The potential for walkability to narrow neighbourhood socioeconomic inequalities in physical function: A case study of middle-aged to older adults in Brisbane,Australia

Residents of disadvantaged neighbourhoods have poorer physical function than their advantaged counterparts, although the reasons for this remain largely unknown. We examined the moderating effects of walkability in the relationship between neighbourhood disadvantage and physical function using 2013 cross-sectional data from 5115 individuals aged 46–72 living in 200 neighbourhoods in Brisbane, Australia. The relationship between neighbourhood disadvantage and physical function differed by levels of walkability: positive associations as levels of walkability increased for those living in more disadvantaged neighbourhoods, and no difference for those living in more advantaged neighbourhoods. Further work is required to better understand the underlying mechanisms.     

Can the built environment reduce health inequalities? A study of neighbourhood socioeconomic disadvantage and walking for transport

Residents of socioeconomically disadvantaged neighbourhoods are more likely to walk for transport than their counterparts in advantaged neighbourhoods; however, the reasons for higher rates of transport walking in poorer neighbourhoods remain unclear. We investigated this issue using data from the HABITAT study of physical activity among 11,037 mid-aged residents of 200 neighbourhoods in Brisbane, Australia. Using a five-step mediation analysis and multilevel regression, we found that higher levels of walking for transport in disadvantaged neighbourhoods was associated with living in a built environment more conducive to walking (i.e. greater street connectivity and land use mix) and residents of these neighbourhoods having more limited access to a motor vehicle. The health benefits that accrue to residents of disadvantaged neighbourhoods as a result of their higher levels of walking for transport might help offset the negative effects of less healthy behaviours (e.g. smoking, poor diet), thus serving to contain or reduce neighbourhood inequalities in chronic disease.     

Associations between physical activity and the neighbourhood social environment: baseline results from the HABITAT multilevel study

Limitations have arisen when measuring associations between the neighbourhood social environment and physical activity, including same-source bias, and the reliability of aggregated neighbourhood-level social environment measures. This study examines cross-sectional associations between the neighbourhood social environment (perceptions of incivilities, crime, and social cohesion) and self-reported physical activity, while accounting for same-source bias and reliability of neighbourhood-level exposure measures, using data from a large population-based clustered sample. This investigation included 11,035 residents aged 40–65 years from 200 neighbourhoods in Brisbane, Australia, in 2007. Respondents self-reported their physical activity and perceptions of the social environment (neighbourhood incivilities, crime and safety, and social cohesion). Models were adjusted for individual-level education, occupation, and household income, and neighbourhood disadvantage. Exposure measures were generated via split clusters and an empirical Bayes estimation procedure. Data were analysed in 2016 using multilevel multinomial logistic regression. Residents of neighbourhoods with the highest incivilities and crime, and lowest social cohesion were reference categories. Individuals were more likely to be in the higher physical activity categories if they were in neighbourhoods with the lowest incivilities and the lowest crime. No associations were found between social cohesion and physical activity. This study provides a basis from which to gain a clearer understanding of the relationship between the neighbourhood social environment and individual physical activity. Further work is required to explore the pathways between perceptions of the neighbourhood social environment and physical activity.     

Accessibility and connectivity in physical activity studies: the impact of missing pedestrian data

OBJECTIVE: One important characteristic in physical activity research into the built environment is network connectivity, usually calculated using street networks. However, a true pedestrian network may have very different connectivity than a street network. This study, conducted in 2004, examines the difference in walkability analyses when street networks versus pedestrian networks are used for four metropolitan suburbs in Perth, Western Australia. METHODS: A street network of Perth was used to represent the current standard of data for walkability analyses. Aerial photography from 2003 was used to create a pedestrian network, which incorporated pedestrian footpaths into the street network. The street and pedestrian networks were compared using three measures of connectivity: Pedsheds, link node ratio and pedestrian route directness. RESULTS: A comparison of the results using street versus pedestrian networks showed very different outcomes for conventional neighbourhood designs. Connectivity measures for conventional neighbourhoods improved up to 120% with the addition of pedestrian networks, although traditional neighbourhoods still had slightly better connectivity values overall. CONCLUSION: The true pedestrian network increases the connectivity of a neighbourhood and may have significant impact on these measures, especially in neighbourhoods with conventional street designs. It is critical that future studies incorporate pedestrian networks into their analyses.     

