Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA; Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
Ann Epidemiol. 2018 Jul;28(7):493-502. doi: 10.1016/j.annepidem.2018.03.008. Epub 2018 Mar 21.
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.
We abstracted information on the environmental and health outcome variables and the methods and data sources used.
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.
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.
我们对 2000 年 1 月至 2017 年 5 月期间发表的文献进行了系统评价，这些文献将电子健康记录 (EHR) 数据与环境信息进行了空间链接，用于人群健康研究。
我们提取了环境和健康结果变量以及使用的方法和数据源的信息。
自动搜索产生了 669 篇文章；128 篇文章被纳入全文综述。随着发表年份的增加，文章数量也在增加；其中大多数（80%）来自美国，平均样本量约为 16 万。大多数文章采用横断面（44%）或纵向（40%）设计。常见的结果是医疗保健利用（32%）、心血管代谢状况/肥胖（23%）和哮喘/呼吸道状况（10%）。常见的环境变量是社会人口统计学指标（42%）、接近医疗设施（15%）以及建筑环境和土地利用（13%）。最常见的空间标识符是行政单位（59%），如普查区。住宅地址也常用于分配点位置，或计算距离或缓冲区。
未来的研究应包括更详细地描述用于地理编码地址的方法，关注更广泛的健康结果，并描述链接方法。研究还应探索使用纵向住宅地址历史来评估随时间变化的环境变量与健康结果之间的关联。
