Association between neighborhood walkability, cardiorespiratory fitness and body-mass index

Division of Public Health Sciences, Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, Washington University in St. Louis, MO 63110, USA.
Social Science [?] Medicine (Impact Factor: 2.89). 12/2011; 73(12):1707-16. DOI: 10.1016/j.socscimed.2011.09.032
Source: PubMed


Many studies have found cross-sectional associations between characteristics of the neighborhood built environment and physical activity (PA) behavior. However, most are based on self-reported PA, which is known to result in overestimation of PA and differential misclassification by demographic and biological characteristics. Cardiorespiratory fitness (CRF) is an objective marker of PA because it is primarily determined by PA. Furthermore, it is causally related to long-term health outcomes. Therefore, analyses of the association between CRF and built environment could strengthen arguments for the importance of built environment influences on health. We examined the association between neighborhood walkability and CRF and body-mass index (BMI). This cross-sectional analysis included 16,543 adults (5017 women, 11,526 men) aged 18-90 years with home addresses in Texas who had a comprehensive clinical examination between 1987 and 2005. Outcomes included CRF from total duration on a maximal exercise treadmill test and measured BMI. Three neighborhood walkability factors emerged from principal components analyses of block-group measures derived from the U.S. Census. In multilevel adjusted analyses, the neighborhood walkability factors were significantly associated with CRF and BMI among men and women in the expected direction. An interaction between one of the neighborhood factors and age was also observed. The interaction suggested that living in neighborhoods with older homes and with residents traveling shorter distances to work was more strongly positively associated with CRF among younger adults and more strongly negatively associated with BMI among older adults. In conclusion, neighborhood characteristics hypothesized to support more PA and less driving were associated with higher levels of CRF and lower BMI. Demonstration of an association between built environment characteristics and CRF is a significant advance over past studies based on self-reported PA. Nevertheless, stronger causal evidence depends on more robust study designs and sophisticated measures of the environment, behavior, and their physiological consequences.

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Available from: Christine M Hoehner
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    • "Moreover, density (measured as either population density or residential density), as a neighborhood characteristic, has been shown to have associations with walking behavior (e.g., [9, 11, 12, 17, 22, 25–27, 29, 30, 32, 38]). Finally, age (measured as either neighborhood age or home age) has been linked to walking behavior (e.g., [9] [31] [38]). These five objective macroscale characteristics have been identified as characteristics which would foster or inhibit walking behavior. "
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    ABSTRACT: An extensive body of literature suggests that physical environment, physical activity, and socioeconomic status (SES) are intrinsically linked to each other and to weight related health problems. In this study, the role of objective and perceived pedestrian environment characteristics (microscale measures) was explored in relation to people’s recreational walking patterns in two neighborhoods with opposite SES. A total of 441 street segments were assessed and a total of 133 questionnaires were conducted. The findings suggest that recreational walking can take place beyond a neighborhood’s suggested SES when objective and especially perceived microscale characteristics (pedestrian environment) are favorable.
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    • "Social impact: increasing social interaction by facilitating meeting between people (Clark and Scott, 2013). Health impact: highlighting the fact that the level of physical activity of people is greatly affected by their neighborhood environment , thus improving their health (Clark et al., 2014; Brown et al., 2013; Hoehner et al., 2011; Smith et al., 2011, 2008; Gebel et al., 2010). Economic impact: creating public and consumer cost savings, more efficient land-use, community livability, and economic development (Cavill et al., 2012, 2008; Litman, 2003). "
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    ABSTRACT: The objective of this work is to develop a new and easily computable measure of pedestrian friendliness for urban neighborhoods that makes the best use of the available data and also addresses the issues concerning other models in use. The Pedestrian Environment Index (PEI) is defined as the product of four components representing land-use diversity (based on the concept of entropy), population density, commercial density, and intersection density. The final PEI is bound between 0 and 1, and uses data that typically are readily available to planners and metropolitan planning organizations (MPO). The results of this method are region-specific; they are comparable only between the zones within the given study area. As a case study, the city of Chicago is analyzed at the sub-traffic analysis zone (sub-TAZ) level. The results agree closely with the expectation of pedestrian friendliness across different parts of the city. Possible extensions are also listed, including a further study to determine statistical relationships between the PEI and common socio-economic characteristics. The method could also be further improved should more types of data become available.
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    ABSTRACT: Obesity represents an important public health concern and has negative health and social consequences. Epidemiological and observational studies have contributed to highlighting the multifactorial and complex etiology of obesity. Among the social components of the obesity epidemic the following appear to be the most relevant: assortative mating, parental age, socio-economical status and educational level, body dissatisfaction, sleep conditions, sedentary environments by build neighborhood, energy saving devices, work occupation and alcohol consumption. The assortative mating and parental traits (age, education level) have shown an important influence on the weight of children. In turn, sleep deprivation may reduce the energy expenditure and increase food intake, which can explain a relation with obesity. Body dissatisfaction in childhood and adolescence seems to increase the risk of obesity in adulthood. The low physical activity and spent sedentary time can be associated with unfavorably built environment, including low walk ability, unsafe playgrounds and pedestrian pathways. Moreover, the obesity per se, over time, may reduce physical activity level and social ability as well as influence in assortative mating, and subsequent intergenerational obesity condition. All findings together demonstrated that social components of obesity are as complex as itself. In summary, more studies concerning social, cultural and environment traits are needed in order to assess the effect of excessive adiposity in its own occurrence and chronicity. In addition, it is urgent to include obesity prevention as a relevant topic on the public health agenda in developing countries.
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