About the Group
In the Energy Balance research group, we examine how the local environment influences human health. Members of this group have been working together for over 15 years on the issue of how the built environment combines with family history to impact health outcomes such as obesity and Type II Diabetes Mellitus (T2DM).
Our research leverages the Utah Population Database (UPDB) and national datasets such as NHANES and NLSY. Within these datasets, the UPDB is an unparalleled resource containing demographic, genealogical, and medical/clinical information on nearly the entire Utah population, both historic and contemporary.
Our research has identified positive impacts of walkability and high-quality food environment for promoting health and well-being. We have also investigated the potential for non-random selection bias in the relationship between walkability and body mass index to ensure that any benefits of a walkable environment do not simply reflect the possibility that healthy people choose to live in walkable places.
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Research
Our current focus is on how neighborhood features can weaken the link between family history of type 2 diabetes mellitus (T2DM) and offspring T2DM risk. The intergenerational transmission of T2DM to offspring has long been known. In this work, we draw on the life course framework to test hypotheses regarding the role of the neighborhood environment in the transmission of T2DM from parents to offspring. The research will transform our understanding of how neighborhood features, such as walkability, the presence of quality food environment, and residential greenness, affect T2DM risk over the life course. This project is funded by NIH/NIDDK (Kowaleski-Jones, PI).
We leverage the comprehensive, longitudinal records in the Utah Population Database, which contain individual-level data on medical, residential, and familial variables spanning decades for an entire population. These intergenerational data will be integrated with measures of neighborhood characteristics across time to construct longitudinal family health and neighborhood histories. This project addresses the following questions:
· Aim 1: Identify how neighborhood-level risk factors for T2DM, such as low walkability and poor-quality food environments, changed in recent decades;
· Aim 2: Estimate how intergenerational T2DM transmission is modified by the neighborhood environment;
· Aim 3: Identify potential savings in healthcare spending that would come from modifying neighborhood features linked to T2DM risk?
What does this study contribute?
This study makes several innovative contributions to the diabetes literature.
· We use decades of data to operationalize neighborhood risk in terms of initial and changing measures of walkability and food environments).
· We utilize genealogical records and family medical health histories, a feature not found in prior T2DM studies, to assemble a cohort of parents and offspring in four urban Utah counties, differentiating between Hispanic and non-Hispanic white populations.
· The combination of intergenerational and neighborhood data allows for a multilevel study of T2DM risk to inform prevention policies.
· We estimate the costs of diabetes attributable to neighborhood conditions subject to policy changes.
People
Lori Kowaleski-Jones is a Professor in the Department of Family and Consumer Studies (FCS) and Director
of the Interdisciplinary Exchange for Utah Science (NEXUS). Her main research interests
are in the areas of physical and social wellbeing of individuals and families with
a focus on how public policy, neighborhood environments and family factors maximize
individual wellbeing. In the past, she has considered the effects of food assistance
programs on child food insecurity and wellbeing. Current work involves an intervention
to considers increasing the reach of the Earned Income Tax Credit (EITC). Connect
to Collect proposes to increase the participation rate in the EITC and Child Tax Credit
programs through innovatively extending provision of free tax preparation via partnerships
with the health care system, grass roots community organizations, and new information
technology. Currently, she is the PI on our NIDDK/NIH project that studies intergenerational
diabetes risk and the role of the built environment using data from the Utah Population
Database.
Barbara Brown, Professor Emerita, is an environmental psychologist. Her work examines how community designs are related to human and non-human health and well-being. Using quasi-experimental approaches, she has examined how the use of new light rail lines relates to increases in objectively-measured physical activity and lower BMI, as well as changed attitudes and walkability features in the neighborhood. Similarly, she has examined how more walkable neighborhood designs are associated with lower BMI. Ongoing research examines whether the walkability predictors of higher BMI are also associated with higher diabetes risks. She also has examined how the design of buildings and landscaping create ecological traps that attract birds into deadly window strikes.
