Abstract
BackgroundStudies 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.ObjectiveWe 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.MethodsWe 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.ResultsWe 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.ConclusionsData 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.International Registered Report Identifier (IRRID)DERR1-10.2196/16787
Highlights
BackgroundResidential context—the features of the neighborhoods we live in—affects our health behaviors and well-being [1,2]
We constructed a retrospective observational cohort of adults and children in King County, Washington, using data from Kaiser Permanente Washington (KPWA) merged with publicly available data on the built environment compiled by the Urban Form Lab at the University of Washington
To construct the study cohort, we initially identified KPWA members aged 18 to 89 years between January 1, 2005, and December 31, 2017, whose home addresses were successfully geocoded to a King County location and for whom height and weight data were available
Summary
BackgroundResidential context—the features of the neighborhoods we live in—affects our health behaviors and well-being [1,2]. As neighborhood features often have only modest effects on behavior [21], studies with few participants frequently fail to identify robust and causally interpretable effects of residential environments [22]. 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 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.
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