Understanding the role of urban social and physical environment in opioid overdose events using found geospatial data

Opioid use disorder is a serious public health crisis in the United States. Manifestations such as opioid overdose events (OOEs) vary within and across communities and there is growing evidence that this variation is partially rooted in community-level social and economic conditions. The lack of high spatial resolution, timely data has hampered research into the associations between OOEs and social and physical environments. We explore the use of non-traditional, “found” geospatial data collected for other purposes as indicators of urban social-environmental conditions and their relationships with OOEs at the neighborhood level. We evaluate the use of Google Street View images and non-emergency “311” service requests, along with US Census data as indicators of social and physical conditions in community neighborhoods. We estimate negative binomial regression models with OOE data from first responders in Columbus, Ohio, USA between January 1, 2016, and December 31, 2017. Higher numbers of OOEs were positively associated with service request indicators of neighborhood physical and social disorder and street view imagery rated as boring or depressing based on a pre-trained random forest regression model. Perceived safety, wealth, and liveliness measures from the street view imagery were negatively associated with risk of an OOE. Age group 50–64 was positively associated with risk of an OOE but age 35–49 was negative. White population, percentage of individuals living in poverty, and percentage of vacant housing units were also found significantly positive however, median income and percentage of people with a bachelor’s degree or higher were found negative. Our result shows neighborhood social and physical environment characteristics are associated with likelihood of OOEs. Our study adds to the scientific evidence that the opioid epidemic crisis is partially rooted in social inequality, distress and underinvestment. It also shows the previously underutilized data sources hold promise for providing insights into this complex problem to help inform the development of population-level interventions and harm reduction policies.     

Love thy neighbour? Associations of social capital and crime with physical activity amongst women

Using a multilevel study design, this study examined the associations between social characteristics of individuals and neighbourhoods and physical activity among women. Women (n = 1405) recruited from 45 Melbourne (Australia) neighbourhoods of varying socioeconomic disadvantage provided data on social factors and leisure-time: physical activity; walking; and walking in one’s own neighbourhood. Individual level social factors were number of neighbours known and social participation. Neighbourhood-level social characteristics (interpersonal trust, norms of reciprocity, social cohesion) were derived by aggregating survey data on these constructs within neighbourhoods. Objective data on crimes within neighbourhoods were obtained from Victoria Police. In bivariable regression models, all social variables at both the individual and neighbourhood level were positively associated with odds of physical activity, walking, and walking in one’s own neighbourhood. Associations with individual social participation (associated with all three physical activity variables) and neighbourhood interpersonal trust (associated with overall physical activity only) remained significant in multivariable models. Neither neighbourhood crime against the person nor incivilities were associated with any form of physical activity. These results demonstrate that women who participated in local groups or events and, less consistently, women living in neighbourhoods where residents trusted one another, were more likely to participate in leisure-time physical activity. While redressing macro-level social and economic policies that contribute to neighbourhood inequalities remains a priority, public health initiatives aimed at promoting physical activity could consider focusing on fostering social interactions targeting both individuals and communities. Further investigation of causal mechanisms underlying these associations is required.     

Multilevel modelling of built environment characteristics related to neighbourhood walking activity in older adults

OBJECTIVE: To examine the relation between built environment factors (representing several dimensions of urban form of neighbourhoods) and walking activity at both the neighbourhood level and the resident level, in an older adult sample. DESIGN, SETTING, PARTICIPANTS: A cross sectional, multilevel design with neighbourhoods as the primary sampling unit and senior residents as the secondary unit. Five hundred and seventy seven residents (mean age = 74 years, SD = 6.3 years) participated in the survey, which was conducted among 56 city defined neighbourhoods in Portland, Oregon, USA. Neighbourhood level variables were constructed using geographical information systems. Resident level variables consisted of a mix of self reports and geocoded data on the built environment. MAIN OUTCOME MEASURE: Self reported neighbourhood walking. MAIN RESULTS: A positive relation was found between built environment factors (density of places of employment, household density, green and open spaces for recreation, number of street intersections) and walking activity at the neighbourhood level. At the resident level, perceptions of safety for walking and number of nearby recreational facilities were positively related to high levels of walking activity. A significant interaction was observed between number of street intersections and perceptions of safety from traffic. CONCLUSIONS: Certain neighbourhood built environment characteristics related to urban form were positively associated with walking activity in the neighbourhoods of senior residents. Public health promotion of walking activity/urban mobility and the design of interventions need to consider the contribution of neighbourhood level built environment influences.     

