Traveling Together: A Road Map for Researching Neighborhood Effects on Population Health and Health Inequities

Abstract

As evidence of the relationship between place and health mounts, more epidemiologists and clinical science researchers are becoming interested in incorporating place-based measures and analyses into their examination of population health and health inequities. Given the extensive literature on place and health, it can be challenging for researchers new to this area to develop neighborhood effects research questions and apply the appropriate measures and methods. This paper provides a Roadmap to guide health researchers through the conceptual and methodological stages of incorporating various dimensions of place into their quantitative health research. Synthesizing across reviews, commentaries, and empirical investigations, this Roadmap consists of four broad stages for considering place and health: 1. WHY: articulating the motivation for assessing place and health and grounding the motivation in theory; 2. WHAT: identifying the relevant place-based characteristics and specifying their link to health to build a conceptual framework; 3. HOW: determining how to operationalize the conceptual framework by defining, measuring, and assessing place-based characteristics and quantifying their effect on health; and 4: NOW WHAT: discussing the implications of neighborhood research findings for future research, policy, and practice. This Roadmap supports efforts to develop conceptually and analytically rigorous neighborhood research projects.

A comparison of content from across contemporary Australian population health surveys

“…Gao et al. 9 describe the broad range of questions that can be explored with relation to population health, ranging from the potential direct effects of the environment, such as neighbourhood features, on health outcomes, but can also be expanded to consider broader questions that have indirect impacts on health, such as the relationships between place and inequality, that in turn influence well-being. Encouraging advancements in processes and procedures to permit, advance, and standardise geocoding and sharing of geocoded information, while balancing ethical and privacy concerns, allows such research questions to be explored for the greatest benefit of the population.…”

“…In addition, access to geo-referenced information, which refers to geospatial information, such as postcodes or other area-related measures, is necessary for understanding questions related to place and health, which is increasingly becoming recognised as a prominent research area. 7 , 8 , 9 Many Australian health surveys contain geo-referenced information at varying levels of granularity, such as the 45 and Up Study 10 and the Household, Income, and Labour Dynamics (HILDA) study. 11 , 12…”