Philip M. Hurvitz

Philip M. Hurvitz
University of Washington | UW · Center for Studies in Demography & Ecology

PhD

About

92
Publications
15,788
Reads
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Introduction
Quantitative research on built environment and behavior; geographic information systems; open source; global positioning system, accelerometer, relational database, R

Publications

Publications (92)
Article
We investigated associations between neighborhood walkability and physical activity using twins (5477 monozygotic and same-sex dizygotic pairs) as “quasi-experimental” controls of genetic and shared environment (familial) factors that would otherwise confound exposure-outcome associations. Walkability comprised intersection density, population dens...
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Introduction This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents. Methods This retrospective cohort study utilized electronic health records of individuals aged 5–18 years living in King County, Washington, from 2005 to 2017. Built environment features such as resident...
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INTRODUCTION We examined whether a combined measure of neighborhood greenspace and neighborhood median income was associated with white matter hyperintensity (WMH) and ventricle size changes. METHODS The sample included 1260 cognitively normal ≥ 65‐year‐olds with two magnetic resonance images (MRI; ≈ 5 years apart). WMH and ventricular size were g...
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The current study examined the associations between perceptions of the social and physical neighborhood environments and cognitive function in older adults. This cross-sectional study analyzed 821 adults aged ≥65 years from the Adult Changes in Thought study. Perceived neighborhood attributes were measured by the Physical Activity Neighborhood Envi...
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Aim To examine whether designed‐to‐be‐rigid ankle–foot orthoses and footwear combinations with individualized alignment and footwear designs (AFO‐FC/IAFD) would be more effective than designed‐to‐be‐rigid AFO with non‐individualized alignment and footwear designs (AFO‐FC/NAFD) in children with cerebral palsy (CP). Method Nineteen children with bil...
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We examined relationships between walkability and health behaviors between and within identical twin pairs, considering both home (neighborhood) walkability and each twin’s measured activity space. Continuous activity and location data (via accelerometry and GPS) were obtained in 79 pairs over 2 weeks. Walkability was estimated using Walk Score® (W...
Article
Introduction: Natural experiments can strengthen evidence linking neighborhood food retail presence to dietary intake patterns and cardiometabolic health outcomes, yet sample size and follow-up duration are typically not extensive. To complement natural experiment evidence, longitudinal data were used to estimate the impacts of neighborhood food r...
Article
Introduction Increasing transit infrastructure could increase transit use and result in higher physical activity if users actively travel to access transit. Few studies have rigorously examined transit use and physical activity change from before to years after among residents living close versus farther away from new transit options. Methods An i...
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Introduction: Unequal access to healthy food in the local food retail environment contributes to diet quality disparities. We assessed whether in-store availability and prices of healthy foods differ by neighborhood-level income and racial and ethnic composition in a representative sample of food stores in Seattle, Washington. Methods: We develo...
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Objectives Physical activity is a cornerstone of chronic disease prevention and treatment, yet most US adults do not perform levels recommended for health. The neighborhood–built environment (BE) may support or hinder physical activity levels. This study investigated whether identical twins who reside in more walkable BEs have greater activity leve...
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Objective To examine associations between neighborhood built environment (BE) variables, residential property values, and longitudinal 1- and 2-year changes in body mass index (BMI). Methods The Seattle Obesity Study III was a prospective cohort study of adults with geocoded residential addresses, conducted in King, Pierce, and Yakima Counties in...
Article
Background: Neighborhoods may play an important role in shaping long-term weight trajectory and obesity risk. Studying the impact of moving to another neighborhood may be the most efficient way to determine the impact of the built environment on health. We explored whether residential moves were associated with changes in body weight. Methods: K...
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Background To address patient’s unmet social needs and improve health outcomes, health systems have developed programs to refer patients in need to social service agencies. However, the capacity to respond to patient referrals varies tremendously across communities. This study assesses the emergence of disparities in spatial access to social servic...
