TY - JOUR
T1 - Association between neighborhood walkability, cardiorespiratory fitness and body-mass index
AU - Hoehner, Christine M.
AU - Handy, Susan L.
AU - Yan, Yan
AU - Blair, Steven N.
AU - Berrigan, David
N1 - Funding Information:
This study was supported in part by an American Cancer Society Mentored Research Scholar Grant ( MRSG-07-016-01-CPPB ), the Applied Research Program of the National Cancer Institute, NIH grants ( AG06945 and HL62508 ), and the Communities Foundation of Texas on recommendation of Nancy Ann and Ray L. Hunt. We thank Dr. Kenneth H. Cooper for establishing the Aerobics Center Longitudinal Study, the Cooper Clinic physicians, nurses, and technicians who collected the clinical data, and The Cooper Institute for maintaining the database, especially Beth Wright. We also thank Dr. Larry Frank for his insights when conceptualizing this study, Drs. William Haskell, Ross Brownson, and Richard Troiano for their critical review comments, and Todd Gibson of IMS Inc and Christine Marx for furnishing the Census data and maps.
PY - 2011/12
Y1 - 2011/12
N2 - Many studies have found cross-sectional associations between characteristics of the neighborhood 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) is an objective marker of PA because it is primarily determined by PA. Furthermore, it is causally related to long-term health outcomes. Therefore, analyses of the association between CRF and built environment could strengthen arguments for the importance of built environment influences on health. We examined the association between neighborhood walkability and CRF and body-mass index (BMI). This cross-sectional analysis included 16,543 adults (5017 women, 11,526 men) aged 18-90 years with home addresses in Texas who had a comprehensive clinical examination between 1987 and 2005. Outcomes included CRF from total duration on a maximal exercise treadmill test and measured BMI. Three neighborhood walkability factors emerged from principal components analyses of block-group measures derived from the U.S. Census. In multilevel adjusted analyses, the neighborhood walkability factors were significantly associated with CRF and BMI among men and women in the expected direction. An interaction between one of the neighborhood factors 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 positively associated with CRF among younger adults and more strongly negatively associated with BMI among older adults. In conclusion, neighborhood characteristics hypothesized to support more PA and less driving were associated with 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 on self-reported PA. Nevertheless, stronger causal evidence depends on more robust study designs and sophisticated measures of the environment, behavior, and their physiological consequences.
AB - Many studies have found cross-sectional associations between characteristics of the neighborhood 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) is an objective marker of PA because it is primarily determined by PA. Furthermore, it is causally related to long-term health outcomes. Therefore, analyses of the association between CRF and built environment could strengthen arguments for the importance of built environment influences on health. We examined the association between neighborhood walkability and CRF and body-mass index (BMI). This cross-sectional analysis included 16,543 adults (5017 women, 11,526 men) aged 18-90 years with home addresses in Texas who had a comprehensive clinical examination between 1987 and 2005. Outcomes included CRF from total duration on a maximal exercise treadmill test and measured BMI. Three neighborhood walkability factors emerged from principal components analyses of block-group measures derived from the U.S. Census. In multilevel adjusted analyses, the neighborhood walkability factors were significantly associated with CRF and BMI among men and women in the expected direction. An interaction between one of the neighborhood factors 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 positively associated with CRF among younger adults and more strongly negatively associated with BMI among older adults. In conclusion, neighborhood characteristics hypothesized to support more PA and less driving were associated with 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 on self-reported PA. Nevertheless, stronger causal evidence depends on more robust study designs and sophisticated measures of the environment, behavior, and their physiological consequences.
KW - Built environment
KW - Cardiorespiratory fitness
KW - Exercise
KW - Neighborhood
KW - Obesity
KW - Physical activity
KW - USA
KW - Walking
UR - http://www.scopus.com/inward/record.url?scp=81555219065&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2011.09.032
DO - 10.1016/j.socscimed.2011.09.032
M3 - Article
C2 - 22030212
AN - SCOPUS:81555219065
SN - 0277-9536
VL - 73
SP - 1707
EP - 1716
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 12
ER -