Housing, neighbourhood and sociodemographic associations with adult levels of physical activity and adiposity: baseline findings from the ENABLE London study

Abstract

ObjectivesThe neighbourhood environment is increasingly shown to be an important correlate of health. We assessed associations between housing tenure, neighbourhood perceptions, sociodemographic factors and levels of physical activity (PA) and adiposity among adults seeking housing in East Village (formerly London 2012 Olympic/Paralympic Games Athletes’ Village).SettingCross-sectional analysis of adults seeking social, intermediate and market-rent housing in East Village.Participants1278 participants took part in the study (58% female). Complete data on adiposity (body mass index (BMI) and fat mass %) were available for 1240 participants (97%); of these, a subset of 1107 participants (89%) met the inclusion criteria for analyses of accelerometer-based measurements of PA. We examined associations between housing sector sought, neighbourhood perceptions (covariates) and PA and adiposity (dependent variables) adjusted for household clustering, sex, age group, ethnic group and limiting long-standing illness.ResultsParticipants seeking social housing had the fewest daily steps (8304, 95% CI 7959 to 8648) and highest BMI (26.0 kg/m2, 95% CI 25.5kg/m2 to 26.5 kg/m2) compared with those seeking intermediate (daily steps 9417, 95% CI 9106 to 9731; BMI 24.8 kg/m2, 95% CI 24.4 kg/m2 to 25.2 kg/m2) or market-rent housing (daily steps 9313, 95% CI 8858 to 9768; BMI 24.6 kg/m2, 95% CI 24.0 kg/m2 to 25.2 kg/m2). Those seeking social housing had lower levels of PA (by 19%–42%) at weekends versus weekdays, compared with other housing groups. Positive perceptions of neighbourhood quality were associated with higher steps and lower BMI, with differences between social and intermediate groups reduced by ~10% following adjustment, equivalent to a reduction of 111 for steps and 0.5 kg/m2 for BMI.ConclusionsThe social housing group undertook less PA than other housing sectors, with weekend PA offering the greatest scope for increasing PA and tackling adiposity in this group. Perceptions of neighbourhood quality were associated with PA and adiposity and reduced differences in steps and BMI between housing sectors. Interventions to encourage PA at weekends and improve neighbourhood quality, especially among the most disadvantaged, may provide scope to reduce inequalities in health behaviour.

Weekend and weekday associations between the residential built environment and physical activity: Findings from the ENABLE London study

“…Associations between residential PA facilities and PA have been shown to vary by time of the day and day of the week [26]. Daily variations in number of steps and minutes of MVPA have been reported in English adults, with more PA on weekdays compared to weekends [5,27]. UK time use surveys highlight how individuals spend more time travelling and in paid work or studying on weekdays, and more time in leisure activities and domestic work on weekends [28,29].…”

“…classic markers of socio-economic vulnerability) compared to those seeking relocation into affordable and market-rent housing (Table 1). Second, literature has highlighted associations of both current housing tenure and aspirational housing tenure with a variety of health outcomes [5,30,42,43] (e.g. BMI, mental health, morbidity and mortality), including PA [44].…”

“…Current population levels of PA are too low in the UK, with 37% of adults aged 16 years or more not meeting recommended levels of activity of at least 150 minutes of moderate-intensity per week [4]. Individuals from more disadvantaged socio-economic groups are less physically active [4], both in terms of daily steps [5] and moderate to vigorous physical activity (MVPA) [6,7]. Recently, epidemiological research has increasingly incorporated socio-ecological models that acknowledge the role of the built environment, especially the local residential environment [8], in influencing PA behaviours [9].…”

The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on mode of travel (ENABLE London study, a natural experiment)

“…While power to examine effects across social sub-groups was limited, this study allays concerns over whether such interventions widen social inequalities, in that effects of moving to East Village were broadly similar and in the same direction across the housing groups. This was despite marked differences in travel mode and physical activity levels between housing groups at baseline [38], showing potential benefits for all. Another major strength was the use of an automated machine learning approach, combining accelerometry and GPS data, to measure travel mode allowing more data points to contribute to the analyses, increasing statistical power to establish the presence or absence of effects.…”

“…[35] An additional 'economically inactive' category included those seeking employment, unable to work due to disability or illness, retired, looking after home and family, and students [36]. Two neighbourhood perception scores, measuring crime (i.e., vandalism, feeling unsafe to walk in neighbourhood, presence of threatening groups) and neighbourhood quality (i.e., accessible features, attractiveness, and enjoyment of living in neighbourhood), were derived at baseline using exploratory factor analysis on 14 neighbourhood perception items in the questionnaire [37,38], and the same items were used to obtain scores at follow-up.…”