Article
Background This study examined associations of local cannabis retail outlet availability and neighborhood disadvantage with cannabis use and related risk factors among young adults. Methods Data were from annual cross-sectional surveys administered from 2015 to 2019 to individuals ages 18 to 25 residing in Washington State (N = 10,009). As outcome...
Article
Background. This study demonstrates the use of geographic ecological momentary assessment (GEMA) methods among young adult marijuana users. Method. Participants were 14 current marijuana users ages 21-27 living in Greater Seattle, Washington. They completed brief surveys four times per day for 14 consecutive days, including measures of marijuana us...
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To explore the built environment (BE) and weight change relationship by age, sex, and racial/ethnic subgroups in adults. Weight trajectories were estimated using electronic health records for 115,260 insured Kaiser Permanente Washington members age 18–64 years. Member home addresses were geocoded using ArcGIS. Population, residential, and road inte...
Article
Walkability is a popular and ubiquitous term at the intersection of urban planning and public health. As the number of potential walkability measures grows in the literature, there is a need to compare their relative importance for specific research objectives. This study demonstrates a classification and regression tree (CART) model to compare fiv...
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To determine whether selected features of the built environment can predict weight gain in a large longitudinal cohort of adults. Weight trajectories over a 5-year period were obtained from electronic health records for 115,260 insured patients aged 18–64 years in the Kaiser Permanente Washington health care system. Home addresses were geocoded usi...
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Background Epidemiological studies utilize residential histories to assess environmental exposure risk. The validity from using commercially-sourced residential histories within national longitudinal studies remains unclear. Our study assessed predictors of non-agreement between baseline addresses from the commercially-sourced LexisNexis database a...
Article
This study examined how buffer type (shape), size, and the allocation of activity bouts inside buffers that delineate the neighborhood spatially produce different estimates of neighborhood-based physical activity. A sample of 375 adults wore a global positioning system (GPS) data logger and accelerometer over 2 weeks under free-living conditions. A...
Article
We determined associations of cumulative exposures to neighborhood physical activity opportunities with risk of incident cardiovascular disease (CVD). We included 3595 participants from the Cardiovascular Health Study recruited between 1989 and 1993 (mean age = 73; 60% women; 11% black). Neighborhood environment measures were calculated using Geogr...
Article
Amenities at bus stops are thought to affect transit ridership, yet this relationship is rarely quantified. We assembled data on ridership and stop amenities, including Real-Time Information System (RTIS), shelters, lighting, litter receptacles, benches, and bike hoops, at 96 stops along two new Bus Rapid Transit lines in King County, Washington, b...
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Objectives: Aging in place (residential stability) is a desirable means of aging where adults remain in their homes, even when facing challenges that impair their capacity for self-care. Residential stability, especially following acute health challenges, depends on individual and community factors, possibly including proximity to medical facilitie...
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Background In‐person assessments of physical activity (PA) and body weight can be burdensome for participants and cost prohibitive for researchers. This study examined self‐reported PA and weight accuracy and identified patterns of misreporting in a diverse sample. Methods King, Pierce, and Yakima county residents, aged 21‐59 years,,(n = 728) self...
Article
Many distinct characteristics of the social, natural, and built neighborhood environment have been included in walkability measures, and it is unclear which measures best describe the features of a place that support walking. We developed the Automatic Context Measurement Tool, which measures neighborhood environment characteristics from public dat...
Article
Background Studies have shown associations between neighborhood disadvantage and alcohol misuse among adults. Less is known about the role of neighborhood context in young adults (YAs), who engage in more disordered forms of alcohol use compared to other age groups. Using data collected monthly, this study examined whether YAs reported more alcohol...
Preprint
BACKGROUND Studies assessing the impact of built environments on body weight are often hobbled by limited power to detect residential effects that are modest for individuals but may nonetheless comprise large attributable risks. OBJECTIVE We used data extracted from electronic health records to construct a large retrospective cohort of patients wh...