David Curtis, Assistant Professor, is an interdisciplinary social scientist who studies community influences on population health and health disparities. His research has leveraged large-scale data resources to measure area-level social and environmental conditions and their link with population health. For instance, to measure access to parks and recreation resources, he has used local government expenditures, satellite imagery, geospatial data, and online user reviews. Such rich park data are being used to understand the weight-related and metabolic effects of being proximate to highly appealing parks. In another research project, David is examining how area-level resources influence the geographic patterning of birth outcomes for Black women, with a focus on structural and institutional determinants of racial heath disparities.
Kyle Kole is a postdoctoral fellow in the Energy Balance Research Group. He graduated from the University of California, Irvine, with a Ph.D. in economics. His research applies empirical methods to address questions regarding health and amenities in urban neighborhoods. Within the research group, Kyle’s primary focus is estimating the annual direct cost of Type 2 Diabetes and forecasting the total direct and indirect cost of Type 2 Diabetes over a lifetime using the All Payer Claims Database.
Huong Meeks, Ph.D., is an Assistant Professor in the Department of Pediatrics and a faculty statistician in the Data Coordinating and Analysis Center (DCAC). She is a life course epidemiologist and demographer with special expertise in population health and longitudinal data, familial and survival analysis. Her research interest focuses on the longitudinal effects of family, individual, and neighborhood socioeconomic status, and other social determinants of health on adverse health outcomes in pediatric critical care context. She is particularly interested in the impact of neighborhood characteristics and family characteristics, including social support network, on outcomes of pediatric patients with chronic conditions and their families.
Ken Smith is a biodemographer and Distinguished Emeritus Professor of Family Studies and Population
Science at the University of Utah. He is also a Huntsman Cancer Institute Investigator
and former Director of the Pedigree and Population Program at the University of Utah
that develops and maintains the Utah Population Database, one of the world’s largest
resources that links individual-level genealogical, medical and demographic records.
He previously was the Director of Interdisciplinary Exchange for Utah Science (NEXUS)
and is presently the Executive Director of the Wasatch Front Research Data Center
(one of 33 secure RDCs in the nation managed by the US Census Bureau). He has long-standing
interests in familial aspects of health, cancer, aging and longevity. He investigates
the socio-environmental and genetic origins of aging in humans and exceptional longevity
in families. His current work includes a focus on the role of early life events in
affecting the mortality dynamics and the life chances and health outcomes of middle
aged and older adults. His research interests extend to the effects of family, community,
and socioeconomic factors affecting health outcomes, obesity, diabetes mortality,
and longevity of individuals.
Cathleen D. Zick, Ph.D. is a consumer economist and professor emeritus in the Department of Family and Consumer Studies. For over 40 years, her research has focused on questions of how public policies shape the choices families make regarding the allocation of scarce time and money resources. Within the context of energy balance research, her contributions to the team science are twofold. First, she is assessing how neighborhood food environments relate to type 2 diabetes risk. Second, she is examining the direct and indirect societal costs of type 2 diabetes and how changes in neighborhood features (e.g., mixed land use zoning, green space requirements) might alter these costs.
Publications
Selected publications
● Brown, B., Yamada, I., Smith, K., Zick, C., Kowaleski-Jones, L., & Fan, J. (2009). Mixed land use and walkability: Variations in land use measures and relationships with BMI, overweight, and obesity. Health and Place, 15, 1130-1141.
● Brown, B. B., Santos, S., & Ocampo-Peñuela, N. (2021). Bird-window collisions: Mitigation efficacy and risk factors across two years. PeerJ, 9, e11867.
● Brown, B.B. (2018). Residential environments and active living. In A. Devlin (Ed.), Environmental Psychology and Human Well-Being: Effects of Built and Natural Settings. Pp 51-76. New York: Academic Press.
● Brown, Barbara; Smith, Ken; Hanson, Heidi; Fan, Jessie; Kowaleski-Jones, Lori; and Zick, Cathleen. (2013). Neighborhood design for walking and biking: Physical activity and body mass index. American Journal of Preventive Medicine. 44(3): 231-238.
● Brown BB, Smith KR, Tharp D, Werner CM, Tribby CP, Miller HJ, Jensen W. A complete street intervention for walking to transit, nontransit walking, and bicycling: A quasi-experimental demonstration of increased use. J Phys Act Health. 2016 Nov;13(11):1210-1219. doi: 10.1123/jpah.2016-0066. Epub 2016 Aug 24. PubMed PMID: 27334024; PubMed Central PMCID: PMC5497517.