Contribution of neighbourhood socioeconomic status and physical activity resources to physical activity among women

INTRODUCTION: Residence in a deprived neighbourhood is associated with lower rates of physical activity. Little is known about the manifestation of deprivation that mediates this relationship. This study aimed to investigate whether access to physical activity resources mediated the relationship between neighbourhood socioeconomic status and physical activity among women. METHOD: Individual data from women participating in the Stanford Heart Disease Prevention Program (1979-90) were linked to census and archival data from existing records. Multilevel regression models were examined for energy expenditure and moderate and vigorous physical activity as reported in physical activity recalls. RESULTS: After accounting for individual-level socioeconomic status, women who lived in lower-socioeconomic status neighbourhoods reported greater energy expenditure, but undertook less moderate physical activity, than women in moderate-socioeconomic status neighbourhoods. In contrast, women living in higher-socioeconomic status neighbourhoods reported more vigorous physical activity than women in moderate-socioeconomic status neighbourhoods. Although availability of physical activity resources did not appear to mediate any neighbourhood socioeconomic status associations, several significant interactions emerged, suggesting that women with low income or who live in lower-socioeconomic status neighbourhoods may differentially benefit from greater physical activity resource availability. DISCUSSION: Although we found expected relationships between residence in a lower-socioeconomic status neighbourhood and undertaking less moderate or vigorous physical activity among women, we also found that these same women reported greater overall energy expenditure, perhaps as a result of greater work or travel demands. Greater availability of physical activity resources nearby appears to differentially benefit women living in lower-socioeconomic status neighbourhoods and low-income women, having implications for policy-making and planning.     

Neighbourhood inequalities in physical inactivity: the role of neighbourhood attractiveness, proximity to local facilities and safety in the Netherlands

We investigated the association between the neighbourhood socioeconomic environment and physical inactivity, and explored the contribution of neighbourhood characteristics to this association. Data were analysed of 20-69 years old participants of the Dutch GLOBE study who lived in 78 neighbourhoods of Eindhoven (n = 8.767). The neighbourhood socioeconomic environment was assessed from aggregated self-reported information of participants' education and occupation level, and employment status. Aspects of physical inactivity investigated were based on the time spent on (a) walking and cycling to shops or work, (b) walking, cycling and gardening in leisure time, and (c) participation in sports activities. Characteristics of neighbourhoods included the proximity to food shops, general physical design of neighbourhoods, quality of green facilities, noise pollution from traffic and required police attention as evaluated by municipal services (professionals) responsible for these characteristics. Compared to those living in the most advantaged neighbourhoods, residents living in the quartile of socio-economically most disadvantaged neighbourhoods were more likely to walk or cycle to shops or work, but less likely to walk, cycle or garden in leisure time and less likely to participate in sports activities (adjusted for age, sex and individual educational level). Neighbourhood inequalities in walking or cycling to shops or work were not mediated by specific neighbourhood characteristics included in our analyses. The increased probability of almost never walking, cycling and gardening in leisure time in the most disadvantaged neighbourhoods was partly mediated by a poorer general physical design in these neighbourhoods. Similarly, the increased probability of almost never participating in sports activities in the most disadvantaged neighbourhoods was partly mediated by larger amounts of required police attention. The direction of neighbourhood inequalities differs for aspects of physical inactivity. Neighbourhood characteristics are related to physical inactivity and contribute to neighbourhood socioeconomic inequalities in physical inactivity.     

