The contribution of area-level walkability to geographic variation in physical activity: a spatial analysis of 95,837 participants from the 45 and Up Study living in Sydney, Australia

Population Health Metrics

Research

Bin B. Jalaludin¹  Adrian E. Bauman²  Darren J. Mayne³  Geoffrey G. Morgan⁴ 

[1] Ingham Institute, University of New South Wales, 2052, Sydney, NSW, Australia;Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, 1871, Liverpool, NSW, Australia;Sydney School of Public Health, The University of Sydney, 2006, Camperdown, NSW, Australia;Sydney School of Public Health, The University of Sydney, 2006, Camperdown, NSW, Australia;Public Health Unit, Illawarra Shoalhaven Local Health District, 2502, Warrawong, NSW, Australia;Graduate School of Medicine, University of Wollongong, 2500, Wollongong, NSW, Australia;Illawarra Health and Medical Research Institute, 2500, Wollongong, NSW, Australia;University Centre for Rural Health - North Coast, School of Public Health, The University of Sydney, 2006, Camperdown, NSW, Australia;

关键词: Disease mapping;    Geographic variation;    Physical activity;    Spatial model;    Walkability;   

DOI  :  10.1186/s12963-017-0149-x

 received in 2016-10-05, accepted in 2017-08-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIndividual-level studies support a positive relation between walkable built environments and participation in moderate-intensity walking. However, the utility of this evidence for population-level planning is less clear as it is derived at much finer spatial scales than those used for regional programming. The aims of this study were to: evaluate if individual-level relations between walkability and walking to improve health manifest at population-level spatial scales; assess the specificity of area-level walkability for walking relative to other moderate and vigorous physical activity (MVPA); describe geographic variation in walking and other MVPA; and quantify the contribution of walkability to this variation.MethodsData on sufficient walking, sufficient MVPA, and high MVPA to improve health were analyzed for 95,837 Sydney respondents to the baseline survey of the 45 and Up Study between January 2006 and April 2010. We used conditional autoregressive models to create smoothed MVPA “disease maps” and assess relations between sufficient MVPA to improve health and area-level walkability adjusted for individual-level demographic, socioeconomic, and health factors, and area-level relative socioeconomic disadvantage.ResultsWithin-cohort prevalence of meeting recommendations for sufficient walking, sufficient MVPA, and high MVPA were 31.7 (95% CI 31.4–32.0), 69.4 (95% CI 69.1–69.7), and 56.1 (95% CI 55.8–56.4) percent. Prevalence of sufficient walking was increased by 1.20 (95% CrI 1.12–1.29) and 1.07 (95% CrI 1.01–1.13) for high and medium-high versus low walkability postal areas, and for sufficient MVPA by 1.05 (95% CrI 1.01–1.08) for high versus low walkability postal areas. Walkability was not related to high MVPA. Postal area walkability explained 65.8 and 47.4 percent of residual geographic variation in sufficient walking and sufficient MVPA not attributable to individual-level factors.ConclusionsWalkability is associated with area-level prevalence and geographic variation in sufficient walking and sufficient MVPA to improve health in Sydney, Australia. Our study supports the use of walkability indexes at multiple spatial scales for informing population-level action to increase physical activity and the utility of spatial analysis for walkability research and planning.

【 授权许可】

CC BY   
© The Author(s) 2017

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