Publications

2024

Wilson, Neal J., and Douglas Bowles. (2024) 2024. “A Parcel Level Housing Conditions Survey in Academic and Civil Context”. SAGE Open 14 (2): 1-14.
Publisher's Version
There is a growing awareness that the condition of the built environment has a substantial impact on health. Systematic housing conditions surveys are a method for developing information about the physical condition of housing. This paper introduces the Center for Economic Information’s (CEI) Neighborhood Housing Conditions Survey (NHCS). We discuss the history and implementation of the NHCS in light of other academic and civic housing conditions surveys. The paper also reviews the history and method of the NHCS. We find that housing conditions surveys are generally designed from scratch for each new research program, translating survey results into policy remains underdeveloped in the scholarly literature, and heterogeneity between surveys reduces the ability to compare observations across space and time. The NHCS may address some of these issues, suitable as an “off the shelf” template, adjustable to suit programmatic needs, and providing a baseline consistency across space and time.

2023

Wilson, Neal, Elizabeth Friedman, Kevin Kennedy, Panayiotis T. Manolakos, and Lori Reierson. (2023) 2023. “Using Exterior Housing Conditions to Predict Elevated Pediatric Blood Lead Levels”. Environmental Research 218.
Publisher's Version

Housing-based lead paint dust is the most common source of lead exposure for US-born children. Although year of housing construction is a critical indicator of the lead hazard to US children, not all housing of the same age poses the same risk to children. Additional information about housing condition is required to differentiate the housing-based lead risk at the parcel level. This study aimed to identify and assess a method for gathering and using observations of exterior housing conditions to identify active housing-based lead hazards at the parcel level. We used a dataset of pediatric blood lead observations (sample years 2000–2013, ages 6–72 months, n = 6,589) to assess associations between observations of exterior housing conditions and housing-based lead risk. We used graphical and Lasso regression methods to estimate the likelihood of an elevated blood lead observation (≥3.5 μg/dL). Our methods estimate a monotonic increase in the likelihood of an elevated blood lead observation as housing conditions deteriorate with the largest changes associated with homes in the greatest disrepair. Additionally we estimate that age of home construction works in consort with housing conditions to amplify risks among those houses built before 1952. Our analysis indicates that a survey of external housing conditions can be used in combination with age of housing in the identification process, at the parcel level, of homes that pose a housing-based lead hazard to children.

2022

Friedman, Elizabeth, Brian Lee, Casey Kalman, and Neal Wilson. (2022) 2022. “Historic Racism in Kansas City Affects Today’s Pediatric Asthma Burden”. Health & Place 78.
Publisher's Version

Asthma morbidity is unequally distributed across populations throughout the United States, and reasons remain unclear. To assess how historical structural racism correlates with current day asthma disparities, we conducted a retrospective cohort study of 10,736 pediatric patients, ages 3–19 years, with two or more asthma encounters between October 2017–October 2019. Patient addresses were matched with historic Home Owners' Loan Corporation (HOLC) maps – which provide a measure of historic structural racism. Residential proximity to pollution sources served as an additional exposure measure. Healthcare utilization and asthma severity were studied against age, race, SES, geographic proximity to pollution, and HOLC grades. Patients living in historically divested neighborhoods and BIPOC patients were likely to require more acute care for asthma, even when adjusting for present day SES and residential proximity to pollution sources. This supports the assertion that historic structural racism influences present-day health.

2018

Wilson, Benjamin, Natalie June Kane, Neal Wilson, Peter J. Eaton, and Doug Bowles. (2018) 2018. “Housing, Health, and History: Interdisciplinary Spatial Analysis in Pursuit of Equity for Future Generations”. In Intergenerational Responsibility in the 21st Century, 57-82. Wilmington, DE: Vernon Press.
Publisher's Version
Where we live plays a critical role in determining socio-economic status and lifetime health outcomes. Developing insights from recent research, this chapter tracks childhood asthma encounters from the hospital to the home, examining health as wealth in a socio-economic and historical context. Spatial inference and visual presentation of the data in maps reinforces this analysis. This interdisciplinary research finds that a child’s home environment is a relevant predictor of their health. These results align with innovations in healthcare provisioning practices that are achieving improved health outcomes by extending treatment regimens from the doctor’s office into the patient’s home. On the basis of these results, it is argued that in economics and healthcare, a responsible path forward is to go beyond traditional policies and treatments that alleviate specific adverse symptoms of intergenerational inequality; and instead take a holistic approach to health and well-being at multiple scales of economic and human geography.

2017

Wilson, Ben, and Neal J. Wilson. (2017) 2017. “An Iterative Approach to the Parcel Level Address Geocoding of a Large Health Dataset to a Shifting Household Geography”. Kansas City, MO: Center for Economic Information.
Publisher's Version

This article details an iterative process for the address geocoding of a large collection of health encounters (n = 242,804) gathered over a 13 year period to a parcel geography which varies by year. This procedure supports an investigation of the relationship between basic housing conditions and the corresponding health of occupants. Successful investigation of this relationship necessitated matching individuals, their health outcomes and their home environments. This match process may be useful to researchers in a variety of fields with particular emphasis on predictive modeling and up-stream medicine.