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Hoehner, Christine M.; Handy, Susan L.; Yan, Yan; Blair, Steven N. FACSM; Berrigan, David
1Washington University in St. Louis, St. Louis, MO. 2University of California at Davis, Davis, CA. 3University of South Carolina, Columbia, SC. 4National Cancer Institute, Bethesda, MD.
(No relationships reported)
Many studies have found cross-sectional associations between characteristics of the built environment and physical activity (PA) behavior. However, most are based on self-reported PA, which is known to result in overestimation of PA and differential misclassification by demographic and biological characteristics. Cardiorespiratory fitness (CRF) represents an important objective marker of PA that is causally related to long-term health outcomes. Analysis of the association between CRF and built environment could strengthen arguments for the importance of built environment influences on health.
PURPOSE: To examine the association between neighborhood walkability and CRF and body-mass index (BMI).
METHODS: This cross-sectional analysis included 16,543 adults (5,017 women, 11,526 men) aged 18-90 years with home addresses in Texas who had a comprehensive examination between 1987 and 2005. Three neighborhood walkability factors emerged from principal components analyses of block group measures derived from the U.S. Census. Higher values of all factors correlated with higher predicted neighborhood walkability. Outcomes included CRF from total duration on a maximal exercise treadmill test and measured BMI.
RESULTS: In multilevel adjusted models, the neighborhood walkability factors were significantly associated with CRF and BMI among both men and women. Significant effect estimates for the neighborhood walkability factors ranged in magnitude from B=0.056 to B=0.082 when CRF was the outcome, and from B=-0.185 to B=-0.422 when BMI was the outcome. An interaction between one neighborhood factor and age was also observed. The interaction suggested that living in neighborhoods with older homes and with residents traveling shorter distances to work was more strongly associated with CRF among younger adults and with BMI among older adults.
CONCLUSIONS: Neighborhood characteristics hypothesized to support more PA and less driving were associated with better health outcomes, namely higher levels of CRF and lower BMI. Demonstration of an association between built environment characteristics and CRF is a significant advance over past studies based solely on self-reported PA. Supported by ACS Grant MRSG-07-016-01-CPPB, Applied Research Program of the NCI, and NIH AG06945 and HL62508.
© 2011 American College of Sports Medicine
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