Walkability of local communities: Using geographic information systems to objectively assess relevant environmental attributes

Leslie, Eva; Coffee, Neil; Frank, Lawrence D.; Owen, Neville; Bauman, Adrian; Hugo, Graeme

doi:10.1016/j.healthplace.2005.11.001

Cited by 535 publications

(447 citation statements)

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“…The literature suggests that levels of physical activity (walking for transportation and recreation, and vigorous exercise) increase in neighbourhoods with ''traditional'' or ''walkable'' designs and where there are pleasant safe parks and green spaces (Bauman et al, 1999;Ellaway, Macintyre, & Bonnefoy, 2005). Walkabillity, was associated with higher levels of moderate PA (Physical Activity) (Cerin et al, 2007), and reduction in body mass index (Frank et al, 2006;Leslie et al, 2007;Pendola & Gen, 2007).…”

Section: Discussionmentioning

confidence: 99%

The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal

Santana

Santos

Nogueira

2009

Social Science & Medicine

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a b s t r a c tAlthough individual factors have been shown to predict weight gain, contextual determinants have also attracted attention, with some authors stressing the role played by deprivation, urban sprawl, social capital and safety. Recent evidence has implicated environmental factors that facilitate the consumption of excess calories and/or make it more difficult to expend them in routine physical activity. The interrelationships found in some places between physical and social environments (key mediators) and body mass index (BMI), as well as the potential that exists for the development of healthier places, mean that more research is required into the contextual determinants of health. In Portugal, particularly in the Lisbon Metropolitan Area (LMA), the effects of physical and social environments on physical activity and BMI have not previously been explored in any detail. This study aims to highlight the associations between residential (physical and social) environment and the risk of weight gain and obesity, over and above individual attributes, assessing which indicators are the best predictors of excess weight in the LMA. The study involved data from 7669 individuals aged 18 and over from 143 neighbourhoods. Self-reported body height and weight were used to define overweight body mass index (BMI ! 25). BMI and individual (socio-demographic and behavioural) characteristics were linked to contextual data and analysed in a multilevel framework. Our findings show that different environmental factors are significantly associated with excess weight and obesity, either directly or indirectly (e.g. health-related behaviours such as eating patterns and physical activity, which are key mediators), after adjustment for individual characteristics. The results suggest that a deeper understanding of these mechanisms is critical if we want to tackle the obesity epidemic, and that policies aimed at weight control and obesity reduction must address people and places in order to bear fruit.

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Section: Discussionmentioning

confidence: 99%

The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal

Santana

Santos

Nogueira

2009

Social Science & Medicine

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“…Measures of population density and street connectivity are frequently used to define the walkability of environments. 26 Consequently, the urban neighborhoods can be considered as high walkable, and the rural neighborhoods as low walkable environments. Data collection took place between October 2008 and March 2009.…”

Section: Methodsmentioning

confidence: 99%

Urban–Rural Differences in Physical Activity in Belgian Adults and the Importance of Psychosocial Factors

et al. 2011

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Recent research in urban planning and public health has drawn attention to the associations between urban form and physical activity in adults. Because little is known on the urban-rural differences in physical activity, the main aims of the present study were to examine differences in physical activity between urban and rural adults and to investigate the moderating effects of the physical environment on the relationship between psychosocial factors and physical activity. In Flanders, Belgium, five rural and five urban neighborhoods were selected. A sample of 350 adults (20-65 years of age; 35 adults per neighborhood) participated in the study. Participants wore a pedometer for 7 days, and self-reported physical activity and psychosocial data were also collected. Results showed that urban adults took more steps/day and reported more walking and cycling for transport in the neighborhood, more recreational walking in the neighborhood, and more walking for transportation outside the neighborhood than rural adults. Rural adults reported more recreational cycling in the neighborhoods. The physical environment was a significant moderator of the associations between several psychosocial factors (modeling from family, self-efficacy, and perceived barriers) and physical activity. In rural participants, adults with psychosocial scores above average were more physically active, whereas there were no differences in physical activity according to psychosocial factors in urban participants. These results are promising and plead for the development of multidimensional interventions, targeting specific population subgroups. In rural environments, where changing the environment would be a very challenging task, interventions focusing on modifiable psychosocial constructs could possibly be effective.

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“…[13][14][15][16] Key components of walkability include residential density, street pattern or connectivity, mixed land use, and pedestrian infrastructure. [15][16][17][18][19][20] The number or density of intersections, called street connectivity, captures the directness of routes between destinations and has shown to be a significant predictor of walking. 15 The purpose of this study was to assess the relative association of neighborhood environment, health system factors, and individual characteristics with health status and mortality among veterans who utilize the VHA.…”

Section: Introductionmentioning

confidence: 99%

Neighborhood Environment and Health Status and Mortality Among Veterans

Nelson¹,

Taylor²,

Lurie³

et al. 2011

J GEN INTERN MED

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BACKGROUND:The VHA is the largest integrated US health system and is increasingly moving care into the communities where veterans reside. Veterans who utilize the VA for their care have worse health status than the general population. However, there is limited evidence about the association of neighborhood environment and health outcomes among veterans. OBJECTIVES: The primary aim of this study is to assess the relative contribution of neighborhood environment, health system, and individual characteristics to health status and mortality of veterans. METHODS: Information on personal socio-economic indicators, existing medical conditions and health status were obtained from baseline data from a multisite, randomized trial of primary care patients (n=15,889). The physical component scale (PCS) and mental component scale (MCS) summarized health status. Census tracts were used as proxies for neighborhoods. A summary score based on census tract data characterized the neighborhood socio-economic environment and walkability. Data were analyzed with multilevel hierarchical models. Analyses of health status were cross-sectional. Mortality analyses were longitudinal as participants were followed for an average of 722.5 days to ascertain vital status. RESULTS: Neighborhood SES was associated with PCS and MCS scores, controlling for individual socio-economic status, self-reported co-morbid disease, smoking status, and health care access. In the lowest versus highest quartiles of neighborhood SES, adjusted PCS scores were 34.4 vs. 35.4 (p<0.05) and adjusted MCS scores were 46.2 versus 47.0 (p<0.05). PCS score was also significantly associated with neighborhood walkability (p<0.05). Mortality was lower for veterans living in neighborhoods with the highest decile neighborhood SES (HR 0.78, highest vs. lowest decile 95% CI 0.63, 0.97). CONCLUSIONS: Veterans living in lower SES neighborhoods have poorer health status and a higher risk of mortality, independent of individual characteristics and health care access. Neighborhood walkability was associated with higher PCS scores.

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Walkability of local communities: Using geographic information systems to objectively assess relevant environmental attributes

Cited by 535 publications

References 40 publications

The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal

The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal

Urban–Rural Differences in Physical Activity in Belgian Adults and the Importance of Psychosocial Factors

Neighborhood Environment and Health Status and Mortality Among Veterans

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