Neighbourhood disadvantage and smoking: Examining the role of neighbourhood-level psychosocial characteristics

PurposeThis study aims to determine if neighbourhood psychosocial characteristics contribute to inequalities in smoking among residents from neighbourhoods of differing socioeconomic disadvantage.MethodsThis cross-sectional study includes 11,035 residents from 200 neighbourhoods in Brisbane, Australia in 2007. Self-reported measures were obtained for smoking and neighbourhood psychosocial characteristics (perceptions of incivilities, crime and safety, and social cohesion). Neighbourhood socioeconomic disadvantage was measured using a census-derived index. Data were analysed using multilevel logistic regression random intercept models.ResultsSmoking was associated with neighbourhood disadvantage; this relationship remained after adjustment for individual-level socioeconomic position. Area-level perceptions of crime and safety and social cohesion were not independently associated with smoking, and did not explain the higher prevalence of smoking in disadvantaged areas; however, perceptions of incivilities showed an independent effect.ConclusionsSome neighbourhood psychosocial characteristics seem to contribute to the higher rates of smoking in disadvantaged areas.     

Compact cities and the Covid-19 pandemic: Systematic review of the associations between transmission of Covid-19 or other respiratory viruses and population density or other features of neighbourhood design

Living in compact neighbourhoods that are walkable, well connected, with accessible green space can benefit physical and mental health. However, the pandemic raises concern up to what extent features of compact neighbourhood design affect transmission of viral respiratory infections. We conducted a systematic review to identify, appraise and synthesise evidence reporting associations between transmission of respiratory viruses, including Covid-19, and dwelling or population density or other features of neighbourhood design. Twenty-one studies met our inclusion criteria. These studies used different measures of neighbourhood design, contributing to inconsistent findings. Whereas no convincing conclusion can be drawn here, the outcome of this review indicates that robust, global evidence is warranted to inform future policies and legislation concerned with compact neighbourhood design and transmission of respiratory and viral infection.     

Using Google Earth to Assess Shade for Sun Protection in Urban Recreation Spaces: Methods and Results

Shade in public spaces can lower the risk of and sun burning and skin cancer. However, existing methods of auditing shade require travel between sites, and sunny weather conditions. This study aimed to evaluate the feasibility of free computer software—Google Earth—for assessing shade in urban open spaces. A shade projection method was developed that uses Google Earth street view and aerial images to estimate shade at solar noon on the summer solstice, irrespective of the date of image capture. Three researchers used the method to separately estimate shade cover over pre-defined activity areas in a sample of 45 New Zealand urban open spaces, including 24 playgrounds, 12 beaches and 9 outdoor pools. Outcome measures included method accuracy (assessed by comparison with a subsample of field observations of 10 of the settings) and inter-rater reliability. Of the 164 activity areas identified in the 45 settings, most (83%) had no shade cover. The method identified most activity areas in playgrounds (85%) and beaches (93%) and was accurate for assessing shade over these areas (predictive values of 100%). Only 8% of activity areas at outdoor pools were identified, due to a lack of street view images. Reliability for shade cover estimates was excellent (intraclass correlation coefficient of 0.97, 95% CI 0.97–0.98). Google Earth appears to be a reasonably accurate and reliable and shade audit tool for playgrounds and beaches. The findings are relevant for programmes focused on supporting the development of healthy urban open spaces.     

Neighbourhood and individual socioeconomic inequalities in smoking: the role of physical neighbourhood stressors

OBJECTIVE: To explore the association between physical neighbourhood stressors and smoking, and the contribution of these stressors to neighbourhood and individual socioeconomic inequalities in smoking. METHODS: Data were analysed of participants of the baseline measurement of the Dutch GLOBE study (1991), aged 20 years and older, who lived in 79 neighbourhoods of the city of Eindhoven (n = 9062). The neighbourhood socioeconomic environment was assessed from aggregated self reported information of participants' education and occupation level, and employment status. Neighbourhood stressors included were the physical quality (decay), required police attention, noise pollution from traffic, and population density in neighbourhoods. Current smokers were distinguished from previous and never smokers. RESULTS: Compared with those living in the most advantaged neighbourhoods, residents living in the socioeconomically most disadvantaged neighbourhoods were more likely to smoke (adjusted for age, sex, education, occupation, and employment status) (OR = 1.24, 95% CI 1.05 to 1.46). An increase in a summary neighbourhood stressor score was associated with smoking, independently of the neighbourhood socioeconomic environment (OR = 1.57, 95% CI 1.11 to 2.21, in the neighbourhoods with the highest stress score). Adjustment for the score substantially reduced the odds ratio for living in the socioeconomic most disadvantaged neighbourhoods (OR = 1.03, 95% CI 0.84 to 1.28, for those in the most disadvantaged neighbourhoods). Neighbourhood stressors contributed 10% to the increased probability of smoking in the lowest educated persons. CONCLUSIONS: Physical neighbourhood stressors are related to smoking and contribute substantially to neighbourhood inequalities in smoking over and above individual level characteristics.     

