Changing the environment to improve population health: a framework for considering exposure in natural experimental studies
Open accessAbstract
There is renewed optimism regarding the use of natural experimental studies to generate evidence as to the effectiveness of population health interventions. Natural experimental studies capitalise on environmental and policy events that alter exposure to certain social, economic or environmental factors that influence health. Natural experimental studies can be useful for examining the impact of changes to ‘upstream’ determinants, which may not be amenable to controlled experiments. However, while natural experiments provide opportunities to generate evidence, they often present certain conceptual and methodological obstacles. Population health interventions that alter the physical or social environment are usually administered broadly across populations and communities. The breadth of these interventions means that variation in exposure, uptake and impact may be complex. Yet many evaluations of natural experiments focus narrowly on identifying suitable ‘exposed’ and ‘unexposed’ populations for comparison. In this paper, we discuss conceptual and analytical issues relating to defining and measuring exposure to interventions in this context, including how recent advances in technology may enable researchers to better understand the nature of population exposure to changes in the built environment. We argue that when it is unclear whether populations are exposed to an intervention, it may be advantageous to supplement traditional impact assessments with observational approaches that investigate differing levels of exposure. We suggest that an improved understanding of changes in exposure will assist the investigation of the impact of complex natural experiments in population health.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Qualitative research can strengthen the design of randomized controlled trials of complex public health interventions, and this argument applies equally to natural experiments.
“Qualitative research can strengthen the design of RCTs of complex public health interventions (10, 56), and this argument applies equally to NEs (38).”
From Natural Experiments: An Overview of Methods, Approaches, and Contributions to Public Health Intervention Research (2017) · cites this paper as [38]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Mostly Harmless Econometrics: An Empiricist's Companion
Angrist, J. D., & Pischke, J.-S. (2009) · doi:10.1515/9781400829828 · Cited by 9,467 · see citing works
Abadie, A., Diamond, A., & Hainmueller, J. (2010) · Journal of the American Statistical Association · doi:10.1198/jasa.2009.ap08746 · Cited by 5,513 · see citing works
Roux, A. V. D., & Mair, C. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.05333.x · Cited by 2,801 · see citing works
(2007) · Cited by 1,428 · see citing works
Strategy of prevention: lessons from cardiovascular disease.
Rose, G. (1981) · BMJ · doi:10.1136/bmj.282.6279.1847 · Cited by 1,302 · see citing works
Process evaluation in randomised controlled trials of complex interventions
Oakley, A., Strange, V., Bonell, C., Allen, E., & Stephenson, J. (2006) · BMJ · doi:10.1136/bmj.332.7538.413 · Cited by 1,247 · see citing works
Counterfactuals and Causal Inference: Methods and Principles for Social Research
Morgan, S. L., & Winship, C. (2007) · doi:10.1017/cbo9780511804564 · Cited by 1,146 · see citing works
Natural Experiments in the Social Sciences
Dunning, T. (2012) · Cambridge University Press eBooks · doi:10.1017/cbo9781139084444 · Cited by 963 · see citing works
Craig, P., Cooper, C. C., Gunnell, D., Haw, S. J., Lawson, K. D., Macintyre, S., Ogilvie, D., Petticrew, M. P., Reeves, B. C., Sutton, M., et al. (2012) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2011-200375 · Cited by 918 · see citing works
Self-citationHappiness is greater in natural environments
MacKerron, G., & Mourato, S. (2013) · Global Environmental Change · doi:10.1016/j.gloenvcha.2013.03.010 · Cited by 899 · see citing works
Purposeful Program Theory: Effective Use of Theories of Change and Logic Models
Funnell, S., & Rogers, P. (2011) · RMIT Research Repository (RMIT University Library) · Cited by 897 · see citing works
Frank, L. D., Saelens, B. E., Powell, K., & Chapman, J. E. (2007) · Social Science & Medicine · doi:10.1016/j.socscimed.2007.05.053 · Cited by 693 · see citing works
Natural Experiments in the Social Sciences: A Design-Based Approach
Dunning, T. (2012) · Thammasat University Digital Collections · Cited by 466 · see citing works
Cummins, S., Flint, E., & Matthews, S. A. (2014) · Health Affairs · doi:10.1377/hlthaff.2013.0512 · Cited by 451 · see citing works
Perchoux, C., Chaix, B., Cummins, S., & Kestens, Y. (2013) · Health and Place · doi:10.1016/j.healthplace.2013.01.005 · Cited by 354 · see citing works
Chaix, B., Méline, J. C., Duncan, S., Merrien, C., Karusisi, N., Perchoux, C., Lewin, A., Labadi, K., & Kestens, Y. (2013) · Health & Place · doi:10.1016/j.healthplace.2013.01.003 · Cited by 336 · see citing works
Natural experiments: an underused tool for public health?
