Neighborhood Characteristics and Walking Behavior Among Adults With Arthritis: A National Health Interview Survey Study

Objective: This study investigated the association of perceived neighborhood qualities with likelihood of transit walking, leisure walking, neighborhood walking, and meeting physical activity (PA) recommendations among US adults with arthritis. Methods: This cross-sectional study used 2020 National Health Interview Survey data. Included participants were adults who reported with clinician-diagnosed arthritis and who reported the ability to walk. Exposures of interest were perceived neighborhood attributes. Outcomes were transit walking, leisure walking, neighborhood walking, and meeting PA recommendations. Standardized mean difference percentage (SMD%) was used to assess relationships between exposures and outcomes, with an SMD% >10% resulting in inclusion in final adjusted multivariate logistic regression models for odds of outcomes. All analyses were weighted to account for complex survey methodology. Results: The analytic sample included 7,322 adults with arthritis. Fully adjusted logistic regression models showed the presence of roads to walk on was associated with meeting PA recommendations (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.07–1.49]). Three attributes were positively associated with transit walking, whereas safety from crime was negatively associated (OR 2.33, 95% CI 1.75–3.10; OR 1.49, 95% CI 1.17–1.91; OR 1.67, 95% CI 1.34–2.08; and OR 0.70, 95% CI 0.53–0.92, respectively). Roads to walk and places to walk and relax were associated with leisure and neighborhood walking (OR 1.46, 95% CI 1.21–1.76; OR 1.56, 95% CI 1.34–1.82; OR 1.58, 95% CI 1.29–1.93; and OR 1.63, 95% CI 1.40–1.90, respectively). Conclusion: This study identified several neighborhood characteristics associated with higher a likelihood of walking behaviors among adults with arthritis. Factors associated with walking behavior varied by the type of walking. The shared correlates between leisure and neighborhood walking imply they occur in the same setting. Patients with arthritis may benefit from exercise recommendations that are informed by the presence or absence of facilitating infrastructure in their neighborhoods.