● Brown BB, Tharp D, Smith KR, Jensen WA. “Objectively measured active travel and uses of activity-friendly neighborhood resources: Does change in use relate to change in physical activity and BMI?” 2017 Aug. 18, Vol 8, pgs. 60-66. doi: 10.1016/j.pmedr.2017.08.004.
● Brown BB, Werner CM, Tribby CP, Miller HJ, Smith KR. Transit Use, Physical Activity, and Body Mass Index Changes: Objective Measures Associated With Complete Street Light-Rail Construction. Am J Public Health. 2015 Jul;105(7):1468-74. doi:
10.2105/AJPH.2015.302561. Epub 2015 May 14. PubMed PMID: 25973829; PubMed Central PMCID: PMC4463394.
● Bryant, W. K., & Zick, C. D. (2005). The economic organization of the household.
● Buder, I., Waitzman, N., & Zick, C. (2020). The medical costs of low leisure-time physical activity among working-age adults: Gender and minority status matter. Preventive Medicine, 141, 106273.
● Buder, I., Zick, C., & Waitzman, N. (2016). Health‐related quality of life associated with physical activity: new estimates by gender and race and ethnicity. World medical & health policy, 8(4), 409-420.
● Buder, I., Zick, C., & Waitzman, N. (2020). The contribution of physical activity to health-related quality of life: New population estimates from national survey data. Applied Research in Quality of Life, 15(1), 55-71.
● Buder, I., Zick, C., Waitzman, N., Simonsen, S., Sunada, G., & Digre, K. (2018). It takes a village coach: Cost-effectiveness of an intervention to improve diet and physical activity among minority women. Journal of Physical Activity and Health, 15(11), 819-826.
● Chernenko, A., Meeks, H. & Smith, K.R. Examining validity of body mass indexcalculated using height and weight data from the US driver license. BMC Public Health 19, 100 (2019). https://doi.org/10.1186/s12889-019-6391-3 (test of BMI was on T2DM)
● Curtis, D. S., Fuller-Rowell, T. E., Carlson, D. L., Wen, M., & Kramer, M. R. (2021). Does a rising median income lift all birth weights? County median income changes and low birth weight rates among births to Black and White mothers. The Milbank Quarterly, 100, 38-77. PMID:34609027
● Curtis, D. S., Fuller-Rowell, T. E., Vilches, S., Vonasek, J., & Wells, N. M. (2019). Associations between local government expenditures and low birth weight incidence: Evidence from national birth records. Preventive Medicine Reports, 16, 100985. PMCID: PMC6734050
● Curtis, D. S., Rigolon, A., Schmalz, D. L., & Brown, B. B. (2022). Policy and environmental predictors of park visits during the first months of the COVID-19 pandemic: Getting out while staying in. Environment & Behavior, 54, 487-515.
● Curtis, D.S., Washburn, T., Lee, H., Smith, K.R., Kim, J., Martz, C. D., Kramer,
M. R., & Chae, D. H. (2021). Racial violence and the mental health of Black Americans. Proceedings of the National Academy of Sciences of the United States of America, 118, e2019624118. PMCID: PMC8092615
● Dude AM, Smid MC, Branch DW, West J, Meeks H, Yu Z, Fraser A, Smith K, Reddy D. Interpregnancy Body Mass Index Change and Offspring Mortality Risk following the Second Pregnancy. Am J Perinatol. 2021 Apr 20;. doi: 10.1055/s-0041-1727230. [Epub ahead of print] PubMed PMID: 33878768.
● Duensing I, Anderson MB, Meeks HD, Curtin K, Gililland JM. Patients with Type-1 Diabetes Are at Greater Risk of Periprosthetic Joint Infection: A Population-Based, Retrospective, Cohort Study. J Bone Joint Surg Am. 2019 Oct 16;101(20):1860-1867. doi: 10.2106/JBJS.19.00080. PubMed PMID: 31626011.
● Fan, J. X., Brown, B. B., Hanson, H., Kowaleski-Jones, L., Smith, K. R., & Zick, C. D. (2013). Moderate to vigorous physical activity and weight outcomes: Does every minute count? American Journal of Health Promotion, 28(1), 41-49.
