Abstract
BackgroundResearch surrounding the built environment (BE) and health has resulted in inconsistent findings. Experts have identified the need to examine methodological choices, such as development and testing of BE indices at varying spatial scales. We sought to examine the impact of construction method and spatial scale on seven measures of the BE using data collected at two time points.MethodsThe Children’s Environmental Health Initiative conducted parcel-level assessments of 57 BE variables in Durham, NC (parcel N = 30,319). Based on a priori defined variable groupings, we constructed seven mutually exclusive BE domains (housing damage, property disorder, territoriality, vacancy, public nuisances, crime, and tenancy). Domain-based indices were developed according to four different index construction methods that differentially account for number of parcels and parcel area. Indices were constructed at the census block level and two alternative spatial scales that better depict the larger neighborhood context experienced by local residents: the primary adjacency community and secondary adjacency community. Spearman’s rank correlation was used to assess if indices and relationships among indices were preserved across methods.ResultsTerritoriality, public nuisances, and tenancy were weakly to moderately preserved across methods at the block level while all other indices were well preserved. Except for the relationships between public nuisances and crime or tenancy, and crime and housing damage or territoriality, relationships among indices were poorly preserved across methods. The number of indices affected by construction method increased as spatial scale increased, while the impact of construction method on relationships among indices varied according to spatial scale.ConclusionsWe found that the impact of construction method on BE measures was index and spatial scale specific. Operationalizing and developing BE measures using alternative methods at varying spatial scales before connecting to health outcomes allows researchers to better understand how methodological decisions may affect associations between health outcomes and BE measures. To ensure that associations between the BE and health outcomes are not artifacts of methodological decisions, researchers would be well-advised to conduct sensitivity analysis using different construction methods. This approach may lead to more robust results regarding the BE and health outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12942-016-0044-x) contains supplementary material, which is available to authorized users.
Highlights
Research surrounding the built environment (BE) and health has resulted in inconsistent findings
Using objective survey data from a BE assessment tool conducted in Durham, NC during 2008 and again in 2011, combined with supplemental administrative data on renter occupancy tenure and crime, we develop seven BE indices according to four different index construction methods that alternatively account for number of parcels and parcel area
Variation in indices constructed using Method 3, which accounted for parcel area, was greater than variation in indices constructed using Method 2, which accounted for number of parcels, with the exception of housing damage
Summary
Research surrounding the built environment (BE) and health has resulted in inconsistent findings. The built environment (BE) is defined as the “humanmade space in which people live, work, and recreate on a day-to-day basis” and includes the physical condition of Strominger et al Int J Health Geogr (2016) 15:15 associations [10,11,12,13]. Such results have led researchers to hypothesize that inconsistent findings may be an artifact of methodological choices, prompting a call for an examination of methodology in the development of measures of the BE [12, 14,15,16]. In health outcomes research, the potential for methodological choice to substantively impact study findings is widely understood [12, 14, 20, 21], and in light of methodological heterogeneity, the difficulty in making inter-study comparisons is not surprising [15]
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