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Ann Epidemiol. 2018 Jul;28(7):493-502. doi: 10.1016/j.annepidem.2018.03.008. Epub 2018 Mar 21.

Using electronic health record data for environmental and place based population health research: a systematic review.

Author information

1
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. Electronic address: lhs36@drexel.edu.
2
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.
3
Children's Hospital of Philadelphia, Philadelphia, PA.

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.

KEYWORDS:

Electronic health records; Environmental exposure/adverse effects; Geographic information systems; Residence characteristics

PMID:
29628285
DOI:
10.1016/j.annepidem.2018.03.008
[Indexed for MEDLINE]

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