● Fan, J. X., Hanson, H. A., Zick, C. D., Brown, B. B., Kowaleski-Jones, L., & Smith, K. R. (2014). Geographic scale matters in detecting the relationship between
neighborhood food environments and obesity risk: an analysis of driver license records in Salt Lake County, Utah. BMJ open, 4(8), e005458.
● Fan, J. X., Kowaleski-Jones, L., & Wen, M. (2013). Walking or Dancing Patterns of Physical Activity by Cross-Sectional Age Among US Women. Journal of Aging and Health, 25(7), 1182-1203.
● Fan, J. X., Wen, M., & Kowaleski-Jones, L. (2014). An ecological analysis of environmental correlates of active commuting in urban US. Health & place, 30, 242-250.
● Fan, J. X., Wen, M., & Kowaleski-Jones, L. (2014). Rural–Urban Differences in Objective and Subjective Measures of Physical Activity: Findings From the National Health and Nutrition Examination Survey (NHANES) 2003–2006. Preventing chronic disease, 11.
● Fan, J. X., Wen, M., & Kowaleski-Jones, L. (2015). Sociodemographic and environmental correlates of active commuting in rural America. The Journal of Rural Health, 31(2), 176-185.
● Fan, J. X., Wen, M., & Kowaleski-Jones, L. (2016). Tract-and county-level income inequality and individual risk of obesity in the United States. Social science research, 55, 75-82.
● Fan, Jessie, Brown, Barbara, Kowaleski-Jones, Lori, Smith, Ken and Zick, Cathleen. (2007). Patterns of household food expenditures: A cluster analysis. Monthly Labor Review. (4): 38-51.
● Frodsham SG, Yu Z, Lyons AM, Agarwal A, Pezzolesi MH, Dong L, Srinivas TR, Ying J, Greene T, Raphael KL, Smith KR. The familiality of rapid renal decline in diabetes. Diabetes. 2019 Feb 1;68(2):420-9.
● Fuller-Rowell, T. E., Curtis, D. S., Boylan, J., El-Sheikh, M., Chae, D., & Ryff, D. (2016). Racial disparities in sleep: The role of neighborhood disadvantage.
Sleep Medicine, 27, 1-8. PMCID: PMC5171231
● Fuller-Rowell, T. E., Curtis, D. S., Klebanov, P. K., Brooks-Gunn, J., & Evans, G. W. (2017). Racial disparities in blood pressure trajectories of preterm children: The role of family and neighborhood socioeconomic status. American Journal of Epidemiology, epub ahead of print. PMCID: PMC5860255
● Fuller-Rowell, T. E., Homandberg, L., Curtis, D. S., Williams, D., Tsenkova, V., & Ryff, C. D. (2019). Disparities in insulin resistance between black and white adults in the United States: The role of lifespan stress exposure. Psychoneuroendocrinology, 107, 1-8. PMCID: PMC6635018
● Jensen WA, Stump TK, Brown BB, Werner CM, Smith KR. Walkability, complete streets, and gender: Who benefits most? Health Place. 2017 Nov;48:80-89. doi: 10.1016/j.healthplace.2017.09.007. PubMed PMID: 29024906; PubMed Central PMCID: PMC5690867.
● Ken Smith, and Cathleen Zick, Barbara Brown, Kowaleski-Jones, Lori, Yamada, Ikuho, and Jessie Fan. (2008). Walkability and body mass index: Density, design, and new diversity measures. American Journal of Preventive Medicine 35(3):237-44.
● Kim S, Park J, Chen Y, Rowe K, Snyder J, Fraser A, Smith K, Deshmukh VG, Newman M, Herget K, Porucznik CA. Long-term diabetes risk among endometrial cancer survivors in a population-based cohort study. Gynecologic oncology. 2020 Jan 1;156(1):185-93.
● Kowaleski-Jones, L., & Wen, M. (2013). Community and child energy balance: differential associations between neighborhood environment and overweight risk by gender. International Journal of Environmental Health Research, 23(5), 434-445.