Physical activity among elderly people in a city population: the influence of neighbourhood level violence and self perceived safety

STUDY OBJECTIVE: To study the associations between neighbourhood level violence/fear of violence and physical activity among elderly people, accounting for somatic health. DESIGN: Self reported data from the Oslo health study, a cross sectional study conducted in 2000, were linked with sociodemographic and social security data from Statistics Norway. A multilevel regression analysis was conducted by MlwiN using contextual level variables provided by the Oslo City Council. SETTING: Oslo, Norway. PARTICIPANTS: 3499 inhabitants aged 74/5 (53.2% of all invitees). MAIN RESULTS: 20.5% of the elderly were physically active less than one hour a week. Somatic health was clearly associated with physical activity among both men and women. Neighbourhood level violence was associated with physical activity only for men, while fear of violence was only associated with physical activity for women. Differences in somatic health did not explain differences in physical activity between neighbourhoods. These differences were explained by socioeconomic variables, and neighbourhood level violence/fear of violence. CONCLUSIONS: In a sample of presumably healthy 75/76 year olds in Oslo, the associations between neighbourhood level violence and physical activity (among men), and fear of violence and physical activity (among women), are of the same sizes as those between somatic health and physical activity. These two dimensions of violence have, in contrast with somatic health, an explanatory function in exploring differences in physical activity between neighbourhoods in Oslo.     

Google street view image availability in the Bronx and San Diego, 2007–2020: Understanding potential biases in virtual audits of urban built environments

Google Street View’s ‘Time Machine’ feature holds promise for longitudinal street audits of built and natural environments for urban health research. As images are only available when Google collected data, differential image availability over time and place could bias audit data quality. We assessed image availability at 2000 randomly selected locations within the Bronx and San Diego from which Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants were recruited. In the Bronx, a mean of 7.4 images (95% CI: 7.2,7.5) were available at each location, and 63% of those locations had imagery in 2007 and 2019. In San Diego, fewer images were available (mean 5.4, 95% CI: 5.2,5.6) especially on minor streets (mean 4.4, 95% CI: 4.1,4.6). Image availability was more spatially clustered in San Diego (Moran’s I 0.14) than the Bronx (Moran’s I 0.04). Differential image availability may affect precision of neighborhood change estimates assessed by longitudinal virtual audit.     

Neighbourhood deprivation and the cost of accessing gyms and fitness centres: National study in Wales

It has been hypothesised that residents of deprived neighbourhoods have poorer economic access to physical activity resources, inhibiting physical activity. Here we explore whether the cost of accessing gyms and fitness centres varies by neighbourhood deprivation in Wales. The location of gyms and fitness suites were obtained, and a telephone survey of all facilities was conducted to collect entry price data. We tested associations between neighbourhood deprivation and mean entry prices for public and private facilities. The cost of accessing private facilities is lower in deprived versus affluent neighbourhoods, whereas costs are similar across all deprivation categories for public facilities.     

