Lawrence D. Frank

Environmental Correlates of Walking and Cycling: Findings From the Transportation, Urban Design, and Planning Literatures

Research in transportation, urban design, and planning has examined associations between physical environment variables and individuals’ walking and cycling for transport. Constructs, methods, and findings from these fields can be applied by physical activity and health researchers to improve understanding of environmental influences on physical activity. In this review, neighborhood environment characteristics proposed to be relevant to walking/cycling for transport are defined, including population density, connectivity, and land use mix. Neighborhood comparison and correlational studies with nonmotorized transport outcomes are considered, with evidence suggesting that residents from communities with higher density, greater connectivity, and more land use mix report higher rates of walking/cycling for utilitarian purposes than low-density, poorly connected, and single land use neighborhoods. Environmental variables appear to add to variance accounted for beyond sociodemographic predictors of walking/cycling for transport. Implications of the transportation literature for physical activity and related research are outlined. Future research directions are detailed for physical activity research to further examine the impact of neighborhood and other physical environment factors on physical activity and the potential interactive effects of psychosocial and environmental variables. The transportation, urban design, and planning literatures provide a valuable starting point for multidisciplinary research on environmental contributions to physical activity levels in the population.

Many Pathways from Land Use to Health: Associations between Neighborhood Walkability and Active Transportation, Body Mass Index, and Air Quality

Abstract The literature shows single-use, low-density land development and disconnected street networks to be positively associated with auto dependence and negatively associated with walking and transit use. These factors in turn appear to affect health by influencing physical activity, obesity, and emissions of air pollutants. We evaluated the association between a single index of walkability that incorporated land use mix, street connectivity, net residential density, and retail floor area ratios, with health-related outcomes in King County, Washington. We found a 5% increase in walkability to be associated with a per capita 32.1% increase in time spent in physically active travel, a 0.23-point reduction in body mass index, 6.5% fewer vehicle miles traveled, 5.6% fewer grams of oxides of nitrogen (NOx) emitted, and 5.5% fewer grams of volatile organic compounds (VOC) emitted. These results connect development patterns with factors that affect several prevalent chronic diseases.

Healthy nutrition environments: concepts and measures.

The authors provide a conceptual model of a healthy nutrition environment, then review the types of measures required to assess various aspects of this environment. Measures fall into priority categories of consumer and community environments.

Neighborhood built environment and income: examining multiple health outcomes.

There is growing interest in the relation of built environments to physical activity, obesity, and other health outcomes. The purpose of the present study was to test associations of neighborhood built environment and median income to multiple health outcomes and examine whether associations are similar for low- and high-income groups. This was a cross-sectional study of 32 neighborhoods in Seattle, WA and Baltimore, MD regions, stratified by income and walkability, and conducted between 2001 and 2005. Participants were adults aged 20-65years (n=2199; 26% ethnic minority). The main outcomes were daily minutes of moderate-to-vigorous physical activity (MVPA) from accelerometer monitoring, body mass index (BMI) based on self-report, and mental and physical quality of life (QoL) assessed with the SF-12. We found that MVPA was higher in high- vs. low-walkability neighborhoods but did not differ by neighborhood income. Overweight/obesity (BMI > or = 25) was lower in high-walkability neighborhoods. Physical QoL was higher in high-income neighborhoods but unrelated to walkability. Adjustment for neighborhood self-selection produced minor changes. We concluded that living in walkable neighborhoods was associated with more physical activity and lower overweight/obesity but not with other benefits. Lower- and higher-income groups benefited similarly from living in high-walkability neighborhoods. Adults in higher-income neighborhoods had lower BMI and higher physical QoL.

The Built Environment and Human Activity Patterns: Exploring the Impacts of Urban Form on Public Health

An increasing body of evidence suggests that moderate forms of physical activity (such as walking and bicycling), when engaged in regularly, can have important beneficial effects on public health. This article reviews current public health, planning, and urban design research to determine, first, how walking and bicycling might be critically important exercise behaviors for improving public health, second, how urban form affects the frequency of walking and bicycling as a form of physical activity, and third, how the public health considerations outlined in this article might reorient planners’ thinking toward the realization of health-promotive environments. The current lack of emphasis on the interdependencies between built form and overall quality of life, as measured by health, safety, and welfare considerations, suggests the need for a rethinking of public policy approaches to transportation investment and land development.

Objective Light-Intensity Physical Activity Associations With Rated Health in Older Adults

The extent to which light-intensity physical activity contributes to health in older adults is not well known. The authors examined associations between physical activity across the intensity spectrum (sedentary to vigorous) and health and well-being variables in older adults. Two 7-day assessments of accelerometry from 2005 to 2007 were collected 6 months apart in the observational Senior Neighborhood Quality of Life Study of adults aged >65 years in Baltimore, Maryland, and Seattle, Washington. Self-reported health and psychosocial variables (e.g., lower-extremity function, body weight, rated stress) were also collected. Physical activity based on existing accelerometer thresholds for moderate/vigorous, high-light, low-light, and sedentary categories were examined as correlates of physical health and psychosocial well-being in mixed-effects regression models. Participants (N = 862) were 75.4 (standard deviation, 6.8) years of age, 56% female, 71% white, and 58% overweight/obese. After adjustment for study covariates and time spent in moderate/vigorous physical activity and sedentary behavior, low-light and high-light physical activity were positively related to physical health (all P < 0.0001) and well-being (all P < 0.001). Additionally, replacing 30 minutes/day of sedentary time with equal amounts of low-light or high-light physical activity was associated with better physical health (all P < 0.0001). Objectively measured light-intensity physical activity is associated with physical health and well-being variables in older adults.