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Background 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 nonetheless comprise large attributable risks. Objective We used data extracted from electronic health records to construct a large retrospective cohort of patients. Thi...
Article
Objectives Extending the health benefits of public-transit investment requires understanding how transit use affects pedestrian activity, including pedestrian activity not directly temporally or spatially related to transit use. In this study, we identified where transit users walked on transit days compared with non-transit days within and beyond...
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Background: Activity spaces (AS), captured using GPS tracking devices, are measures of dynamic exposure to the built environment (BE). Methods: Seven days of Global Positioning Systems (GPS) tracking data were obtained for 433 adult participants in the Seattle Obesity Study (SOS II). Heights and weights were measured. Dietary intakes from a food...
Article
SafeBoda is a transportation company that provides road safety training and helmets to its motorcycle taxi drivers in Kampala. We sought to determine whether risk of road traffic crash (RTC) was lower in SafeBoda compared to regular (non-SafeBoda) motorcycle taxi drivers during a 6-month follow-up period. We collected participant demographic and be...
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Background: Individual sociodemographic and home neighborhood built environment (BE) factors influence the probability of engaging in health-enhancing levels of walking or moderate-to-vigorous physical activity (MVPA). Methods are needed to parsimoniously model the associations. Methods: Participants included 2392 adults drawn from a community-b...
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Exposure to food environments has mainly been limited to counting food outlets near participants’ homes. This study considers food environment exposures in time and space using global positioning systems (GPS) records and fast food restaurants (FFRs) as the environment of interest. Data came from 412 participants (median participant age of 45) in t...
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Background Device-collected data from GPS and accelerometers for identifying active travel behaviors have dramatically changed research methods in transportation planning and public health. Automated algorithms have helped researchers to process large datasets with likely fewer errors than found in other collection methods (e.g., self-report travel...
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Improving the built environment (BE) is viewed as one strategy to improve community diets and health. The present goal is to review the literature on the effects of BE on health, highlight its limitations, and explore the growing use of natural experiments in BE research, such as the advent of new supermarkets, revitalized parks, or new transportat...
Article
Background SafeBoda is a motorcycle taxi company that provides road safety training and helmets to its drivers in Kampala, Uganda. We sought to determine whether SafeBoda drivers are more likely to engage in safe riding behaviours than regular drivers (motorcycle taxi drivers not part of SafeBoda ). Methods We measured riding behaviours in SafeBo...
Article
We explored links between food environments, dietary intake biomarkers, and sudden cardiac arrest in a population-based longitudinal study using cases and controls accruing between 1990 and 2010 in King County, WA. Surprisingly, presence of more unhealthy food sources near home was associated with a lower 18:1 trans-fatty acid concentration (-0.05%...
Article
Background: Medical establishments in the neighborhood, such as pharmacies and primary care clinics, may play a role in improving access to preventive care and treatment and could explain previously reported neighborhood variations in sudden cardiac arrest (SCA) incidence and survival. Methods: The Cardiac Arrest Blood Study Repository is a popu...
Article
Objectives Utilitarian and recreational walking both contribute to physical activity. Yet walking for these two purposes may be different behaviors. We sought to provide operational definitions of utilitarian and recreational walking and to objectively measure their behavioral, spatial, and temporal differences in order to inform transportation and...
Article
Purpose: We assessed the associations between a change in time spent walking and a change in total physical activity (PA) time within an urban living adult sample, to test for additive or substitution effects. Methods: Participants living in the greater Seattle area were assessed in 2008-2009 and again 1-2 years later (2010-2011). At each time p...
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To assess differences between GPS and self-reported measures of location, we examined visits to fast food restaurants and supermarkets using a spatiotemporal framework. Data came from 446 participants who responded to a survey, filled out travel diaries of places visited, and wore a GPS receiver for seven consecutive days. Provided by Public Health...
