Linking objectively measured physical activity with objectively measured urban form: Findings from SMARTRAQ

doi:10.1016/j.amepre.2004.11.001

American Journal of Preventive Medicine

Volume 28, Issue 2, Supplement 2, February 2005, Pages 117-125

https://doi.org/10.1016/j.amepre.2004.11.001 Get rights and content

Background

To date, nearly all research on physical activity and the built environment is based on self-reported physical activity and perceived assessment of the built environment.

Objective

To assess how objectively measured levels of physical activity are related with objectively measured aspects of the physical environment around each participant’s home while controlling for sociodemographic covariates.

Methods

Objective measures of the built environment unique to each household’s physical location were developed within a geographic information system to assess land-use mix, residential density, and street connectivity. These measures were then combined into a walkability index. Accelerometers were deployed over a 2-day period to capture objective levels of physical activity in 357 adults.

Results

Measures of land-use mix, residential density, and intersection density were positively related with number of minutes of moderate physical activity per day. A combined walkability index of these urban form factors was significant (p =0.002) and explained additional variation in the number of minutes of moderate activity per day over sociodemographic covariates. Thirty-seven percent of individuals in the highest walkability index quartile met the ≥30 minutes of physical activity recommended, compared to only 18% of individuals in the lowest walkability quartile. Individuals in the highest walkability quartile were 2.4 times more likely (confidence interval=1.18–4.88) than individuals in the lowest walkability quartile to meet the recommended ≥30 minutes of moderate physical activity per day.

Conclusions

This research supports the hypothesis that community design is significantly associated with moderate levels of physical activity. These results support the rationale for the development of policy that promotes increased levels of land-use mix, street connectivity, and residential density as interventions that can have lasting public health benefits.

Introduction

There are now sufficient studies documenting associations between the built environment and physical activity to consider transportation investments and land-use decisions as critical public health issues.1, 2, 3, 4 Transportation and urban planning studies show that land-use patterns and transportation systems design are consistently related to walking and cycling for transport.1, 5 Studies in the health literature indicate that a wide range of environmental variables is correlated with recreational physical activity.6, 7 The built environment may be contributing to the obesity epidemic, because obesity is more prevalent in areas where land use makes it difficult to walk to destinations1, 2, 3, 4, 8 and where there are relatively few recreational resources.⁹ The built environment has emerged as a high priority for public health,10, 11 and there are many important gaps in the research that need to be filled.

Most studies to date have been limited by large-scale regionally averaged or self-reported measures of the built environment that do not provide the detailed information needed by policymakers.8, 12, 13 Virtually all studies to date have used self-reported measures of physical activity that are known to have limited validity.¹⁴ With few exceptions,13, 15 studies have used limited physical activity outcome variables, such as active transport or recreational activity, although total physical activity may be most predictive of health outcomes. This study focuses on moderate physical activity, and does not distinguish between transportation, recreational, and other sources of physical activity.

The present study was designed by an interdisciplinary team to fill several gaps in the literature. The present study examined multiple, objectively measured characteristics of community design. These environmental variables were examined separately, and in an index designed to reflect overall walkability of neighborhoods. Building off recent advances in environmental assessment4, 16 each environmental variable was computed individually for each participant, using geographic information systems (GIS) to describe the “microenvironments” that people experience regularly where they live. Physical activity was measured with an accelerometer that is among the best existing measures of objective physical activity.¹⁷

Section snippets

Recruitment and data collection

Strategies for Metropolitan Atlanta’s Regional Transportation and Air Quality (SMARTRAQ) is a study of transportation, land use, air quality, and health in the 13-county metropolitan Atlanta region. A total of 523 people were recruited from the SMARTRAQ study area. Figure 1 shows the study area and the home location of these 523 participants.

Data collection occurred between 2001 and 2003. A random-digit-dialing method of computer-aided telephone interview recruitment and data collection was

Results

Descriptive statistics are presented in Table 2 for demographics and urban form variables. Study participants were somewhat more likely to be female (55.7%), and were well educated, as 66.4% had at least a bachelor’s degree. Study participants were 74.9% white and 15.9% black. The average age was 43.8 years, and 47% were overweight or obese (body mass index >25). The purposive sampling strategy resulted in a wider range of land-use mix, intersection density, and residential density than would

Discussion

An objectively measured walkability index was significantly related to objectively measured moderate-intensity physical activity in adults. The association was observed, after accounting for demographic variables, with a continuous measure of moderate-intensity physical activity, and with meeting the ≥30-minute/day recommendation. The results indicate that when people have many destinations near their homes and can get there in a direct pathway, they are more likely to engage in moderate

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¹: At the time this research was conducted, James Chapman worked at the Georgia Institute of Technology.

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ArticlesLinking objectively measured physical activity with objectively measured urban form: Findings from SMARTRAQ

Background

Objective

Methods

Results

Conclusions

Introduction

Section snippets

Recruitment and data collection

Results

Discussion

Am J Prev Med

Am J Prev Med

Am J Prev Med

Aust N Z J Public Health

Transportation Res D

Am J Prev Med

Neighborhood-based differences in physical activityan environment scale evaluation

Am J Public Health

The public health impacts of sprawldesigning, planning, and building healthy communities

Relationship between urban sprawl and physical activity, obesity and morbidity

Am J Health Promotion

Travel and the built environmenta synthesis

Transportation Res Rec

Environmental influences on eating and physical activity

Ann Rev Public Health

Health and community designthe impact of the built environment on physical activity

The impact of community design and land-use choices on public healtha scientific research agenda

Am J Public Health

Making the case for active living communities

Am J Public Health

Articles
Linking objectively measured physical activity with objectively measured urban form: Findings from SMARTRAQ