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      One size doesn’t fit all: cross-sectional associations between neighborhood walkability, crime and physical activity depends on age and sex of residents

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          Abstract

          Background

          Low-income African American adults are disproportionately affected by obesity and are also least likely to engage in recommended levels of physical activity (Flegal et al. JAMA 303(3):235-41, 2010; Tucker et al. Am J Prev Med 40(4):454-61, 2011). Moderate-to-vigorous physical activity (MVPA) is an important factor for weight management and control, as well as for reducing disease risk (Andersen et al. Lancet 368(9532):299-304, 2006; Boreham and Riddoch J Sports Sci 19(12):915-29, 2001; Carson et al. PLoS One 8(8):e71417, 2013). While neighborhood greenspace and walkability have been associated with increased MVPA, evidence also suggests that living in areas with high rates of crime limits MVPA. Few studies have examined to what extent the confluence of neighborhood greenspace, walkability and crime might impact MVPA in low-income African American adults nor how associations may vary by age and sex.

          Methods

          In 2013 we collected self-reported data on demographics, functional limitations, objective measures of MVPA (accelerometry), neighborhood greenspace (geographic information system), and walkability (street audit) in 791 predominantly African-American adults (mean age 56 years) living in two United States (U.S.) low-income neighborhoods. We also acquired data from the City of Pittsburgh on all crime events within both neighborhoods. Exposure: To examine cross-sectional associations of neighborhood-related variables (i.e., neighborhood greenspace, walkability and crime) with MVPA, we used zero-inflated negative binomial regression models. Additionally, we examined potential interactions by age (over 65 years) and sex on relationships between neighborhood variables and MVPA.

          Results

          Overall, residents engaged in very little to no MVPA regardless of where they lived. However, for women, but not men, under the age of 65 years, living in more walkable neighborhoods was associated with more time engaged in MVPA in (β = 0.55, p = 0.007) as compared to their counterparts living in less walkable areas. Women and men age 65 years and over spent very little time participating in MVPA regardless of neighborhood walkability. Neither greenspace nor crime was associated with MVPA in age-sex subgroups.

          Conclusions

          Neighborhood walkability may play a stronger role on MVPA than accessible greenspace or crime in low-income urban communities. Walkability may differentially impact residents depending on their age and sex, which suggests tailoring public health policy design and implementation according to neighborhood demographics to improve activity for all.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-016-3959-z) contains supplementary material, which is available to authorized users.

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          Most cited references50

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          Neighborhood environment and physical activity among youth a review.

          Research examining the association between environmental attributes and physical activity among youth is growing. An updated review of literature is needed to summarize the current evidence base, and to inform policies and environmental interventions to promote active lifestyles among young people. A literature search was conducted using the Active Living Research (ALR) literature database, an online database that codes study characteristics and results of published papers on built/social environment and physical activity/obesity/sedentary behavior. Papers in the ALR database were identified through PubMed, Web of Science, and SPORTDiscus using systematically developed and expert-validated search protocols. For the current review, additional inclusion criteria were used to select observational, quantitative studies among youth aged 3-18 years. Papers were categorized by design features, sample characteristics, and measurement mode. Relevant results were summarized, stratified by age (children or adolescents) and mode of measurement (objective or perceived) for environmental attributes and physical activity. Percentage of significant results was calculated. Mode of measurement greatly influenced the consistency of associations between environmental attributes and youth physical activity. For both children and adolescents, the most consistent associations involved objectively measured environmental attributes and reported physical activity. The most supported correlates for children were walkability, traffic speed/volume, access/proximity to recreation facilities, land-use mix, and residential density. The most supported correlates for adolescents were land-use mix and residential density. These findings support several recommendations for policy and environmental change from such groups as the IOM and National Physical Activity Plan. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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            Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans.

            To date, no study has objectively measured physical activity levels among U.S. adults according to the 2008 Physical Activity Guidelines for Americans (PAGA). The purpose of this study was to assess self-reported and objectively measured physical activity among U.S. adults according to the PAGA. Using data from the NHANES 2005-2006, the PAGA were assessed using three physical activity calculations: moderate plus vigorous physical activity ≥150 minutes/week (MVPA); moderate plus two instances of vigorous physical activity ≥150 minutes/week (M2VPA); and time spent above 3 METs ≥500 MET-minutes/week (METPA). Self-reported physical activity included leisure, transportation, and household activities. Objective activity was measured using Actigraph accelerometers that were worn for 7 consecutive days. Analyses were conducted in 2009-2010. U.S. adults reported 324.5 ± 18.6 minutes/week (M ± SE) of moderate physical activity and 73.6 ± 3.9 minutes/week of vigorous physical activity, although accelerometry estimates were 45.1 ± 4.6 minutes/week of moderate physical activity and 18.6 ± 6.6 minutes/week of vigorous physical activity. The proportion of adults meeting the PAGA according to M2VPA was 62.0% for self-report and 9.6% for accelerometry. According to the NHANES 2005-2006, fewer than 10% of U.S. adults met the PAGA according to accelerometry. However, physical activity estimates vary substantially depending on whether self-reported or measured via accelerometer. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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              The built environment and obesity: a systematic review of the epidemiologic evidence.

              We completed a systematic search of the epidemiologic literature on built environment and obesity and identified 63 relevant papers, which were then evaluated for the quality of between-study evidence. We were able to classify studies into one of two primary approaches for defining place and corresponding geographic areas of influence: those based on contextual effects derived from shared pre-determined administrative units and those based on individually unique geographic buffers. The 22 contextual papers evaluated 80 relations, 38 of which did not achieve statistical significance. The 15 buffer papers evaluated 40 relations, 24 of which did not achieve statistical significance. There was very little between-study similarity in methods in both types of approaches, which prevented estimation of pooled effects. The great heterogeneity across studies limits what can be learned from this body of evidence. Copyright 2009 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                arichard@rand.org
                wtroxel@rand.org
                bonnieg@rand.org
                beckman@rand.org
                ghunter@rand.org
                desantis@rand.org
                colabian@umich.edu
                dubowitz@rand.org
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                19 January 2017
                19 January 2017
                2017
                : 17
                : 97
                Affiliations
                [1 ]ISNI 0000 0004 0370 7685, GRID grid.34474.30, , RAND Corporation, Health Division, ; 4570 Fifth Avenue, Pittsburgh, PA 15213 USA
                [2 ]ISNI 0000 0004 0370 7685, GRID grid.34474.30, , RAND Corporation, Health Division, ; Santa Monica, CA 90407-2138 USA
                [3 ]ISNI 0000000086837370, GRID grid.214458.e, , University of Michigan, School of Kinesiology, ; Ann Arbor, MI 48109-2013 USA
                Article
                3959
                10.1186/s12889-016-3959-z
                5248471
                28103842
                f7d0c62e-8c0b-4bbc-b620-78a359e0e26c
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 June 2016
                : 16 December 2016
                Funding
                Funded by: National Heart, Lung, and Blood Institute (US)
                Award ID: R01 HL122460
                Award Recipient :
                Funded by: National Cancer Institute (US)
                Award ID: R01CA164137
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Public health
                physical activity,environment,low-income populations
                Public health
                physical activity, environment, low-income populations

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