Data
Descriptive statistics of GPS—sensed visits to fast food restaurants and supermarkets. (DOCX)
Data
Seattle Obesity Study II seven-day travel log. (PDF)
Data
Explanations for reported visits that were not GPS—sensed. (DOCX)
Data
Correlations among GPS-sensed variables of matched visits to fast food restaurants and supermarkets. (DOCX)
Article
Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian-motor vehicle collision is unknown. We examined associations between individuals' walking bouts and walking risk, measured as mean exposure to the risk of pedestria...
Article
Background: Physical inactivity is a risk factor for cancer that may be influenced by environmental factors. Indeed, dense and well-connected built environments and environments with natural vegetation may create opportunities for higher routine physical activity. However, studies have focused primarily on residential environments to define exposu...
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Background The built environment (BE) is said to influence local obesity rates. Few studies have explored causal pathways between home-neighborhood BE variables and health outcomes such as obesity. Such pathways are likely to involve both physical activity and diet. Methods The Seattle Obesity Study (SOS II) was a longitudinal cohort of 440 adult...
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The long term effects of untreated mental health need for individuals, families and society has prompted a number of federal policy statements encouraging the use of evidence-based programs (EBP) in children’s healthcare. However, among other challenges of evidence-based practice implementation, states often do not know where to make investments ba...
Article
To address the current obesity and inactivity epidemics, public health researchers have attempted to identify spatial factors that influence physical inactivity and obesity. Technologic and methodologic developments have led to a revolutionary ability to examine dynamic, high-resolution measures of temporally matched location and behavior data thro...
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Walking is the most popular choice of aerobic physical activity to improve health among U.S. adults. Physical characteristics of the home neighborhood can facilitate or hinder walking. The purpose of this study was to quantify neighborhood walking, using objective methods and to examine the association between counts of walking bouts in the home ne...
Conference Paper
Introduction. Maintaining correct time stamp values is critical for management and analysis of time-indexed data, including GPS and accelerometry. Methods. Objective location and activity data were collected for one week periods in four projects, for 1551 subjects, using Qstarz BT1000 GPS data loggers and Actigraph GT3X accelerometers, in King Coun...
Article
Immigrant and minority women are less physically active than White women particularly during leisure time. However, prior research demonstrates that reported household physical activity (PA) and non-leisure time walking/biking were higher among the former. Using accelerometers, GPS, and travel logs, transport-related, home-based, and leisure time P...
Article
Walking is a popular form of physical activity associated with clear health benefits. Promoting safe walking for pedestrians requires evaluating the risk of pedestrian-motor vehicle collisions at specific roadway locations in order to identify where road improvements and other interventions may be needed. The objective of this analysis was to estim...
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Background: This paper examined whether the reported health impacts of frequent eating at a fast food or quick service restaurant on health were related to having such a restaurant near home. Methods: Logistic regressions estimated associations between frequent fast food or quick service restaurant use and health status, being overweight or obes...
Article
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Statement of purpose A safe walking environment may improve public health by facilitating environmental health, physical activity and injury prevention. We studied the walking behaviour of adult pedestrians to examine the relationship between walking and walking route safety. Methods A cross-sectional study of adults in King County, WA in 2007–2008...
Article
In the past 15 years, a major research enterprise has emerged that is aimed at understanding associations between geographic and contextual features of the environment (especially the built environment) and elements of human energy balance, including diet, weight and physical activity. Here we highlight aspects of this research area with a particul...
Article
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Sidewalk geodata are essential to understand walking behavior. However, such geodata are scarce, only available at the local jurisdiction and not at the regional level. If they exist, the data are stored in geometric representational formats without network characteristics such as sidewalk connectivity and completeness. This article presents the Sp...
Article
Objectives: The role of the built environment on walking in rural United States (U.S.) locations is not well characterized. We examined self-reported and measured built environment correlates of walking for utilitarian purposes among adult residents of small rural towns. Methods: In 2011-12, we collected telephone survey and geographic data from...
