The Internet has already proven to be a great way to share health information or bring groups of patients or health care workers together. Now, Robert Wood Johnson Foundation Health & Society Scholar (2009-2011) Michael Bader, Ph.D., has found that if you let Google do the walking, you can also use the Internet to dramatically cut the costs of certain types of environmental studies, while expanding your reach.
It’s a long established fact that neighborhood settings can have a powerful impact on health. Not surprisingly, people are far more likely to take a brisk, long walk, ride a bike or visit their local park if their streets are clean, well-maintained, crime-free and lined with leafy, green foliage. For these reasons, public health experts invest a good deal of time, money and legwork in assessing the health saving or health damaging potential of different geographical areas.
“Physical disorder in a neighborhood, along with trash on the street, broken sidewalks and boarded up houses are things that will make people walk less,” Bader says. “So it’s important to measure these things. The problem is that it’s really expensive to conduct these types of studies.”
The primary cost, Bader notes, is the expense of moving people from neighborhood to neighborhood, even by public transportation and of course accommodating meal times and other breaks. “Because of these costs, I decided to investigate the feasibility of using Google to capture the same type of information.”
The Google Solution
The results of Bader and his team’s investigation were published in “Using Google Street View to Audit Neighborhood Environments,” in the January 2011 issue of the American Journal of Preventive Medicine. The work compared measurements of neighborhoods using Google Street View to assess 143 items associated with healthy community environments, including: aesthetics, physical disorder, pedestrian safety, motorized traffic and parking, infrastructure for active travel, sidewalk amenities, social and commercial activity. The evaluation was then tested. They found that 54.3 percent of the items, such as measures of pedestrian safety and infrastructure for travel, were accurately measured. Street View was less accurate at assessing disorder caused by small objects such as broken glass. But Bader and his group concluded that Google could be used to audit neighborhood environments.
Comparing the Google-enabled study to previous research in the same area conducted by walking through neighborhoods, Bader also quickly observed one other, immediate benefit. “With earlier studies, 68 percent of the time it took to complete the work was travel time. That was eliminated when we used Google Street View. It also increased productivity because one person can cover more ground using Street View than a team can cover walking around,” he says.
While there are some limitations with Street View, Bader explains, “we were still able to get an overall sense of walkability when we compared the Street View data with non-Street View information. The only drawback was the inability to see small debris.”
Exploring the Environment/Health Connection
The Google study is the most recent contribution to Bader’s ongoing analyses of how health care disparities are influenced by where people live. A sociologist by training, he has previously looked at segregation, mobility and health care access issues for residents of low-income communities that are related to environmental factors. “My interest began as a graduate student working with the Built Environment and Health Project which was really put together by a group of Robert Wood Johnson Foundation scholars and faculty at Columbia University,” Bader says. Crediting that experience with the formulation of his current ideas, he adds, “as a Health & Society scholar, I also participated in a conference on neighborhood measurement that was very helpful. We explored broad ideas about environment and health. I’ve also gotten incredibly helpful feedback from my program director and fellow scholars on how to frame and approach this research.”
Combining the lessons learned from the Google study and other work, Bader has developed a more comprehensive approach to his latest project—a national assessment of the implications of built environments on child health. “The new project is funded by a $250,000 National Institutes of Health grant that we will use over two years to design an efficient rating system for walkability in neighborhoods,” Bader says. “We hope to have our first results by early 2012. The team is designing an online interface to rate streets on a national sample of blocks. Then we will examine whether children’s health issues, like obesity, are related to the neighborhood conditions in which a child lives.”
The Robert Wood Johnson Foundation Health & Society Scholars program is based on the principle that progress in the field of population health depends upon multidisciplinary collaboration and exchange. Its goal is to improve health by training scholars to investigate rigorously the connections among biological, genetic, behavioral, environmental, economic and social determinants of health and develop interventions that integrate and act on these determinants to improve health. The program is intended to produce leaders who will change the questions asked, the methods employed to analyze problems and the range of solutions to reduce population health disparities and improve the health of all Americans.