The social environment and walking behavior among low-income housing residents
ABSTRACT Walking, both for leisure and for travel/errands, counts toward meeting physical activity recommendations. Both social and physical neighborhood environmental features may encourage or inhibit walking. This study examined social capital, perceived safety, and disorder in relation to walking behavior among a population of low-income housing residents. Social and physical disorder were assessed by systematic social observation in the area surrounding 20 low-income housing sites in greater Boston. A cross-sectional survey of 828 residents of these housing sites provided data on walking behavior, socio-demographics, and individual-level social capital and perceived safety of the areas in and around the housing site. Community social capital and safety were calculated by aggregating individual scores to the level of the housing site. Generalized estimating equations were used to estimate prevalence rate ratios for walking less than 10 min per day for a) travel/errands, b) leisure and c) both travel/errands and leisure. 21.8% of participants walked for travel/errands less than 10 min per day, 34.8% for leisure, and 16.8% for both kinds of walking. In fully adjusted models, those who reported low individual-level social capital and safety also reported less overall walking and less walking for travel/errands. Unexpectedly, those who reported low social disorder also reported less walking for leisure, and those who reported high community social capital also walked less for all outcomes. Physical disorder and community safety were not associated with walking behavior. For low-income housing residents, neighborhood social environmental variables are unlikely the most important factors in determining walking behavior. Researchers should carefully weigh the respective limitations of subjective and objective measures of the social environment when linking them to health outcomes.
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ABSTRACT: Objective To analyse whether an individual's neighbourhood influences the uptake of weight management strategies and if there is an interaction between individual socio-economic status (SES) and neighbourhood deprivation.MethodologyData were collected from the Yorkshire Health Study (2010-2012) for 27 806 individuals on the use of the following weight management strategies; 'slimming clubs', 'healthy eating', 'increasing exercise' and 'controlling portion size'. A multi-level logistic regression was fit to analyse the use of these strategies, controlling for age, sex, body mass index, education, neighbourhood deprivation and neighbourhood population turnover (a proxy for neighbourhood social capital). A cross-level interaction term was included for education and neighbourhood deprivation. Lower Super Output Area was used as the geographical scale for the areal unit of analysis.ResultsSignificant neighbourhood effects were observed for use of 'slimming clubs', 'healthy eating' and 'increasing exercise' as weight management strategies, independent of individual- and area-level covariates. A significant interaction between education and neighbourhood deprivation was observed across all strategies, suggesting that as an area becomes more deprived, individuals of the lowest education are more likely not to use any strategy compared to those of the highest education.Conclusions Neighbourhoods modify/amplify individual disadvantage and social inequalities, with individuals of low education disproportionally affected by deprivation. It is important to include neighbourhood-based explanations in the development of community based policy interventions to help tackle obesity.International Journal of Obesity accepted article preview online, 4 August 2014; doi:10.1038/ijo.2014.152.International journal of obesity (2005) 08/2014; 39(3). DOI:10.1038/ijo.2014.152 · 5.39 Impact Factor
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ABSTRACT: Acculturation may influence health behaviors, yet mechanisms underlying its effect are not well understood. In this study, we describe relationships between acculturation and health behaviors among low-income housing residents, and examine whether these relationships are mediated by social and contextual factors. Residents of 20 low-income housing sites in the Boston metropolitan area completed surveys that assessed acculturative characteristics, social/contextual factors, and health behaviors. A composite acculturation scale was developed using latent class analysis, resulting in four distinct acculturative groups. Path analysis was used to examine interrelationships between acculturation, health behaviors, and social/contextual factors, specifically self-reported social ties, social support, stress, material hardship, and discrimination. Of the 828 respondents, 69% were born outside of the U.S. Less acculturated groups exhibited healthier dietary practices and were less likely to smoke than more acculturated groups. Acculturation had a direct effect on diet and smoking, but not physical activity. Acculturation also showed an indirect effect on diet through its relationship with material hardship. Our finding that material hardship mediated the relationship between acculturation and diet suggests the need to explicate the significant role of financial resources in interventions seeking to promote healthy diets among low-income immigrant groups. Future research should examine these social and contextual mediators using larger, population-based samples, preferably with longitudinal data.Social Science & Medicine 10/2014; DOI:10.1016/j.socscimed.2014.10.034 · 2.56 Impact Factor
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ABSTRACT: Rates of active travel vary by socio-economic position, with higher rates generally observed among less affluent populations. Aspects of both social and built environments have been shown to affect active travel, but little research has explored the influence of physical environmental characteristics, and less has examined whether physical environment affects socio-economic inequality in active travel. This study explored income-related differences in active travel in relation to multiple physical environmental characteristics including air pollution, climate and levels of green space, in urban areas across England. We hypothesised that any gradient in the relationship between income and active travel would be least pronounced in the least physically environmentally-deprived areas where higher income populations may be more likely to choose active transport as a means of travel. Adults aged 16+ living in urban areas (n = 20,146) were selected from the 2002 and 2003 waves of the UK National Travel Survey. The mode of all short non-recreational trips undertaken by the sample was identified (n = 205,673). Three-level binary logistic regression models were used to explore how associations between the trip being active (by bike/walking) and three income groups, varied by level of multiple physical environmental deprivation. Likelihood of making an active trip among the lowest income group appeared unaffected by physical environmental deprivation; 15.4% of their non-recreational trips were active in both the least and most environmentally-deprived areas. The income-related gradient in making active trips remained steep in the least environmentally-deprived areas because those in the highest income groups were markedly less likely to choose active travel when physical environment was 'good', compared to those on the lowest incomes (OR = 0.44, 95% CI = 0.22 to 0.89). The socio-economic gradient in active travel seems independent of physical environmental characteristics. Whilst more affluent populations enjoy advantages on some health outcomes, they will still benefit from increasing their levels of physical activity through active travel. Benefits of active travel to the whole community would include reduced vehicle emissions, reduced carbon consumption, the preservation or enhancement of infrastructure and the presentation of a 'normalised' behaviour.International Journal of Behavioral Nutrition and Physical Activity 06/2015; 12(1):73. DOI:10.1186/s12966-015-0217-1 · 3.68 Impact Factor