The neighborhood effect averaging problem (NEAP): An elusive confounder of the neighborhood effect

Ignoring people’s daily mobility and exposures to nonresidential contexts may lead to erroneous results in epidemiological studies of people’s exposures to and the health impact of environmental factors. This paper identifies and describes a phenomenon called neighborhood effect averaging, which may significantly confound the neighborhood effect as a result of such neglect when examining the health impact of mobility-dependent exposures (e.g., air pollution). Several recent studies that provide strong evidence for the neighborhood effect averaging problem (NEAP) are discussed. The paper concludes that, due to the observed attenuation of the neighborhood effect associated with people’s daily mobility, increasing the mobility of those who live in disadvantaged neighborhoods may be helpful for improving their health outcomes.