Information Systems (GIS) / spatial data 2

3. What is neighborhood? • People – composition • % poverty level incomes • % unemployed • People – relationships (social environment) • Collective efficacy • Social support • Physical/Built environment • Green space / parks • Roads • Housing

4. What is neighborhood – part II • Public services • Public transit • police • Commercial services • grocery • Retail stores

5. Neighborhood-Health Connections • 2001-2006; 235 articles study neighborhood-health • Main outcomes of interest: • Self-reported health • Chronic disease • Injury alcohol violence • Health behaviors • Mortality

6. Neighborhood environment – health disparities • Policies that create diversity in neighborhoods: • public investment • zoning • Characteristics of neighborhoods • Composition: poverty, segregation • “built environment”: stores, parks, trees • Social environment: threats, social cohesion

7. Neighborhood - Definitions • Census boundaries • Zip code • ½ mile around home • Perceived – no concrete definition

8. Neighborhood - Measures Administrative data: census, city planning zoning perceptions Direct observation Geospatial data

9. Part I. Administrative data

10. Census variables - examples • Family income - Median income for all households • Poverty - Proportion of persons whose annual income falls at or below 175% of the poverty line • Education - Proportion of persons 25 years and older with less than a high school education • Housing value - Median value of owner-occupied housing units

11. Is neighborhood environment associated with mortality? Alameda County Study *1983 data - 50% sample (n=1,799)*Alameda County residents in 1983 (n=1,129)*neighborhood defined as census tract Yen IH, Kaplan GA. American Journal of Epidemiology 1999

12. Chicago School of Sociology CityCenter Transition Workers’ homes Residential Commuter Yen IH, Syme SL. Annual Review of Public Health 1999

13. Is neighborhood environment associated with mortality? Alameda County Study Commercial Services • Supermarkets • Laundromats / Dry cleaners • Beauty Parlor / Barber Ships • Pharmacies Environment/Housing • Total population of census tract • Area of census tract • % renters • % single family dwellings Community SES • Per capita income • % white collar employees • crowding Yen IH, Kaplan GA. American Journal of Epidemiology 1999

14. Low social environmental quality and 11-year mortality risk 2-level logistic regression; Alameda County Study 1983 (n=996) Yen IH, Kaplan GA. American Journal of Epidemiology 1999

15. Commercial services and 11-year mortality risk 2-level logistic regression; Alameda County Study 1983 (n=996) Yen IH, Kaplan GA. American Journal of Epidemiology 1999

16. 6 High Income 5 Low income 4 3 2 1 0 Lowest community SES Highest community SES Community SES & 11-year Mortality Risk By individual income level Odds Ratio Yen IH, Kaplan GA. American Journal of Epidemiology 1999

17. Part III. Survey assessment of perceived neighborhood

18. What happens when we measure perceived neighborhood environment? Self-administered questions over-ride limitation of census boundaries

19. UCSF Asthma and Rhinitis Panel • began in 1992 • sample of patients with asthma from northern California physicians (RDD sample added in 1999). • ages 18 to 50 at baseline • Wave 5 (Feb 2000 – May 2001); n=439 Yen IH, et al. Am J Public Health 2006.

20. Assessing neighborhood environment “Thinking about your neighborhood as a whole, how much of a problem do you feel each of the following is in your neighborhood?” [on a scale of 0 to 5, 0 is not a problem, 5 is a serious problem] • Too much traffic • Excessive noise • Trash and litter • Smells or odors from factories or farms • Smoke from fires or burning

21. neighborhood problems and physical functioning REF=0 SF-12 score difference * * adjusted for age, sex, income, education, ethnicity, & asthma severity Yen IH, et al. Am J Public Health 2006.

22. Part IV. Direct observation

23. Kaiser CYGNET Study - overview 444 7-year old girls Follow for 5 years through pubertal transition Collect information on diet, physical activity, height, and weight Live in Alameda, San Francisco, Marin, and Contra Costa Counties

24. Auxiliary study to CYGNET – neighborhood observations Select half of the 7-year old girls Send trained observer to girls’ neighborhood. Walk around to collect information about presence/absence of food stores, fast food, restaurants, recreation opportunities, and walkability/bikeability.

25. Example of a map given to a street observer

27. Preliminary results Collected street observation data for 213 girls Observed 3 to 32 street blocks per address; total of 2,301 street blocks Created combination variables for items in audit form, e.g. food stores, public services (e.g. library, post office), walkability/bikeability (e.g. sidewalks, cross walks, speed bumps) Used factor analysis to see how variables cluster together

28. Social context of pregnancy • 39-item survey representing four categories of neighborhood attributes: • neighborhood physical conditions; • social interactions; • nonresidential land use (commercial property); • public, residential and nonresidential space. Laraia BA, et al. Int J Health Geographics 2006.

29. Examples of items recorded Adult activity (Code all that apply) If no adults present ……………………… Walking …………………………………… Socializing (Talking with neighbors) …… Socializing in mixed racial groups ……… Home repair, landscaping, or car care … Sitting/standing on porch or stoop ……… Supervising children ……………………… Patronizing business establishments …… Standing on the sidewalk ………………… Sitting/standing at the bus stop ………… Getting into or out of vehicles …………… Walking a dog ……………………………. Conducting home-based vending ……… Recreational activity (e.g., jogging) …… Laraia BA, et al. Int J Health Geographics 2006.

30. Operationalizing neighborhood concepts – physical incivilities • combination of physical disorder and poor housing conditions • theorized to communicate decreased local social control and may contribute to crime and further neighborhood deterioration. • Items : • fences • hedges • Physical and symbolic signs that demarcate residential property

31. Operationalizing neighborhood concepts – territoriality • Ownership and social control leading to protective effects against crime and other adverse events • Items : • condition of housing, yards, commercial and public spaces, • vacant or burned property • litter and graffiti

32. Part V. Gis / spatial data

33. Stephen A. Matthews (Pennsylvania State University) - Multiple Activity Spaces (and Temporal Rhythms)

35. “Our Space” GIS database: UCSF, UC Berkeley, and Kaiser DOR • census data • retail store data (InfoUSA or Dunn &Bradstreet) • pollution • traffic • green space / parks