April 30 | 2018
Using electronic health record data for environmental and place based population health research: a systematic review.
Schinasi LH, Auchincloss AH, Forrest CB, Diez Roux AV.
Ann Epidemiol. 2018 Mar 21. pii: S1047-2797(18)30059-0. [Epub ahead of print] DOI:10.1016/j.annepidem.2018.03.008
Abstract
PURPOSE:
We conducted a systematic review of literature published on January 2000-May 2017 that spatially linked electronic health record (EHR) data with environmental information for population health research.
METHODS:
We abstracted information on the environmental and health outcome variables and the methods and data sources used.
RESULTS:
The automated search yielded 669 articles; 128 articles are included in the full review. The number of articles increased by publication year; the majority (80%) were from the United States, and the mean sample size was approximately 160,000. Most articles used cross-sectional (44%) or longitudinal (40%) designs. Common outcomes were health care utilization (32%), cardiometabolic conditions/obesity (23%), and asthma/respiratory conditions (10%). Common environmental variables were sociodemographic measures (42%), proximity to medical facilities (15%), and built environment and land use (13%). The most common spatial identifiers were administrative units (59%), such as census tracts. Residential addresses were also commonly used to assign point locations, or to calculate distances or buffer areas.
CONCLUSIONS:
Future research should include more detailed descriptions of methods used to geocode addresses, focus on a broader array of health outcomes, and describe linkage methods. Studies should also explore using longitudinal residential address histories to evaluate associations between time-varying environmental variables and health outcomes.