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Published in: Population Health Metrics 1/2017

Open Access 01-12-2017 | Research

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

Authors: Darren J. Mayne, Geoffrey G. Morgan, Bin B. Jalaludin, Adrian E. Bauman

Published in: Population Health Metrics | Issue 1/2017

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Abstract

Background

Individual-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.

Methods

Data 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.

Results

Within-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.

Conclusions

Walkability 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.
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Metadata
Title
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
Authors
Darren J. Mayne
Geoffrey G. Morgan
Bin B. Jalaludin
Adrian E. Bauman
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Population Health Metrics / Issue 1/2017
Electronic ISSN: 1478-7954
DOI
https://doi.org/10.1186/s12963-017-0149-x

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