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

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Despite 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 Findings

          Participants 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).

          Conclusions

          Residing 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.

          Abstract

          Garry Bennett and colleagues measured exercise levels and obtained opinions on neighborhood safety. They concluded that residing in a neighborhood perceived to be unsafe at night is a barrier to regular physical activity.

          Editors' Summary

          Background.

          Nowadays we are all encouraged to do more physical activity, as it has been shown that inactivity increases the risk of many medical conditions, including obesity, heart attacks, and strokes. Inactive people die younger. Previous research has shown that people on a low income and those from ethnic or racial minorities have the lowest activity levels. There are, however, many barriers to being active. It has been claimed that people who live in neighborhoods that are unsafe face particular difficulties. They might want to walk, cycle, or take other forms of outdoor exercise near their home, but they fear they would be injured as a result of a violent attack. It is usually the poorest members of society who live in unsafe areas. It is also known that those poor people who belong to minority racial or ethnic groups are particularly likely to feel unsafe.

          Why Was This Study Done?

          The researchers who did this study wanted to find out whether people in a low-income urban area in the US considered themselves to be unsafe in their neighborhood, and how much physical activity they took part in. Their aim was to establish whether there was an association between the perceived safety level and the amount of activity taken, or if the two were unrelated. Other researchers have tried to look for such an association before, but they have usually relied on how much activity people say they remember taking, not on the actual measured amount. The results from such research have been very varied and inconclusive.

          What Did the Researchers Do and Find?

          Working in one low-income district of one US city (Boston), they found over 1,000 people to participate in their study, most of whom were from ethnic minorities. They asked them the question: “How safe do you feel walking alone in your neighborhood?” Response options included “safe,” “a little unsafe,” and “unsafe.” The same question was asked about walking alone in the daylight and walking alone after dark. The people in the study also agreed to wear a pedometer for five days. This instrument measures the number of steps that the wearer takes. It is thus a much more accurate way of finding out about activity levels than asking people how much activity they think they have engaged in.

          Four out of five people said they did feel safe during the day, but there was no association between daytime safety and physical activity. This was the case for both men and women. Two-thirds of the people in the study felt unsafe in the night-time. There was no association between perceived night-time safety and physical activity among men, but women who reported feeling unsafe at night took around 1,000 fewer steps per day than other women. That amounts to around 20% less physical activity.

          What Do These Findings Mean?

          Even the women who felt safe at night were only taking around 5,000 steps per day, around half of what the US Surgeon General recommends for good health. So all the women in the study would benefit from more physical activity. However, the much lower amount of activity of the women who felt unsafe does suggest that a perceived lack of safety is an important factor, which could increase the risks to their health. It is interesting that the association between perceived safety and activity was not found in men and only applied to night-time safety. However, the authors argue that their findings provide preliminary evidence that perceived low neighborhood safety may serve as a barrier to physical activity in low-income areas. They discuss in the article the need for further research.

          Additional Information.

          Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0040306.

          • The UK National Health Service publishes the online NHS Direct Health Encyclopedia, which describes the benefits of exercise and gives recommendations

          • Information on exercise may also be found on MedlinePlus, a service of the US National Library of Medicine and the National Institutes of Health

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          Most cited references75

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          Environmental factors associated with adults' participation in physical activity: a review.

          N Humpel (2002)
          Promoting physical activity is a public health priority, and changes in the environmental contexts of adults' activity choices are believed to be crucial. However, of the factors associated with physical activity, environmental influences are among the least understood. Using journal scans and computerized literature database searches, we identified 19 quantitative studies that assessed the relationships with physical activity behavior of perceived and objectively determined physical environment attributes. Findings were categorized into those examining five categories: accessibility of facilities, opportunities for activity, weather, safety, and aesthetic attributes. Accessibility, opportunities, and aesthetic attributes had significant associations with physical activity. Weather and safety showed less-strong relationships. Where studies pooled different categories to create composite variables, the associations were less likely to be statistically significant. Physical environment factors have consistent associations with physical activity behavior. Further development of ecologic and environmental models, together with behavior-specific and context-specific measurement strategies, should help in further understanding of these associations. Prospective studies are required to identify possible causal relationships.
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            How many steps/day are enough? Preliminary pedometer indices for public health.

