Predictors of discordance between perceived and objective neighborhood data.
OBJECTIVE
Pathways by which the social and built environments affect health can be influenced by differences between perception and reality. This discordance is important for understanding health impacts of the built environment. This study examines associations between perceived and objective measures of 12 nonresidential destinations, as well as previously unexplored sociodemographic, lifestyle, neighborhood, and urbanicity predictors of discordance.


METHODS
Perceived neighborhood data were collected from participants of the Survey of the Health of Wisconsin, using a self-administered questionnaire. Objective data were collected using the Wisconsin Assessment of the Social and Built Environment, an audit-based instrument assessing built environment features around each participant's residence.


RESULTS
Overall, there was relatively high agreement, ranging from 50% for proximity to parks to more than 90% for golf courses. Higher education, positive neighborhood perceptions, and rurality were negatively associated with discordance. Associations between discordance and depression, disease status, and lifestyle factors appeared to be modified by urbanicity level.


CONCLUSIONS
These data show perceived and objective neighborhood environment data are not interchangeable and the level of discordance is associated with or modified by individual and neighborhood factors, including the level of urbanicity. These results suggest that consideration should be given to including both types of measures in future studies.
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Erin J
EJ
Bailey
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison. Electronic address: kmalecki@wisc.edu.
Kristen C
KC
Malecki
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Corinne D
CD
Engelman
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Matthew C
MC
Walsh
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Andrew J
AJ
Bersch
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Ana P
AP
Martinez-Donate
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Paul E
PE
Peppard
Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
F Javier
FJ
Nieto
D004779:Environment Design; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D010465:Perception; D011159:Population Surveillance; D011998:Recreation; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012424:Rural Population; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population
Environment design; Epidemiological methods; Obesity; Perception; Rural population; Urban population; Validity (epidemiology)