Dataset Information

Does time spent in the residential neighbourhood moderate the relationship between neighbourhood walkability and transport-related walking? a cross-sectional study from Toronto, Canada.

ABSTRACT:

Objectives

Studies have investigated the influence of neighbourhood walkability on residents' walking behaviour, aiming to increase physical activity and reduce dependence on automobiles. Previous research, however, has not considered how the amount of time spent in the residential neighbourhood may modify this relationship. Our objective was to determine how time spent in the residential neighbourhood affects the relationship between neighbourhood walkability and walking for transport.

Design

Using a cross-sectional sample of 2411 adults, we analysed the association between walkability (an index combining land-use mix, dwelling density and street connectivity) and transport-related walking (controlling for the effects of gender, age, income, self-rated health and regular access to private transport) testing for interactions by time spent in the neighbourhood.

Primary outcome measure

Minutes spent walking for transport per week.

Setting

Toronto, Canada.

Participants

Participants were aged 25 to 65. The survey had a 72% response rate.

Results

After adjusting for potential confounders, the walkability index was weakly associated with walking (1 SD of walkability score is associated with 0.25 more minutes walking/week, p<0.01). Land-use mix was more strongly associated with walking than the walkability index. Time spent at the residential neighbourhood modified the relationship between land-use mix and transport-related walking in a dose-effect manner (p<0.01), those spending 5?hours on average at their residential neighbourhood have 0.2?min/day more walking for each additional land-use mix score and those spending 12?hours have 0.5?min/day more walking for each additional land-use mix score.

Conclusions

Our findings suggest that walkability is associated with increased walking time, but it is modified by time spent in the neighbourhood. Our study underscores the importance of testing 'time spent in the neighbourhood' as a modifier of environmental exposures in studies of environmental correlates of walking.

SUBMITTER: Chum A

PROVIDER: S-EPMC6500339 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Does time spent in the residential neighbourhood moderate the relationship between neighbourhood walkability and transport-related walking? a cross-sectional study from Toronto, Canada.

Chum Antony A Atkinson Peter P O'Campo Patricia P

BMJ open 20190403 4

<h4>Objectives</h4>Studies have investigated the influence of neighbourhood walkability on residents' walking behaviour, aiming to increase physical activity and reduce dependence on automobiles. Previous research, however, has not considered how the amount of time spent in the residential neighbourhood may modify this relationship. Our objective was to determine how time spent in the residential neighbourhood affects the relationship between neighbourhood walkability and walking for transport.< ...[more]

PMID: 30948565

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Project description:ObjectiveTo determine whether neighbourhood walkability is associated with clinical measures of obesity, hypertension, diabetes and dyslipidaemia in an urban adult population.DesignObservational cross-sectional study.SettingUrban primary care patients.Participants78?023 Toronto residents, aged 18?years and over, who were formally rostered or had at least 2 visits between 2012 and 2014 with a primary care physician participating in the University of Toronto Practice Based Research Network (UTOPIAN), within the Canadian Primary Care Sentinel Surveillance Network (CPCSSN).Main outcome measuresDifferences in average body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, haemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglyceride between residents in the highest versus the lowest quartile of neighbourhood walkability, as estimated using multivariable linear regression models and stratified by age. Outcomes were objectively measured and were retrieved from primary care electronic medical records. Models adjusted for age, sex, smoking, medications, medical comorbidities and indices of neighbourhood safety and marginalisation.ResultsCompared with those in the lowest walkability quartile, individuals in the highest quartile had lower mean BMI (-2.64?kg/m2, 95% CI -2.98 to -2.30; p<0.001), systolic blood pressure (-1.35?mm?Hg, 95% CI -2.01 to -0.70; p<0.001), diastolic blood pressure (-0.60?mm?Hg, 95% CI 1.06 to -0.14; p=0.010) and HbA1c (-0.063%, 95% CI -0.11 to -0.021; p=0.003) and higher mean HDL (0.052?mmol/L, 95% CI 0.029 to 0.075; p<0.001). In age-stratified analyses, differences in the mean BMI were consistently observed for adults aged 18 to under 40 (-4.44?kg/m2, 95% CI -5.09 to -3.79; p<0.001), adults aged 40-65 (-2.74?kg/m2, 95% CI -3.24 to -2.23; p<0.001) and adults aged over 65 (-0.87?kg/m2, 95% CI -1.48 to -0.26; p=0.005).ConclusionsThere was a clinically meaningful association between living in the most walkable neighbourhoods and having lower BMI in adults of all ages.

Project description:The design of suburban communities encourages car dependency and discourages walking, characteristics that have been implicated in the rise of obesity. Walkability measures have been developed to capture these features of urban built environments. Our objective was to examine the individual and combined associations of residential density and the presence of walkable destinations, two of the most commonly used and potentially modifiable components of walkability measures, with transportation, overweight, obesity, and diabetes. We examined associations between a previously published walkability measure and transportation behaviors and health outcomes in Toronto, Canada, a city of 2.6 million people in 2011. Data sources included the Canada census, a transportation survey, a national health survey and a validated administrative diabetes database. We depicted interactions between residential density and the availability of walkable destinations graphically and examined them statistically using general linear modeling. Individuals living in more walkable areas were more than twice as likely to walk, bicycle or use public transit and were significantly less likely to drive or own a vehicle compared with those living in less walkable areas. Individuals in less walkable areas were up to one-third more likely to be obese or to have diabetes. Residential density and the availability of walkable destinations were each significantly associated with transportation and health outcomes. The combination of high levels of both measures was associated with the highest levels of walking or bicycling (p<0.0001) and public transit use (p<0.0026) and the lowest levels of automobile trips (p<0.0001), and diabetes prevalence (p<0.0001). We conclude that both residential density and the availability of walkable destinations are good measures of urban walkability and can be recommended for use by policy-makers, planners and public health officials. In our setting, the combination of both factors provided additional explanatory power.

Dataset Information

Does time spent in the residential neighbourhood moderate the relationship between neighbourhood walkability and transport-related walking? a cross-sectional study from Toronto, Canada.

Objectives

Design

Primary outcome measure

Setting

Participants

Results

Conclusions

Publications

Does time spent in the residential neighbourhood moderate the relationship between neighbourhood walkability and transport-related walking? a cross-sectional study from Toronto, Canada.

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