The Promise of Geospatial Methods in Prevention Research

The importance of neighborhood context has long been acknowledged in vulnerable populations, such as the homeless, and other groups at risk for addictions (1). The ability to conceptualize and measure neighborhood and other spatial characteristics of the geophysical environment, however, has been limited due to the inability of the available methodologies to quantify these characteristics. Historically, methods to measure neighborhood characteristics have been either qualitative (e.g., ethnography) or gross numerical measurements, lacking the nuanced reflection of fine details. The advent of usable technologies such as geographic information systems (GIS) has now made it feasible to conduct more sophisticated investigations of the effects of neighborhoods and their geospatial features on behaviors and service needs within populations. The article by Ridenour et al. (2), in this issue of The American Journal of Drug and Alcohol Abuse, represents an important step forward, both methodologically, and conceptually, for exploring associations among geospatial factors and various population characteristics. More specifically, these associations were used to inform the potential development and application of prevention services by demonstrating geographical areas where populations with the greatest needs can be found. This aim was accomplished by the clustering of children with neurobehavioral disinhibition (ND) in association with parental substance use disorder (SUD) severity and neighborhood quality in terms of concentrated disadvantage and residential instability. The novel part of this study, in particular, was the application of established GIS methods to study social problems in neighborhoods. The addition of geographic barriers into the analysis represented a novel methodological application and sharpened the representation of the high-ND areas. The results of this study were relatively intuitive; clustering of children with high ND was strongly associated with neighborhood quality and with severity of parental SUD, with lower quality of neighborhood associated with greater clustering of children with high ND. The intuitive nature of these findings is an indicator of the face validity of the results. The results further point to potential promise of these geographic methods to inform the delivery of services. With the addition of more layers of complexity and fine-tuned details of geospatial characteristics, future studies have the potential to uncover important underlying associations. For example, such studies might allow for prediction of which of the neighborhoods or neighborhood pockets might be most prone to specific kinds of substance problems (e.g., Does the sudden appearance of head shops in a neighborhood presage a “bath salts” drug epidemic? ), and which of the individuals in these areas are most at risk. The study of neighborhoods offers further opportunities to examine positive variables that exist within these environments, rather than focusing entirely on negative characteristics (such as those used in this study). The positive strength and resilience aspects of neighborhoods, such as churches and community-based services that may provide important foundations to neighborhood stability and vitality, have been relatively neglected in geospatial investigation. As this type of investigation moves forward, one of the most complex issues is determining causality. Similar to difficulties encountered in examining the role of addiction in homelessness, the relationships between characteristics of individuals and the neighborhoods where they are found can vary in causal direction. The Ridenour et al. study (2), for example, raises the question of whether addiction attracts individuals to a particular neighborhood, or whether characteristics of certain neighborhoods lead to addiction among their inhabitants. In other words, did addiction severity increase the likelihood of these parents