Neighborhood-based differences in walkability, physical activity, and weight status in India

Introduction Data on built environment (BE) and physical activity (PA) in low- and middle- income countries is sparse. This study compared BE features, PA levels, and weight status among adults living in neighborhoods stratified by walkability and socio-economic status (SES) in the city of Chennai, India. Methods This cross sectional study design surveyed 370 adults (≥18 years) from four neighborhoods with differing walkability and socio-economic status. Participants were asked to complete a survey on their neighborhood environment, leisure and travel PA, height, weight, and demographic characteristics. One-way analysis of variance tests were used to examine differences across neighborhoods. Results Residents of high-walkability/high-SES neighborhoods reported higher land use mix diversity, land use mix access, street connectivity, aesthetics, and safety from crime. Residential density and walking/bicycling infrastructure were highest in the high-walkability/low-SES neighborhood. Transport PA was the maximum contributor to total PA in low-SES neighborhoods, while residents of high-SES neighborhoods reported greater levels of leisure-time PA. Sitting time and BMI were greater among high-SES participants. Patterns of PA, sedentary time, and weight status varied significantly by neighborhood walkability and SES. Conclusions An understanding of BE correlates of domain-specific PA can support the development of contextually tailored interventions to promote physical activity and reverse the determinants of inactivity occurring through patterns of urbanization and sedentary behaviors in India.