Urban Form Relationships with Walk Trip Frequency and Distance among Youth

Purpose. To assess the relationship among objectively measured urban form variables, age, and walking in youth. Design. Cross-sectional analyses of travel diary data mapped against urban form characteristics within a 1-km buffer of participants place of residence. Setting. Youth in the Atlanta, Georgia region with selection stratified by income, household size, and residential density. Subjects. A total of 3161 5- to 20-year-olds who completed 2-day travel diaries. Diaries of those under 15 years were completed by a parent or legal guardian. Measures. Walking distances were calculated from a 2-day travel diary. Residential density, intersection density, land use mix, and commercial and recreation space were assessed within a 1-km network distance around residences. Analysis. Logistic regression analyses were performed for each urban form variable by age groups controlling for the demographic variables. All variables were then entered simultaneously into an analysis of the whole sample. Results. All five urban form variables tested were related to walking. Recreation space was the only variables associated with walking across the four different age groups. All the urban form variables were related to walking in the 12 to 15 years age cohort. For this group, the odds of walking were 3.7 times greater for those in highest- versus lowest-density tertile and 2.6 times greater for those with at least one commercial and 2.5 times greater for those with at least one recreational destination within 1 km from home. In the analysis of the full sample, number of cars, recreation space, and residential density were most strongly related to walking. Conclusions. Access to recreation or open space was the most important urban form variable related to walking for all age groups. Children aged 12 to 15 years old may be particularly influenced by urban form.

Land Use and Transportation Interaction Implications on Public Health and Quality of Life

Increases in per capita vehicle usage and associated emissions have spawned an increased examination of the ways in which our communities and regions are developing. Associated with increased vehicle usage are decreased levels of walking and biking, two valid forms of physical activity. The Surgeon General’s 1996 report, Physical Activity and Health, highlights the increasing level of physical inactivity as a growing cause of mortality. The costs and benefits of contrasting land development and transportation investment practices have been the subject of considerable debate in the literature. Findings have been refuted based on methodological grounds and inaccurate interpretation of data. Several of these studies, their methodological approaches, and their critiques are analyzed. While most agree that the built environment influences travel, considerable disagreement exists over the likely impacts of increased density, mix, and street connectivity on air quality, and on transportation system performance and household activity patterns.

Physical activity in relation to urban environments in 14 cities worldwide : a cross-sectional study

BACKGROUND Physical inactivity is a global pandemic responsible for over 5 million deaths annually through its effects on multiple non-communicable diseases. We aimed to document how objectively measured attributes of the urban environment are related to objectively measured physical activity, in an international sample of adults. METHODS We based our analyses on the International Physical activity and Environment Network (IPEN) adult study, which was a coordinated, international, cross-sectional study. Participants were sampled from neighbourhoods with varied levels of walkability and socioeconomic status. The present analyses of data from the IPEN adult study included 6822 adults aged 18-66 years from 14 cities in ten countries on five continents. Indicators of walkability, public transport access, and park access were assessed in 1·0 km and 0·5 km street network buffers around each participants residential address with geographic information systems. Mean daily minutes of moderate-to-vigorous-intensity physical activity were measured with 4-7 days of accelerometer monitoring. Associations between environmental attributes and physical activity were estimated using generalised additive mixed models with gamma variance and logarithmic link functions. RESULTS Four of six environmental attributes were significantly, positively, and linearly related to physical activity in the single variable models: net residential density (exp[b] 1·006 [95% CI 1·003-1·009]; p=0·001), intersection density (1·069 [1·011-1·130]; p=0·019), public transport density (1·037 [1·018-1·056]; p=0·0007), and number of parks (1·146 [1·033-1·272]; p=0·010). Mixed land use and distance to nearest public transport point were not related to physical activity. The difference in physical activity between participants living in the most and least activity-friendly neighbourhoods ranged from 68 min/week to 89 min/week, which represents 45-59% of the 150 min/week recommended by guidelines. INTERPRETATION Design of urban environments has the potential to contribute substantially to physical activity. Similarity of findings across cities suggests the promise of engaging urban planning, transportation, and parks sectors in efforts to reduce the health burden of the global physical inactivity pandemic. FUNDING Funding for coordination of the IPEN adult study, including the present analysis, was provided by the National Cancer Institute of National Institutes of Health (CA127296) with studies in each country funded by different sources.

Aging in neighborhoods differing in walkability and income: Associations with physical activity and obesity in older adults

While there is a growing literature on the relations between neighborhood design and health factors such as physical activity and obesity, less focus has been placed on older adults, who may be particularly vulnerable to environmental influences. This study evaluates the relations among objectively measured neighborhood design, mobility impairment, and physical activity and body weight in two U.S. regional samples of community dwelling older adults living in neighborhoods differing in walkability and income levels. An observational design involving two time points six months apart was employed between 2005 and 2008. U.S. Census block groups in Seattle-King County, Washington and Baltimore, Maryland-Washington DC regions were selected via geographic information systems to maximize variability in walkability and income. Participants were 719 adults ages 66 years and older who were able to complete surveys in English and walk at least 10 feet continuously. Measurements included reported walking or bicycling for errands (i.e., transport activity) and other outdoor aerobic activities measured via the CHAMPS questionnaire: accelerometry-based moderate-to-vigorous physical activity; reported body mass index; and reported lower extremity mobility impairment measured via the Late-Life Function and Disability Instrument. Across regions, time, and neighborhood income, older adults living in more walkable neighborhoods had more transport activity and moderate-to- vigorous physical activity and lower body mass index relative to those living in less walkable neighborhoods. The most mobility-impaired adults living in more walkable neighborhoods reported transport activity levels that were similar to less mobility-impaired adults living in less walkable neighborhoods. The results add to the small literature aimed at understanding how neighborhood design may influence physical activity and related aspects of health linked with day-to-day function and independence as people age.