● Kowaleski-Jones, L., Brown, B. B., Fan, J. X., Hanson, H. A., Smith, K. R., & Zick, C. D. (2017). The joint effects of family risk of obesity and neighborhood environment on obesity among women. Social Science & Medicine, 195, 17-24.
● Kowaleski-Jones, L., Fan, J. X., Wen, M., & Hanson, H. (2016). Neighborhood Context and Youth Physical Activity Differential Associations by Gender and Age. American Journal of Health Promotion.
● Kowaleski-Jones, L., Fan, J. X., Yamada, I., Zick, C. D., Smith, K. R., & Brown, B. B. (2009). Alternative measures of food deserts: fruitful options or empty cupboards. Ann Arbor: National Poverty Centre.
● Kowaleski-Jones, L., Wen, M., & Fan, J. X. (2019). Unpacking the paradox: testing for mechanisms in the food insecurity and BMI association. Journal of Hunger & Environmental Nutrition, 14(5), 683-697.
● Kowaleski-Jones, L., Zick, C., Smith, K. R., Brown, B., Hanson, H., & Fan, J. (2018). Walkable neighborhoods and obesity: Evaluating effects with a propensity score approach. SSM-population health, 6, 9-15.
● Kowaleski-Jones, Lori, Barbara B. Brown, Jessie X. Fan, Ken R. Smith, and Cathleen D. Zick. (2009). Are you what your mother eats? Evaluating the impact of maternal weight trajectories on youth overweight. Maternal and Child Health.
● Kowaleski-Jones, Lori. and Rachel Dunifon. (2012). Community influences on parenting and child behavior: Exploring race differences. Youth and Society.
● Miller HJ, Tribby CP, Brown BB, Smith KR, Werner CM, Wolf J, Wilson L, and Simas Oliveira MG. “Public transit generates new physical activity: Evidence from individual GPS accelerometer data before and after light rail construction in a neighborhood of Salt Lake City (vol 36, pg 8, 2015).” Health & Place 2016 May. 39, 177. doi:10.1016/j.healthplace.2016.04.007
● Nguyen QC, Brunisholz KD, Yu W, McCullough M, Hanson HA, Litchman ML, Li F, Wan Y, Van Derslice JA, Wen M, Smith KR. Twitter-derived neighborhood characteristics associated with obesity and diabetes. Scientific reports. 2017 Nov 27;7(1):1-0.
● Nguyen QC, Kath S, Meng HW, Li D, Smith KR, VanDerslice JA, Wen M, and LiF. “Leveraging geotagged Twitter data to examine neighborhood happiness, diet, and physical activity.” Applied Geography 2016 Aug. 73, 77-88. PMCID: PMC5438210
● Schumacher MC, Smith KR. Diabetes in Utah among adults: interaction between diabetes and other risk factors for microvascular and macrovascular complications. American journal of public health. 1988 Sep;78(9):1195-201.
● Sharareh, N., Hess, R., Wan, N., Zick, C. D., & Wallace, A. S. (2020). Incorporation of Information-Seeking Behavior Into Food Insecurity Research. American Journal of Preventive Medicine, 58(6), 879-887.
● Smith, K. R., Hanson, H. A., Brown, B. B., Zick, C. D., Kowaleski-Jones, L., & Fan, J. X. (2016). Movers and stayers: how residential selection contributes to the association between female body mass index and neighborhood characteristics. International Journal of Obesity, 40(9), 1384-1391.
● Smith, Ken, Kowaleski-Jones, Lori. Zick, Cathleen, Smith, Ken., Brown, Barbara. and
Fan, Jessie. (2011). Effects of neighborhood SES and walkability on obesity: Assessing selection and causal influences. Social Science Research. 40(5): 1445 –1455.
