Is Walk Score associated with hospital admissions from chronic diseases? Evidence from a cross-sectional study in a high socioeconomic status Australian city-state

Abstract

ObjectivesTo explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs.DesignA cross-sectional analysis of public hospital episode data (2007–2013).SettingHospitalisations from the ACT, Australia at very small geographic areas.ParticipantsSecondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013. No restrictions on age, sex or ethnicity.Main exposure measuresGeographic Information System derived or compatible measures of general practitioner access, neighbourhood socioeconomic status, alcohol access, exposure to traffic and Walk Score walkability.Main outcome measuresHospitalisations of circulatory diseases, specific endocrine, nutritional and metabolic diseases, respiratory diseases and specific cancers.ResultsGeographic clusters with significant high and low risks of NCDs were found that displayed an overall geographic pattern of high risk in the outlying suburbs of the territory. Significant relationships between neighbourhood walkability as measured by Walk Score and the likelihood of hospitalisation with a primary diagnosis of myocardial infarction (heart attack) were found. A possible relationship was also found with the likelihood of being hospitalised with 4 major lifestyle-related cancers.ConclusionsOur research augments the growing literature underscoring the relationships between the built environment and health outcomes. In addition, it supports the importance of walkable neighbourhoods, as measured by Walk Score, for improved health.

Relationships between Neighborhood Walkability and Objectively Measured Physical Activity Levels in Hemodialysis Patients

“…The WS measures neighborhood characteristics on a scale of 0 (poorest walkability) to 100 (greatest walkability) based on distance and a variety of key public and commercial destinations (e.g., grocery stores, retail stores, parks, schools). The WS has been validated to be correlated with objective neighborhood walkability indexes based on geographic information systems data [20], and has been demonstrated to be related to physical activity levels and associated with health outcomes in the general population [19, 21, 22]. It has been shown in the general population that the probability of people meeting physical activity recommendations increases by 26% for every 10-point increase in the WS [19].…”

Association of Perceived Built Environment Attributes with Objectively Measured Physical Activity in Community-Dwelling Ambulatory Patients with Stroke

“…Although some reports investigated the correlation between built environment attributes and cardiovascular disease and stroke incidence [32,33], few reports from around the world have investigated the correlation between perceived built environment attributes and physical activity after such diseases [16,17,34].…”

Neighborhood Walkability and Active Transportation: A Correlation Study in Leisure and Shopping Purposes

“…Consequently, several indices such as the Walk Score, Walkability Index, and Pedestrian Index of the Environment were developed combining various built environmental variables that influence walking behavior [7,[19][20][21][22][23][24][25][26][27][28][29][30][31][32]. The Walk Score is one of the popular indices that objectively measures neighborhood walkability, taking into account the accessibility of amenities in the vicinity (e.g., grocery stores, restaurants, shopping centers, coffee shops, parks, schools) and pedestrian friendliness (e.g., intersection density and average block length) [25], and is currently used in various fields, including public health, real estate, and urban planning [33][34][35][36][37]. Studies have verified whether the Walk Score is appropriate to describe the level of walkability, and correspondingly, several works of the literature showed that a higher level of Walk Score is positively correlated with walking behavior [7,26,29,30,[38][39][40][41][42].…”