Safe To Walk? Neighborhood Safety and Physical Activity Among Public Housing Residents

Abstract

BackgroundDespite its health benefits, physical inactivity is pervasive, particularly among those living in lower-income urban communities. In such settings, neighborhood safety may impact willingness to be regularly physically active. We examined the association of perceived neighborhood safety with pedometer-determined physical activity and physical activity self-efficacy.Methods and FindingsParticipants were 1,180 predominantly racial/ethnic minority adults recruited from 12 urban low-income housing complexes in metropolitan Boston. Participants completed a 5-d pedometer data-collection protocol and self-reported their perceptions of neighborhood safety and self-efficacy (i.e., confidence in the ability to be physically active). Gender-stratified bivariate and multivariable random effects models were estimated to account for within-site clustering. Most participants reported feeling safe during the day, while just over one-third (36%) felt safe at night. We found no association between daytime safety reports and physical activity among both men and women. There was also no association between night-time safety reports and physical activity among men (p = 0.23) but women who reported feeling unsafe (versus safe) at night showed significantly fewer steps per day (4,302 versus 5,178, p = 0.01). Perceiving one's neighborhood as unsafe during the day was associated with significantly lower odds of having high physical activity self-efficacy among both men (OR 0.40, p = 0.01) and women (OR 0.68, p = 0.02).ConclusionsResiding in a neighborhood that is perceived to be unsafe at night is a barrier to regular physical activity among individuals, especially women, living in urban low-income housing. Feeling unsafe may also diminish confidence in the ability to be more physically active. Both of these factors may limit the effectiveness of physical activity promotion strategies delivered in similar settings.

Self-reported Neighborhood Safety and Nonadherence to Treatment Regimens Among Patients with Type 2 Diabetes

“…Adjusted odds ratios (aOR) are adjusted for age, sex, education, race/ethnicity, nativity, income, urbanicity, insurance status, number of visits to the doctor, access to an automobile, duration of diabetes, general health condition and psychological distress of recommended processes of care, but was associated with treatment nonadherence beyond what was explained by individual socioeconomic status, barriers to access to care, and self-reported health. The higher rate of delays in filling prescriptions observed in respondents living in unsafe neighborhoods has not been previously demonstrated in the literature, but is consistent with other work linking neighborhood safety to general health behaviors [21][22][23] and a study linking neighborhood-level socioeconomic disadvantage with adherence to CPAP therapy for obstructive sleep apnea. 32 In the current study, approximately half of the respondents who reported delays in filling prescriptions and obtaining needed care cited cost as the reason for the delay.…”

“…[14][15][16][17][18][19][20] Individuals who live in neighborhoods perceived to be unsafe, for example, report lower levels of physical activity 21 , higher rates of smoking 22,23 , and greater levels of obesity 12 compared to individuals living in neighborhoods perceived to be safe, even after accounting for individual-level markers of socioeconomic status, such as household income. Such "neighborhood effects" on health may be particularly pronounced among individuals with type 2 diabetes, which requires consistent adherence to management regimens that are often challenging and complex.…”

Investigating Environmental Determinants of Diet, Physical Activity, and Overweight among Adults in Sao Paulo, Brazil

“…Neighborhood safety and esthetic appeal have also been associated with rates of physical activity and obesity prevalence in other countries, as public open spaces in unsafe areas may actually discourage physical activity. 55,56 The study is subject to some limitations. First, it is cross-sectional in nature and thus cannot prove causality.…”

Why the Neighborhood Social Environment Is Critical in Obesity Prevention

“…1 Lack of neighborhood safety, defined as perceptions of unsafe neighborhoods as well as objectively measured high-crime neighborhoods have been associated with obesity among both adults and children even after adjusting for socioeconomic factors. [11][12][13] Several studies have noted associations between crime and perceptions of unsafe neighborhoods and low levels of physical among adults and children, 14 with several studies noting associations only among women. 12,15 As women are more often the victims of sexual crimes, they may be more likely to modify their behaviors (i.e., limiting time outdoors engaging in physical activity) if they perceive their environment to be unsafe.…”

“…12,15 As women are more often the victims of sexual crimes, they may be more likely to modify their behaviors (i.e., limiting time outdoors engaging in physical activity) if they perceive their environment to be unsafe. 14 crime may be a pathway through which neighborhood crime impacts obesity. Neighborhood safety and crime may also influence social networks and cohesion among neighborhood residents by limiting opportunities for social interaction and promoting distrust among residents.…”