Developing a tool for conducting assessments of the built environment

Increasing attention is being paid to the influence of the built environment on health outcomes, yet limited research methods exist to examine this relationship in a rigorous and systematic fashion. Interest in the influence of the built environment on health is especially high in Durham, North Carolina - an urban area that performs poorly on multiple key health metrics. To better understand the effects of the built environment on human health outcomes in general, and in Durham in particular, the Children's Environmental Health Initiative at Duke University developed a GIS-based tool for studying the built environment in Central Durham neighborhoods. After generating a list of built environment variables in Durham in collaboration with community partners, we constructed a geo-referenced database supported by an ArcGIS platform. Field technicians then loaded this database, as well as GIS overlays of Durham's roads and parcels, onto handheld GPS units and proceeded to field-transect Central Durham neighborhoods to conduct a consistent, parcel-level survey of built environment characteristics. Data collected at this refined scale is linked with other parcel-level data such as housing tenure, crime incidence, housing code violations, community resources, and a variety of health outcome data. The neighborhood assessments are shared with local government and community organizations to better address housing and health needs in the city. In addition, built environment variables are incorporated into analyses of the etiology of complex health outcomes. This work represents an innovative approach for serving community and health care needs through better understanding of the built environment.