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Do Inequalities in Neighborhood Walkability Drive Disparities in Older Adults' Outdoor Walking?

ABSTRACT: Older residents of high-deprivation areas walk less than those of low-deprivation areas. Previous research has shown that neighborhood built environment may support and encourage outdoor walking. The extent to which the built environment supports and encourages walking is called "walkability". This study examines inequalities in neighborhood walkability in high- versus low-deprivation areas and their possible influences on disparities in older adults' outdoor walking levels. For this purpose, it focuses on specific neighborhood built environment attributes (residential density, land-use mix and intensity, street connectivity, and retail density) relevant to neighborhood walkability. It applied a mixed-method approach, included 173 participants (?65 years), and used a Geographic Information System (GIS) and walking interviews (with a sub-sample) to objectively and subjectively measure neighborhood built environment attributes. Outdoor walking levels were measured by using the Geographic Positioning System (GPS) technology. Data on personal characteristics was collected by completing a questionnaire. The results show that inequalities in certain land-use intensity (i.e., green spaces, recreation centers, schools and industries) in high- versus low-deprivation areas may influence disparities in older adults' outdoor walking levels. Modifying neighborhood land use intensity may help to encourage outdoor walking in high-deprivation areas.

SUBMITTER: Zandieh R

PROVIDER: S-EPMC5551178 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Do Inequalities in Neighborhood Walkability Drive Disparities in Older Adults' Outdoor Walking?

Zandieh Razieh R Flacke Johannes J Martinez Javier J Jones Phil P van Maarseveen Martin M

International journal of environmental research and public health 20170707 7

Older residents of high-deprivation areas walk less than those of low-deprivation areas. Previous research has shown that neighborhood built environment may support and encourage outdoor walking. The extent to which the built environment supports and encourages walking is called "walkability". This study examines inequalities in neighborhood walkability in high- versus low-deprivation areas and their possible influences on disparities in older adults' outdoor walking levels. For this purpose, it ...[more]

PMID: 28686219

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Project description:Walking, and in particular, outdoor walking, is the most common form of physical activity for older adults. To date, no study investigated the association between the neighborhood built environment and physical activity habits of older adults of low SES. Thus, our overarching aim was to examine the association between the neighborhood built environment and the spectrum of physical activity and walking for transportation in older adults of low socioeconomic status.Cross-sectional data were from the Walk the Talk Study, collected in 2012. Participants (n?=?161, mean age?=?74 years) were in receipt of a rental subsidy for low income individuals and resided in neighbourhoods across Metro Vancouver, Canada. We used the Street Smart Walk Score to objectively characterize the built environment main effect (walkability), accelerometry for objective physical activity, and the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure walking for transportation. We used regression analyses to examine associations of objectively measured physical activity [total volume, light intensity and moderate intensity physical activity (MVPA)] and self-reported walking for transportation (any, frequency, duration) with walkability. We adjusted analyses for person- and environment-level factors associated with older adult physical activity.Neighbourhood walkability was not associated with physical activity volume or intensity and self-reported walking for transportation, with one exception. Each 10-point increase in Street Smart Walk Score was associated with a 45% greater odds of any walking for transportation (compared with none; OR?=?1.45, 95% confidence interval?=?1.18, 1.78). Sociodemographic, physical function and attitudinal factors were significant predictors of physical activity across our models.The lack of associations between most of the explored outcomes may be due to the complexity of the relation between the person and environment. Given that this is the first study to explore these associations specifically in older adults living on low income, this study should be replicated in other settings.

Project description:Background:Outdoor walking groups are widely-used programmes aimed at improving physical activity and health outcomes. Despite being promoted as accessible and inclusive, emerging work highlights participation biases based on gender, age and socioeconomic status, for example. To explicate the impact of outdoor walking groups on physical activity inequities, we conducted a scoping review of published outdoor walking group literatures. Specifically, we critically examined: (a) equity integration strategies; (b) intervention reach; (c) effectiveness; and (d) potential social determinants of engagement relating to the World Health Organization's conceptual framework. Methods:Arksey and O'Malley's scoping review protocol was used to develop a comprehensive search strategy and identify relevant academic and grey literatures, which were screened using pre-defined inclusion and exclusion criteria. Data were organised by Cochrane PROGRESS-Plus equity characteristics and a narrative summary was presented for each thematic area. Findings:Sixty-two publications were included. Key findings were: (a) some evidence of targeted intervention trials. Large-scale national programmes were tailored to regional activity and health needs, which may contribute toward addressing inequities. However, participant demographics seldom informed reported analyses; (b) participation was more likely among white, more socioeconomically advantaged, middle-to-older aged, female and able-bodied adults; (c) positive physical and psychological outcomes were unlikely to extend along social gradients; and (d) interventions primarily addressed intermediary determinants (e.g. psychosocial barriers; material resource). Social capital (e.g. friend-making) was identified as potentially important for addressing physical activity inequalities. Conclusions:The published literature on outdoor walking groups leaves unanswered questions regarding participation inequalities, with implications for future physical activity promotion. Currently, participation in outdoor walking groups is typically more prevalent among advantaged subpopulations. We make recommendations for research and practice to address these issues, as well as aid the translation of existing knowledge into practice. We advocate increased focus on the social determinants of engagement. A more consistent approach to collecting and analysing participant socio-demographic data is required. Our findings also support recommendations that appropriate tailoring of universal programmes to community needs and embedding strategies to increase social cohesion are important in developing equitable programmes.

Dataset Information

Do Inequalities in Neighborhood Walkability Drive Disparities in Older Adults' Outdoor Walking?

Publications

Do Inequalities in Neighborhood Walkability Drive Disparities in Older Adults' Outdoor Walking?

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