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Int. J. Environ. Res. Public Health 2015, 12(10), 12489-12504; doi:10.3390/ijerph121012489

Neighborhood Self-Selection: The Role of Pre-Move Health Factors on the Built and Socioeconomic Environment

1
Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02215, USA
2
Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
3
Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA
4
Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 30 June 2015 / Revised: 16 September 2015 / Accepted: 23 September 2015 / Published: 8 October 2015
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Abstract

Residential self-selection bias is a concern in studies of neighborhoods and health. This bias results from health behaviors predicting neighborhood choice. To quantify this bias, we examined associations between pre-move health factors (body mass index, walking, and total physical activity) and post-move neighborhood factors (County Sprawl Index, Census tract socioeconomic status (SES)) in the Nurses’ Health Study (n = 14,159 moves from 1986–2008). Individuals in the highest quartile of pre-move BMI (BMI > 28.4) compared to the lowest quartile (BMI < 22.5) moved to counties that averaged 2.57 points lower on the sprawl index (95% confidence interval −3.55, −1.59) indicating that individuals moved to less dense counties; however, no associations were observed for pre-move walking nor total physical activity. Individuals with higher pre-move BMI tended to move to Census tracts with lower median income and home values and higher levels of poverty. Analyses examining the change in neighborhood environments after a move demonstrated that healthy pre-move behaviors were associated with moves to worse socioeconomic environments. This type of self-selection would bias results downward, underestimating the true relationship between SES and physical activity. Generally, the magnitudes of associations between pre-move health factors and neighborhood measures were small and indicated that residential self-selection was not a major source of bias in analyses in this population. View Full-Text
Keywords: residential self-selection; built environment; socioeconomic status; body mass index; physical activity residential self-selection; built environment; socioeconomic status; body mass index; physical activity
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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James, P.; Hart, J.E.; Arcaya, M.C.; Feskanich, D.; Laden, F.; Subramanian, S. Neighborhood Self-Selection: The Role of Pre-Move Health Factors on the Built and Socioeconomic Environment. Int. J. Environ. Res. Public Health 2015, 12, 12489-12504.

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Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
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