● Smith, Ken R. and Norman J. Waitzman, “Effects of Marital Status on the Risk of Mortality in Poor and Non-poor Neighborhoods,” Annals of Epidemiology 1997; 7(5):343-349. PMID:9250629
● Waitzman, Norman, and Ken R. Smith, "Phantom of the Area: Poverty Residence and Mortality in the U.S.," American Journal of Public Health 1998; 88: 973-976. PMID:9618634
● Waitzman, Norman J., Ken R. Smith, and Antoinette Stroup. “The Direct and Indirect Effects of Metropolitan Area Inequality on Mortality: A Hierarchical Analysis.” Annals of the New York Academy of Sciences December 1999; 896:347-350. PMID:10681918
● Waitzman, Norman J. and Ken R. Smith. "Separate but Lethal: The Effects of Economic Segregation on Mortality in Metropolitan America," The Milbank Quarterly 1998; 76(3):341-73. PMID:9738167
● Wen, M., & Kowaleski-Jones, L. (2012). Sex and ethnic differences in validity of self-reported adult height, weight and body mass index. Ethnicity & Disease, 22(1), 72.
● Wen, M., & Kowaleski-Jones, L. (2012). The built environment and risk of obesity in the United States: Racial– ethnic disparities. Health & Place, 18(6), 1314-1322.
● Wen, M., Fan, J. X., Kowaleski-Jones, L., & Wan, N. (2018). Rural–Urban Disparities in Obesity Prevalence Among Working Age Adults in the United States: Exploring the Mechanisms. American Journal of Health Promotion, 32(2).
● Wen, M., Kowaleski-Jones, L., & Fan, J.X. (2013). Ethnic-immigrant disparities in total and abdominal obesity in the US. American Journal of Health Behavior, 37(6): 807-818.
● Willis, S. K., Simonsen, S. E., Hemmert, R. B., Baayd, J., Digre, K. B., & Zick, D. (2020). Food Insecurity and the Risk of Obesity, Depression, and Self-Rated Health in Women. Women's Health Reports, 1(1), 308-317.
● Yamada, Ikuho, Zick, Cathleen D., Ken R. Smith, Jessie X. Fan, Barbara B. Brown, and Kowaleski-Jones, Lori. (2011). Mixed land use and obesity: an empirical comparison of alternative land use measures and geographic scales. Professional Geographer 64: 1-21.
● Zick, C., & Birtulescu, A. (2019). Diet Quality of Farm and Nonfarm Households in the First Half of the Twentieth Century: The Roles of Technological Change and Women’s Work. Social Science History, 43(4), 705-731.
● Zick, C. D., & Stevens, R. B. (2010). Trends in Americans’ food-related time use: 1975–2006. Public health nutrition, 13(7), 1064-1072.
● Zick, C. D., & Stevens, R. B. (2011). Time spent eating and its implications for Americans’ energy balance. Social Indicators Research, 101(2), 267-273.
● Zick, C. D., Buder, I., Waitzman, N. J., Simonsen, S., & Digre, K. (2019). The nexus between health and time use among racially and ethnically diverse women. Ethnicity & health, 24(2), 147-167.
● Zick, C. D., Hanson, H., Fan, J. X., Smith, K. R., Kowaleski-Jones, L., Brown,
B. B., & Yamada, I. (2013). Re- visiting the relationship between neighborhood environment and BMI: an instrumental variable approach to correcting for residential selection bias. International Journal of Behavioral Nutrition and Physical Activity, 10(1), 27.
● Zick, C. D., Smith, K. R., Fan, J. X., Brown, B. B., Yamada, I., & Kowaleski-Jones, L.
(2009). Running to the store? The relationship between neighborhood environments and the risk of obesity. Social science & medicine, 69(10), 1493-1500.
● Zick, C. D., Smith, K. R., Kowaleski-Jones, L., Uno, C., & Merrill, B. J. (2013). Harvesting more than vegetables: the potential weight control benefits of community gardening. American Journal of Public Health, 103(6), 1110-1115. (citation count: 7)
● Zick, C. D., Stevens, R. B., & Bryant, W. K. (2011). Time use choices and healthy body weight: a multivariate analysis of data from the American Time Use Survey. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 1-14.
● Zick, C. D. (2010). The shifting balance of adolescent time use. Youth & Society, 41(4), 569-596.
● Zick, C. D. (2014). Does daylight savings time encourage physical activity? Journal of Physical Activity and Health, 11(5), 1057-1060.
● Zick, Cathleen, Smith, Ken., Brown, Barbara., Fan, Jessie, and Kowaleski-Jones, Lori. (2007). Physical Activity during the Transition from Adolescence to Adulthood. Journal of Physical Activity and Health 4(2): 125-137.