The impact of the built environment on health across the life course: design of a cross-sectional data linkage study

Abstract

IntroductionThe built environment is increasingly recognised as being associated with health outcomes. Relationships between the built environment and health differ among age groups, especially between children and adults, but also between younger, mid-age and older adults. Yet few address differences across life stage groups within a single population study. Moreover, existing research mostly focuses on physical activity behaviours, with few studying objective clinical and mental health outcomes. The Life Course Built Environment and Health (LCBEH) project explores the impact of the built environment on self-reported and objectively measured health outcomes in a random sample of people across the life course.Methods and analysisThis cross-sectional data linkage study involves 15 954 children (0–15 years), young adults (16–24 years), adults (25–64 years) and older adults (65+years) from the Perth metropolitan region who completed the Health and Wellbeing Surveillance System survey administered by the Department of Health of Western Australia from 2003 to 2009. Survey data were linked to Western Australia's (WA) Hospital Morbidity Database System (hospital admission) and Mental Health Information System (mental health system outpatient) data. Participants’ residential address was geocoded and features of their ‘neighbourhood’ were measured using Geographic Information Systems software. Associations between the built environment and self-reported and clinical health outcomes will be explored across varying geographic scales and life stages.Ethics and disseminationThe University of Western Australia's Human Research Ethics Committee and the Department of Health of Western Australia approved the study protocol (#2010/1). Findings will be published in peer-reviewed journals and presented at local, national and international conferences, thus contributing to the evidence base informing the design of healthy neighbourhoods for all residents.

Sedentary behaviour and health: mapping environmental and social contexts to underpin chronic disease prevention

“…Overview of relationships that need to be identified—between the built, policy and social environments, prolonged sitting in particular settings and chronic disease risk (modified from Villanueva et al 26). …”

“…For example, high-walkable neighbourhoods—that have higher residential density and more destinations—often have more traffic, and exposure to traffic is negatively associated with active forms of transport in children 22–24. In the context of physical activity research, there is a paucity of age differences in response to environmental exposures 25 26. Frank et al 27 examined urban form relationships with walking among youth aged 5–20 years, stratifying the sample by age group.…”

Variations in active transport behavior among different neighborhoods and across adult life stages

“…The segregation of a population in more alike groups defined by ethnic, economic and social characteristics is widely accepted (Riggs, 2014). Additionally, the life stage itself can have great impact on the transport behavior and therefore also on the relation to the built environment (Villanueva et al, 2013). Within the health and place based research there has been a focus on four main groups: children, adolescents, adults and older adults (Papas et al, 2007).…”

“…Thus, adults living in high walkable neighborhoods were more likely to walk independent of life stage (Villanueva et al, 2013). This study did however not report differences in self-selection across the four groups.…”

A systematic scoping review of the domains and innovations in secondary uses of digitised health-related data

“…In addition to data linkage studies using health-related datasets, existing examples of studies using cross-sectoral data linkage included the linking of population-wide health and justice datasets in Western Australia to study hospitalisations among exprisoners during the first year after their release29 and seeking evidence to help plan healthy neighbourhoods across the lifespan by investigating measures of the built environment linked to health outcomes and to self-reported health behaviours 30…”