Walkable Neighborhoods Mean Less Obesity and Diabetes

Miriam E. Tucker

January 15, 2014

The more "walkable" an area, the less likely its residents are to be overweight/obese or to have diabetes, a new study conducted in Toronto has found.

Results from the research, which also sought to determine the best measures of "walkability" for public policy purposes, were published online January 14 in PLOS One by Richard H. Glazier, MD, from St. Michael's Hospital, Toronto, Ontario, and colleagues.

"While interventions to prevent obesity and promote healthy body weight are most often aimed at individuals, there is a growing recognition of upstream environmental factors, including the urban built environment, as potential targets for intervention," the authors write.

Data were obtained from the Canadian census, an urban transportation survey, a national health survey, and an administrative diabetes database for the city of Toronto, which had a population of 2.6 million people in 2011.

The investigators based "walkability" on population density, the number of walkable destinations (including retail stores, services, public recreation centers, and schools), and street connectivity. Of these, street connectivity isn't easily modifiable in developed areas, whereas the former 2 components are potentially subject to change through alterations in zoning, urban planning, and design, Dr. Glazier and colleagues point out.

Residents of Least Walkable Areas Had More Cars

For the period 2003–2009, individuals living in the least walkable areas owned nearly twice as many vehicles as those living in the most walkable places, with a ratio of 1.8 for the highest vs the lowest quintiles of walkability. Those in the least walkable quintile were also nearly twice as likely to travel by automobile (1.75), were half as likely to use public transportation (0.58), and about one-third as likely to walk or bicycle (0.32). (Geographical area was based on "dissemination blocks," a term used by the Canadian census to refer to the rough equivalent of a city block.)

Nearly half (49.7%) of people living in the least walkable areas were overweight or obese, compared with 41.8% of those living in the most walkable (ratio, 1.18). More than 1 in 10 (11.3%) had diabetes in the least walkable quintile, vs just 8.5% in the most walkable (ratio, 1.33).These differences were statistically significant.

The measures of both residential density and the availability of walkable destinations were both found to be significantly associated with transportation and health outcomes, while using both in combination "provided additional explanatory power," Dr. Glazier and colleagues note.

"We conclude that walkable urban environments may be important for stemming the tide of physical inactivity, overweight or obesity, and diabetes."

The authors have reported no relevant financial relationships.

PLOS One. Published online January 14, 2014. Article

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