            Pedometers are simple and inexpensive body-worn motion sensors that are readily being used by researchers and practitioners to assess and motivate physical activity behaviours. Pedometer-determined physical activity indices are needed to guide their efforts. Therefore, the purpose of this article is to review the rationale and evidence for general pedometer-based indices for research and practice purposes. Specifically, we evaluate popular recommendations for steps/day and attempt to translate existing physical activity guidelines into steps/day equivalents. Also, we appraise the fragmented evidence currently available from associations derived from cross-sectional studies and a limited number of interventions that have documented improvements (primarily in body composition and/or blood pressure) with increased steps/day.A value of 10000 steps/day is gaining popularity with the media and in practice and can be traced to Japanese walking clubs and a business slogan 30+ years ago. 10000 steps/day appears to be a reasonable estimate of daily activity for apparently healthy adults and studies are emerging documenting the health benefits of attaining similar levels. Preliminary evidence suggests that a goal of 10000 steps/day may not be sustainable for some groups, including older adults and those living with chronic diseases. Another concern about using 10000 steps/day as a universal step goal is that it is probably too low for children, an important target population in the war against obesity. Other approaches to pedometer-determined physical activity recommendations that are showing promise of health benefit and individual sustainability have been based on incremental improvements relative to baseline values. Based on currently available evidence, we propose the following preliminary indices be used to classify pedometer-determined physical activity in healthy adults: (i). or=10000 steps/day indicates the point that should be used to classify individuals as 'active'. Individuals who take >12500 steps/day are likely to be classified as 'highly active'.
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              Perceived and objective environmental measures and physical activity among urban adults.

              Enhancing community environments to support walking and bicycling serves as a promising approach to increase population levels of physical activity. However, few studies have simultaneously assessed perceptions and objectively measured environmental factors and their relative association with transportation or recreational physical activity. For this cross-sectional study, high- and low-income study areas were selected among census tracts in St. Louis MO ("low-walkable" city) and Savannah GA ("high-walkable" city). Between February and June 2002, a telephone survey of 1068 adults provided measures of the perceived environment and physical activity behavior. In this timeframe, objective measures were collected through environmental audits of all street segments (n =1158). These measures were summarized using 400-m buffers surrounding each respondent. Neighborhood characteristics included the land use environment, transportation environment, recreational facilities, aesthetics, and social environment. Associations were examined between neighborhood features and transportation- and recreation-based activity. After adjusting for age, gender, and education, transportation activity was negatively associated with objective measures of sidewalk levelness and perceived and objective neighborhood aesthetics. It was positively associated with perceived and objectively measured number of destinations and public transit, perceived access to bike lanes, and objective counts of active people in the neighborhood. Recreational activity was positively associated with perceived access to recreational facilities and objective measures of attractive features. These findings indicate that physical activities for transportation or recreational are associated with different perceived and objective environmental characteristics. Modifications to these features may change the physical activity behavior of residents exposed to them.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS Med
                pmed
                PLoS Medicine
                Public Library of Science (San Francisco, USA )
                1549-1277
                1549-1676
                October 2007
                23 October 2007
                : 4
                : 10
                : e306
                Affiliations
                [1 ] Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
                [2 ] Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America
                [3 ] Department of Health Disparities Research, University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States of America
                [4 ] Department of Surgery, Washington University School of Medicine, St Louis, Missouri, United States of America
                [5 ] Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts, United States of America
                Institut de Médecine Sociale et Preventive, Switzerland
                Author notes
                * To whom correspondence should be addressed. E-mail: gary_bennett@ 123456dfci.harvard.edu
                Article
                07-PLME-RA-0209R2 plme-04-10-11
                10.1371/journal.pmed.0040306
                2039759
                17958465
                6a4a5a5b-ecd8-4e98-946d-0d2579bdc9d8
                Copyright: © 2007 Bennett et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 28 March 2007
                : 7 September 2007
                Page count
                Pages: 9
                Categories
                Research Article
                Cardiovascular Disorders
                Diabetes and Endocrinology
                Public Health and Epidemiology
                Epidemiology
                Public Health
                Health Policy
                Obesity
                Diabetes
                Custom metadata
                Bennett GG, McNeill LH, Wolin KY, Duncan DT, Puleo E, et al. (2007) Safe to walk? Neighborhood safety and physical activity among public housing residents. PLoS Med 4(10): e306. doi: 10.1371/journal.pmed.0040306

                Medicine
                Medicine

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