Are residents of downtown Toronto influenced by their urban neighbourhoods? Using concept mapping to examine neighbourhood characteristics and their perceived impact on self-rated mental well-being

ABSTRACT: BACKGROUND: There is ample evidence that residential neighbourhoods can influence mental well-being (MWB), with most studies relying on census or similar data to characterize communities. Few studies have actively investigated local residents' perceptions. METHODS: Concept mapping was conducted with residents from five Toronto neighbourhoods representing low income and non-low income socio-economic groups. These residents participated in small groups and attended two sessions per neighbourhood. The first session (brainstorming) generated neighbourhood characteristics that residents felt influenced their MWB. A few weeks later, participants returned to sort these neighbourhood characteristics and rate their relative importance in affecting residents' 'good' and 'poor' MWB. The data from the sorting and rating groups were analyzed to generate conceptual maps of neighbourhood characteristics that influence MWB. RESULTS: While agreement existed on factors influencing poor MWB (regardless of neighbourhood, income, gender and age), perceptions related to factors affecting good MWB were more varied. For example, women were more likely to rank physical beauty of their neighbourhood and range of services available as more important to good MWB, while men were more likely to cite free access to computers/internet and neighbourhood reputation as important. Low-income residents emphasized aesthetic attributes and public transportation as important to good MWB, while non-low-income residents rated crime, negative neighbourhood environment and social concerns as more important contributors to good MWB. CONCLUSION: These findings contribute to the emerging literature on neighbourhoods and MWB, and inform urban planning in a Canadian context.     

Individual,social and environmental correlates of physical activity among women living in socioeconomically disadvantaged neighbourhoods

Women living in socioeconomically disadvantaged neighbourhoods are at heightened risk for physical inactivity, but little is known about the correlates of physical activity among this group. Using a social-ecological framework, this study aimed to determine the individual, social and neighbourhood environmental correlates of physical activity amongst women living in such neighbourhoods. During 2007–2008 women (n = 4108) aged 18–45 years randomly selected from urban and rural neighbourhoods of low socioeconomic status in Victoria, Australia completed the International Physical Activity Questionnaire (long). They reported on individual (self-efficacy, enjoyment, intentions, outcome expectancies, skills), social (childcare, social support from family and friends/colleagues, dog ownership) and neighbourhood environmental (neighbourhood cohesion, aesthetics, personal safety, ‘walking environment’) factors. Multinomial logistic regression was used to examine the odds of increasing categories of leisure time physical activity (LTPA) and transport-related physical activity (TRPA) for each individual, social and environmental factor. In partially adjusted analyses, all individual, social and environmental variables were positively associated with LTPA, while all individual factors, family and friend support and the walking environment were positively associated with TRPA. In fully adjusted multivariable models, all individual and social factors remained significantly associated with LTPA, while self-efficacy, enjoyment, intentions, social support, and neighbourhood ‘walking environment’ variables remained significantly associated with TRPA. In conclusion, individual and social factors were most important for LTPA, while individual, social and neighbourhood environmental factors were all associated with TRPA. Acknowledging the cross-sectional design, the findings highlight the importance of different levels of potential influence on physical activity in different domains, which should be considered when developing strategies to promote physical activity amongst women living in socioeconomically disadvantaged neighbourhoods.     

Residents' perceptions of walkability attributes in objectively different neighbourhoods: a pilot study

Physical attributes of local environments may influence walking. We used a modified version of the Neighbourhood Environment Walkability Scale to compare residents' perceptions of the attributes of two neighbourhoods that differed on measures derived from Geographic Information System databases. Residents of the high-walkable neighbourhood rated relevant attributes of residential density, land-use mix (access and diversity) and street connectivity, consistently higher than did residents of the low-walkable neighbourhood. Traffic safety and safety from crime attributes did not differ. Perceived neighbourhood environment characteristics had moderate to high test-retest reliabilities. Neighbourhood environment attribute ratings may be used in population surveys and other studies.     

Neighbourhood built environment and physical function among mid-to-older aged adults: A systematic review

This systematic review included 23 quantitative studies that estimated associations between aspects of the neighbourhood built environment and physical function among adults aged ≥45 years. Findings were analysed according to nine aspects of the neighbourhood built environment: walkability, residential density, street connectivity, land use mix, public transport, pedestrian infrastructure, aesthetics, safety and traffic. Evidence was found for a positive association of pedestrian infrastructure and aesthetics with physical function, while weaker evidence was found for land use mix, and safety from crime and traffic. There was an insufficient number of studies for walkability, residential density, street connectivity and access to public transport.