Petticrew, M., Cummins, S., Ferrell, C., Findlay, A., Higgins, C., Hoy, C., Kearns, A., & Sparks, L. (2005) · Public Health · doi:10.1016/j.puhe.2004.11.008 · Cited by 318 · see citing works
Burgoine, T., Forouhi, N. G., Griffin, S. J., Wareham, N. J., & Monsivais, P. (2014) · BMJ · doi:10.1136/bmj.g1464 · Cited by 313 · see citing works
An Interactive Mapping Tool to Assess Individual Mobility Patterns in Neighborhood Studies
Chaix, B., Kestens, Y., Perchoux, C., Karusisi, N., Merlo, J., & Labadi, K. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.06.026 · Cited by 289 · see citing works
Goodman, A., Sahlqvist, S., & Ogilvie, D. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302059 · Cited by 256 · see citing works
Self-citationConceptual Approaches to the Study of Health Disparities
Roux, A. V. D. (2012) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031811-124534 · Cited by 241 · see citing works
Use of Global Positioning Systems to Study Physical Activity and the Environment
Krenn, P. J., Titze, S., Oja, P., Jones, A., & Ogilvie, D. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.06.046 · Cited by 223 · see citing works
Self-citationActivity Fields and the Dynamics of Crime
Wikström, P. H., Ceccato, V. A., Hardie, B., & Treiber, K. (2009) · Journal of Quantitative Criminology · doi:10.1007/s10940-009-9083-9 · Cited by 215 · see citing works
The Renaissance of Field Experimentation in Evaluating Interventions
Shadish, W. R., & Cook, T. D. (2008) · Annual Review of Psychology · doi:10.1146/annurev.psych.60.110707.163544 · Cited by 208 · see citing works
Neighborhoods, daily activities, and measuring health risks experienced in urban environments
Basta, L., Richmond, T., & Wiebe, D. (2010) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2010.09.008 · Cited by 170 · see citing works
Commentary: Investigating neighbourhood effects on health--avoiding the 'Local Trap'
Cummins, S. (2007) · International Journal of Epidemiology · doi:10.1093/ije/dym033 · Cited by 166 · see citing works
Merom, D., Bauman, A. E., Vita, P., & Close, G. (2003) · Preventive Medicine · doi:10.1016/s0091-7435(02)00025-7 · Cited by 161 · see citing works
Burgoine, T., & Monsivais, P. (2013) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-10-85 · Cited by 160 · see citing works
When are food deserts? Integrating time into research on food accessibility
Widener, M. J., & Shannon, J. (2014) · Health & Place · doi:10.1016/j.healthplace.2014.07.011 · Cited by 154 · see citing works
Bowers, K. J., Johnson, S. D., Guerette, R. T., Summers, L., & Poynton, S. (2011) · Journal of Experimental Criminology · doi:10.1007/s11292-011-9134-8 · Cited by 150 · see citing works
Ogilvie, D., Bull, F., Cooper, A. R., Rutter, H., Adams, E. J., Brand, C., Ghali, K., Jones, T. J., Mutrie, N., Powell, J. E., et al. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000694 · Cited by 137 · see citing works
Self-citationBranas, C. C., Kastanaki, A. E., Michalodimitrakis, M., Tzougas, J., Kranioti, E. F., Theodorakis, P. N., Carr, B. G., & Wiebe, D. J. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-005619 · Cited by 137 · see citing works
Evaluating complex and unfolding interventions in real time
Ling, T. (2012) · Evaluation · doi:10.1177/1356389011429629 · Cited by 110 · see citing works
Craig, P., Cooper, C. C., Gunnell, D., Haw, S. J., Lawson, K. D., Macintrye, S., Ogilvie, D., Petticrew, M. P., Reeves, B. C., Sutton, M., et al. (2011) · ResearchOnline at James Cook University (James Cook University) · Cited by 89 · see citing works
Self-citationEvaluating Health Effects of Transport Interventions
Ogilvie, D., Mitchell, R., Mutrie, N., Petticrew, M. P., & Platt, S. D. (2006) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2006.03.030 · Cited by 82 · see citing works
