Objectives To explore patterns of non-communicable diseases (NCDs) in the Australian Capital Territory (ACT).To ascertain the effect of the neighbourhood built environmental features and especially walkability on health outcomes, specifically for hospital admissions from NCDs.
Design A cross-sectional analysis of public hospital episode data (2007–2013).
Setting Hospitalisations from the ACT, Australia at very small geographic areas.
Participants Secondary data on 75 290 unique hospital episodes representing 39 851 patients who were admitted to ACT hospitals from 2007 to 2013. No restrictions on age, sex or ethnicity.
Main exposure measures Geographic Information System derived or compatible measures of general practitioner access, neighbourhood socioeconomic status, alcohol access, exposure to traffic and Walk Score walkability.
Main outcome measures Hospitalisations of circulatory diseases, specific endocrine, nutritional and metabolic diseases, respiratory diseases and specific cancers.
Results Geographic clusters with significant high and low risks of NCDs were found that displayed an overall geographic pattern of high risk in the outlying suburbs of the territory. Significant relationships between neighbourhood walkability as measured by Walk Score and the likelihood of hospitalisation with a primary diagnosis of myocardial infarction (heart attack) were found. A possible relationship was also found with the likelihood of being hospitalised with 4 major lifestyle-related cancers.
Conclusions Our research augments the growing literature underscoring the relationships between the built environment and health outcomes. In addition, it supports the importance of walkable neighbourhoods, as measured by Walk Score, for improved health.
- Geographical Information Systems
- Chronic Diseases
- Spatial Analysis
- Built Environment and Health
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Contributors SM, VL and TC implemented the data cleaning, statistical analyses and the writing. RD, HP and BO provided analytical oversight, reviewed the manuscript and helped with the writing.
Funding The research was funded by the Australian Capital Territory Health Directorate (http://www.health.act.gov.au).
Disclaimer The opinions expressed in this paper are those of the authors and not those of the funding body.
Competing interests None declared.
Ethics approval The research was approved by the ACT Health Human Research Ethics Committee (Ref.: ETH.11.14.310) on 8 December 2014.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The hospital data were provided after ethics and other data regulation requirements from the data custodian at HealthInfo@act.gov.au. Anyone with the appropriate ethics clearances can request the data custodian for the data.
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