Elsevier

Health & Place

Volume 21, May 2013, Pages 86-93
Health & Place

Conceptualization and measurement of environmental exposure in epidemiology: Accounting for activity space related to daily mobility

https://doi.org/10.1016/j.healthplace.2013.01.005Get rights and content

Abstract

A considerable body of literature has investigated how environmental exposures affect health through various pathways. These studies have generally adopted a common approach to define environmental exposures, focusing on the local residential environment, using census tracts or postcodes to delimit exposures. However, use of such administrative units may not be appropriate to evaluate contextual effets on health because they are generally not a ‘true’ representation of the environments to which individuals are exposed. Recent work has suggested that advances may be made if an activity-space approach is adopted. The present paper investigates how various disciplines may contribute to the refinement of the concept of activity space for use in health research. In particular we draw on seminal work in time geography, which provides a framework to describe individual behavior in space and time, and can help the conceptualization of activity space. In addition we review work in environmental psychology and social networks research, which provides insights on how people and places interact and offers new theories for improving the spatial definition of contextual exposures.

Highlights

► Administrative units might not be the best way to delimit environmental exposures. ► The activity space may be more relevant because it accounts for space–time behavior. ► Few studies have theorized how activity spaces may capture contextual exposures. ► We explore how various disciplines may enrich the concept of activity space.

Introduction

A considerable body of literature in social science and population health research has investigated the field of contextual effects over the past two decades. Despite ongoing discussions on the best way to define geographic context (Bernard et al., 2007; Cummins et al., 2007; Daniel et al., 2008; Macintyre et al., 2002), ecologic and multilevel analysis have generally adopted a common approach based on the notion of “neighborhood”. Most studies focus on the residential neighborhood and used local administrative units, such as census tracts, as spatial delimitations (Diez Roux, 2001). Such choices are primarily based on the availability of routine administrative data rather than on the theoretical underpinnings concerning the appropriate spatial scale at which environmental exposures are meant to affect individuals. Census tracts, block groups, or postal units provide a readily usable spatial delimitation for the assessment of social or built characteristics of local areas. Nevertheless, administrative units are probably ill-suited to represent the appropriate space to evaluate environmental effects on health, as they generally do not represent the potentially accessible environment of an individual nor the true experienced exposure (Lee et al., 2008). Prior research on environment-health relationships has observed a relatively marginal effect of neighborhood factors (Adams et al., 2009, Diez Roux, 2001, Oakes, 2004, Pickett and Pearl, 2001). However, a misspecification of contextual boundaries could explain the weakness of such observed associations (Spielman and Yoo, 2009). Until now, social and spatial epidemiology have not fully integrated individual space–time behavior, even if fixed residential spatial units may not be the most relevant way to account for environnemental exposure in epidemiologic research.

By reviewing the concept of space and mobility in the fields of epidemiology, geography, transportation research, and environmental psychology, the present article aims to help refine the conceptual and operational elements for environmental exposure assessment in epidemiological research. First, we question the relevance of routinely using administrative units. Second, the role of mobility is explored in relation to the current focus on residential exposure in aetiological studies. Given the transdisciplinary nature of research on mobility and exposure, the present article performs a scoping review in various disciplines in order to explore how notions of mobility and activity spaces may contribute to a refinement of contextual exposures in health research.

Section snippets

Residential neighborhoods as fixed spatial units

Several literature reviews (Chaix, 2009, Cummins et al., 2007, Leal and Chaix, 2010, Riva et al., 2007, Schaefer-McDaniel et al., 2010a) have questioned the legitimacy of using fixed spatial units such as census tracts, census block groups, postal codes, voting precincts or administrative unit clusters as geographic boundaries to investigate social and physical influences. Relationships between neighborhood residential environments and various health behaviours and outcomes have traditionally

A brief definition of activity space

The notion of “activity space”, originally rooted in social sciences, has been defined as “the subset of all locations within which an individual has direct contact as a result of his or her day-to-day activities” (Golledge and Stimson, 1997, p. 279). The activity space, in reflecting daily mobility, is an individual measure of spatial behavior (Sherman et al., 2005a). Accordingly, the present paper focuses on daily mobility without losing sight of the fact that daily mobility is strongly

Conclusion

In this paper, we have investigated how notions of mobility and activity space can improve our capacity to integrate space in the measurement of exposure to environmental factors. Our assessment of the literature covered four disciplines in which notions of activity space were used.

It appears that time geography and transportation research offer interesting theoretical and analytical frameworks to investigate individual mobility in space and time, with related notions of daily activities and

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