Self-citationPreventing non-communicable diseases through structural changes in urban environments
Franco, M., Bilal, U., & Roux, A. V. D. (2014) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2014-203865 · Cited by 81 · see citing works
A dose of realism for healthy urban policy: lessons from area-based initiatives in the UK: Table 1
Thomson, H. (2008) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2007.068775 · Cited by 80 · see citing works
Ignorability and stability assumptions in neighborhood effects research
VanderWeele, T. J. (2007) · Statistics in Medicine · doi:10.1002/sim.3139 · Cited by 68 · see citing works
Health impacts of the Cambridgeshire Guided Busway: a natural experimental study
Ogilvie, D., Panter, J., Guell, C., Jones, A., Mackett, R. L., & Griffin, S. J. (2016) · Public Health Research · doi:10.3310/phr04010 · Cited by 46 · see citing works
Self-citationTen Propositions on Science and Antiscience
Levins, R. (1996) · Social Text · doi:10.2307/466847 · Cited by 39 · see citing works
Old Myths, New Myths: Challenging Myths in Public Health
Viehbeck, S. M., Petticrew, M. P., & Cummins, S. (2015) · American Journal of Public Health · doi:10.2105/ajph.2014.302433 · Cited by 34 · see citing works
Heinen, E., Panter, J., Dalton, A. M., Jones, A., & Ogilvie, D. (2014) · Journal of Transport & Health · doi:10.1016/j.jth.2014.10.006 · Cited by 26 · see citing works
Self-citationCummins, S. (2009) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199563623.003.018 · Cited by 7 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [27]Pawson R, Tilly N Realistic evaluation. London: SAGE Publications Ltd, 1997.
Cited by
Sorted by citations
Craig, P., Katikireddi, S. V., Leyland, A., & Popham, F. (2017) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031816-044327 · Cited by 570 · see citing works
Meta-Analysis of Complex Interventions
Tanner-Smith, E. E., & Grant, S. (2018) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-040617-014112 · Cited by 62 · see citing works
- Authors
- Humphreys, D. K., Panter, J., Sahlqvist, S., Goodman, A., & Ogilvie, D.
- Affiliations
- University of Cambridge (GB)
- Deakin University (AU)
- Corresponding author
- Humphreys, David K
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2016-04-07
- Volume
- 70
- Issue
- 9
- Pages
- 941-946
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC5390281
- OpenAlex
- W2327636044
- Cited by
- 84
- References
- 44
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 3 · 2022: 8 · 2021: 12 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 14 · 2016: 1
- FWCI
- 12.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Journal of Epidemiology & Community Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Figshare (submittedVersion, cc-by-nc)
- HighWire Press Open Archive (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Apollo (cc-by)
- Funders
- Wellcome Trust (MC_UU_12015/6, 087636/Z/08/Z)
- United Kingdom Clinical Research Collaboration (RES-590-28-0002, MC_UU_12015/6)
- National Institute for Health and Care Research (09/3001/06, PDF-2012-05-157, MC_UU_12015/6, PDF-2010-03-15)
- British Heart Foundation (MC_UU_12015/6)
- Centre for Diet and Activity Research (RES-590-28-0002, MC_UU_12015/6)
- Medical Research Council (MC_UU_12015, MC_UU_12015/6, MR/K023187/1)
- Engineering and Physical Sciences Research Council (EP/G00059X/1)
- Economic and Social Research Council (ES/G007462/1, RES-590-28-0002, MC_UU_12015/6)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- natural experiment, population health interventions, exposure measurement, built environment, upstream determinants of health, environmental change, intervention impact evaluation, exposure heterogeneity
- MeSH terms
- Population Health, Health Promotion, Humans, Research Design, Social Environment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
