Neighborhood Access to the Built Environment and Allostatic Load: A Systematic Review of the Use of Geographic Information Systems.

ABSTRACT

Objectives: This paper systematically reviews how spatial analysis has been used to measure relationships between access to the built environment and Allostatic Load (AL) or biomarkers relevant to the stress pathway. Geographic Information Systems (GIS) facilitate objective measurement of built environment access that may explain unequal health outcomes linked to living in stressful environments. Methods: Systematic review, search date 13 July 2022 with methods published a priori. Included studies that quantitatively assessed associations between GIS measures of neighborhood attributes and biomarkers of stress. Results: 23 studies from 14 countries were included having used GIS measures to assess relationships between access to the built environment and biomarkers relevant to AL, with 17 being cross-sectional and 6 longitudinal. Just 2 studies explicitly assessed associations between GIS measures and AL, but 21 explored biomarkers relevant to the stress pathway. GIS was used to calculate density (how much of x within y) and proximity (how far from a to b) measures. Conclusion: GIS measures of greenspace, the food environment, area-level demographics, and land-use measures were found to influence biomarkers relevant to the stress pathway, highlighting the utility of this approach. GIS use is extremely limited when measuring the built environment and its influence on AL but has been widely used to consider effects on individual biomarkers of stress. Systematic Review Registration [https//www.crd.york.ac.uk/prospero/display_record.php?RecordID=348355], identifier [CRD42022348355].