Invited commentary: Taking advantage of time-varying neighborhood environments

Neighborhood built environment characteristics may encourage physical activity, but previous literature on the topic has been critiqued for its reliance on cross-sectional data. In this issue of the Journal, Knuiman et al. (Am J Epidemiol. 2014;180(5):453-461) present longitudinal analyses of built environment characteristics as predictors of neighborhood transportation walking. We take this opportunity to comment on self-selection, exposure measurement, outcome form, analyses, and future directions. The Residential Environments (RESIDE) Study follows individuals as they relocate into new housing. The outcome, which is neighborhood transportation walking, has several important limitations with regards to public health relevance, dichotomization, and potential bias. Three estimation strategies were pursued: marginal modeling, random-effects modeling, and fixed-effects modeling. Knuiman et al. defend fixed-effects modeling as the one that most effectively controls for unmeasured time-invariant confounders, and it will do so as long as confounders have a constant effect over time. Fixed-effects modeling requires no distributional assumptions regarding the heterogeneity of subject-specific effects. Associations of time-varying neighborhood characteristics with walking are interpreted at the subject level for both fixed- and random-effects models. Cross-sectional data have set the stage for the next generation of neighborhood research, which should leverage longitudinal changes in both place and health behaviors. Careful interpretation is warranted as longitudinal data become available for analysis.