Article
Background: Studies have tried to link obesity rates and physical activity with multiple aspects of the built environment. Purpose: To determine the relation between residential property values and multiple perceived (self-reported) measures of the obesogenic environment. Methods: The Seattle Obesity Study (SOS) used a telephone survey of a represe...
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Objectives: We isolated physical activity attributable to transit use to examine issues of substitution between types of physical activity and potential confounding of transit-related walking with other walking. Methods: Physical activity and transit use data were collected in 2008 to 2009 from 693 Travel Assessment and Community study participa...
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Objectives: We examined whether supermarket choice, conceptualized as a proxy for underlying personal factors, would better predict access to supermarkets and fruit and vegetable consumption than mere physical proximity. Methods: The Seattle Obesity Study geocoded respondents' home addresses and locations of their primary supermarkets. Primary s...
Article
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Precise measurement of physical activity is important for health research, providing a better understanding of activity location, type, duration, and intensity. This article describes a novel suite of tools to measure and analyze physical activity behaviors in spatial epidemiology research. We use individual-level, high-resolution, objective data c...
Article
Objective: To assess a county population’s exposure to different types of food sources reported to affect both diet quality and obesity rates. Design: Food permit records obtained from the local health department served to establish the full census of food stores and restaurants. Employing prior categorization schemes which classified the relati...
Article
Purpose: This study developed and tested an algorithm to classify accelerometer data as walking or nonwalking using either GPS or travel diary data within a large sample of adults under free-living conditions. Methods: Participants wore an accelerometer and a GPS unit and concurrently completed a travel diary for seven consecutive days. Physical...
Article
Food prices are indeed a mechanism that links obesity and poverty.(1) As incomes decrease, energy-dense grains, sweets, and fats become the best way to provide daily calories at a manageable cost.(2) Added sugars and fats can be inexpensive, flavorful, satisfying, readily accessible, and convenient,(3) but these ingredients can also provide minimal...
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Objectives: We explored new ways to identify food deserts. Methods: We estimated physical and economic access to supermarkets for 5 low-income groups in Seattle-King County, Washington. We used geographic information system data to measure physical access: service areas around each supermarket were delineated by ability to walk, bicycle, ride tr...
Article
We examined whether physical proximity to supermarkets or supermarket price was more strongly associated with obesity risk. The Seattle Obesity Study (SOS) collected and geocoded data on home addresses and food shopping destinations for a representative sample of adult residents of King County, Washington. Supermarkets were stratified into 3 price...
Article
Studies of social determinants of weight and health in the US have typically relied on self-reported education and incomes as the two primary measures of socioeconomic status (SES). The assessed value of one's home, an important component of wealth, may be a better measure of the underlying SES construct and a better predictor of obesity. The Seatt...
Article
Built environment and health research have focused on characteristics of home neighborhoods, whereas overall environmental exposures occur over larger spatial ranges. Differences in built environment characteristics were analyzed for home and nonhome locations using GPS data. GPS data collected in 2007-2008 were analyzed for 41 subjects in the Seat...
Article
Measures of neighborhood deprivation used in health research are typically based on conventional area-based SES. The aim of this study is to examine new data and measures of SES for use in health research. Specifically, assessed property values are introduced as a new individual-level metric of wealth and tested for their ability to substitute for...
Article
This study examined the correlates of injury severity using police records of pedestrian-motor-vehicle collisions on state routes and city streets in King County, Washington. Levels of influence on collision outcome considered (1) the characteristics of individual pedestrians and drivers and their actions; (2) the road environment; and (3) the neig...
Article
Proximity to supermarkets at the census tract level has been linked to improved diet quality and better health. The Seattle Obesity Study examined the key distinction between the nearest supermarkets and those reported as primary food stores using a stratified random sample of 2001 households in King County, WA. The survey asked about locations of...