ABSTRACTObjectivesTo demonstrate the methodology and results for linking measures of neighbourhood walking-friendliness or "walkability" to Canadian health surveys and Canadian health surveys linked to administrative health care records.
ApproachWe linked multiple measures of neighbourhood walkability to hundreds of thousands of 6-digit postal codes of respondents to three large Canadian surveys using geographic information systems and anonymized banks of postal codes.
ResultsLong term exposure to walkable neighbourhoods was associated with increased reporting of walking for utilitarian purposes. Moving to a high walkable neighbourhood from a low walkable neighbourhood was associated with a full unit decrease in the body mass index of Canadian men over a 12-year follow-up. In a linkage of walkability measures to respondents who wore biosensors for a one-week period in several Canadian cities, we found that neighbourhood walkability was associated with increased reporting of utilitarian walking but not overall physical activity and step counts as measured by biosensors.
ConclusionThere is potential for walkable neighbourhoods to influence physical activity and body weight of Canadians which is more evident when individuals are followed for long periods of time.
Introduction & BackgroundEvidence is mounting that children's physical environment (e.g. in and around the home, school, and neighbourhood) is critical for their long-term health and education. Early life exposure to factors such as indoor and outdoor air pollution, or a lack of access to greenspaces are associated with the development of long-term health conditions such as asthma or mental health problems. Local and central government in England are implementing numerous policies to improve air quality and housing, and mitigate climate change. Further, England has seen large scale changes to local service provision (including childcare and libraries) due to austerity policies and the COVID-19 pandemic. Currently, there is no national, linked data resource for England that allows research into how the local environment impacts children's health and education.
Objectives & ApproachThe Kids' Environment and Health Cohort will be a new, linked national data resource for England currently being developing by researchers from UCL, London School of Hygiene and Tropical Medicine, London School of Economics and Political Science, Brock University, and City, University of London in collaboration with the Office for National Statistics (ONS), and funded by Administrative Data Research-UK (ADR-UK). The Kids' Environment and Health Cohort will be a de-identified and annually updated national birth cohort of all children born in England from 2006 onwards – around 10.5 million children until 2023. The cohort will be constructed using linked administrative data from vital registration (live and stillbirth, and death registration), Census (housing and socio-economic indicators), health (hospital contacts, mental health referrals, and community dispensing data), and education (key stage results, special educational needs, absenteeism). Environmental exposure data can be securely linked to the Cohort via longitudinal residential unique property reference numbers (UPRNs) and postcodes from the Personal Demographic Service, and school location from education records.
Relevance to Digital FootprintsThe Kids' Environment and Health Cohort will, for the first time, link health, education, Census and environmental data at national level in England. It will allow researchers to integrate data on local environments, including physical characteristics (such as temperature, building energy efficiency, or greenspace access) or the social environment (including proximity to food outlets, or services like libraries) with individual level data on health and education outcomes in children. This will be done using the ONS's 5 safes framework, ensuring highest standards of data security and confidentiality.
ResultsThe Kids' Environment and Health Cohort will be constructed using administrative datasets, including national linked vital statistics, health, education and Census data from multiple data providers (ONS, NHS England and Department for Education), combined with small-area level environmental data for England. Together, these datasets allow detailed analyses of the impact of environmental exposures on health and education outcomes in children, with robust confounder adjustment. The Kids' Environment and Health Cohort will be made available in a de-identified format in the ONS Secure Research Service (SRS).
Conclusions & ImplicationsThe Kids' Environment and Health Cohort will provide researchers secure access to a national data resource integrating environmental and administrative health and education data, for child public health research.
ObjectiveTo estimate the association between household tenure and the odds of hospital admission for acute lower respiratory tract infections (LRTI) in children under age 2 years.
MethodsWe developed a birth cohort of all singleton children born in Scotland 2010-2012, using linked birth registration records and maternal Census 2011 data. Further linkage to hospital admission records provided information on acute LRTI (pneumonia, bronchitis, bronchiolitis, influenza, unspecified LRTI) admissions in children aged less than 2 years. Using logistic regression models, we estimated the association between housing tenure at birth (owned, social rented, private rented/lives rent free) with odds of hospital admission for LRTI before and after adjustment for parental occupational class (household reference), family type and highest qualification level.
ResultsFrom the cohort of all 174,279 births in 2010-2012, 84.1% linked to a maternal census record. Children whose parents were married or had a UK-born mother were more likely to link to a Census record. In the final linked cohort of 141,336 children, 7,486 (5.3%) were admitted to hospital for one or more LRTI during the 2 years of follow up. We found an association between housing tenure and LRTI admissions, with children residing in social rented, compared to owned housing having higher odds of an LRTI admission, OR: 1.40 (1.32-1.47); and children living in private rented/rent free housing, compared to owned, OR: 1.18 (1.11-1.26). After adjustment for household socioeconomic circumstances, these estimates attenuated to OR: 1.18 (1.11-1.27) and OR: 1.10 (1.03-1.18) respectively.
ConclusionAfter accounting for household socioeconomic circumstances, children living in social and private tenured accommodation, compared to children living in owned accommodation were more likely to be hospitalised for an acute LRTI during the first 2 years of life. Further research to understand the contribution specific housing circumstances make to inequalities in LRTI hospitalisations early in life is needed.
