Google Street View Images as Predictors of Patient Health Outcomes, 2017-2019.

Jessica Keralis,Xiaohe Yue,Ross Whitaker,Tom Belnap,Abhinav Kumar,Dapeng Li,Quynh C Nguyen,Amir Hossein Nazem Deligani,Heran Mane,Kim D Brunisholz,Tolga Tasdizen,Pallavi Dwivedi,Thu T Nguyen

doi:10.3390/bdcc6010015

Abstract

Collecting neighborhood data can both be time- and resource-intensive, especially across broad geographies. In this study, we leveraged 1.4 million publicly available Google Street View (GSV) images from Utah to construct indicators of the neighborhood built environment and evaluate their associations with 2017–2019 health outcomes of approximately one-third of the population living in Utah. The use of electronic medical records allows for the assessment of associations between neighborhood characteristics and individual-level health outcomes while controlling for predisposing factors, which distinguishes this study from previous GSV studies that were ecological in nature. Among 938,085 adult patients, we found that individuals living in communities in the highest tertiles of green streets and non-single-family homes have 10–27% lower diabetes, uncontrolled diabetes, hypertension, and obesity, but higher substance use disorders—controlling for age, White race, Hispanic ethnicity, religion, marital status, health insurance, and area deprivation index. Conversely, the presence of visible utility wires overhead was associated with 5–10% more diabetes, uncontrolled diabetes, hypertension, obesity, and substance use disorders. Our study found that non-single-family and green streets were related to a lower prevalence of chronic conditions, while visible utility wires and single-lane roads were connected with a higher burden of chronic conditions. These contextual characteristics can better help healthcare organizations understand the drivers of their patients’ health by further considering patients’ residential environments, which present both risks and resources.

Highlights

The importance of the built environment as a determinant of health is well established in the literature [1]
The use of electronic medical records allows for the assessment of associations between neighborhood characteristics and individual-level health outcomes while controlling for predisposing factors, which distinguishes this study from previous Google Street View (GSV) studies that were ecological in nature
GSV-derived built environment variables were statistically significantly associated with health outcomes, with green space and non-single-family homes being protective of negative outcomes

Summary

Introduction

The importance of the built environment as a determinant of health is well established in the literature [1]. Certain built environment features can facilitate accessibility, which in turn can influence physical and mental health. Roads and public transportation can improve access to nutrition and healthcare facilities, while built environment features such as parks and trails can help promote physical activities [4,5,6,7,8,9]. Previous research has reported the influence of neighborhood features such as presence of roadways, buildings, access to public transportation, green spaces, and walkability on both physical and mental health outcomes [10,11,12,13]. We found that built environment features at the ZIP code level such as green streets, crosswalks, and commercial buildings were associated with a lower prevalence of individual-level obesity and diabetes [15]

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