Measuring the built environment: validity of a site survey instrument for use in urban settings

There are few reliable measures of place with which to study the effects of socio-economic context on health. We report on the development and inter-r ater reliability of a 27-item observer-rated built environment site survey checklist (BESSC). Across eleven 'housing areas' (defined as areas of homog eneity in housing form) and two raters, kappa coefficients were greater tha n or equal to0.5 for fifteen categorical items, and intra-class correlation coefficients exceeded 0.6 for a further three continuous measures. Ratings on several BESSC items were associated to a statistically significant degr ee with the prevalence of depression and residents' dissatisfaction with 't heir area as a place to live'. BESSC items may prove to be valuable descrip tors of the urban built environment in future studies. (C) 2001 Elsevier Sc ience Ltd. All rights reserved.