Luis Fernando Gómez

Influences of Built Environments on Walking and Cycling: Lessons from Bogota

ABSTRACT Bogotá, Colombia, is well known for its sustainable urban transport systems, including an extensive network of bike lanes and set-aside street space for recreational cyclists and pedestrians on Sundays and holidays, called Ciclovía (“cycleway”). This paper examines how such facilities along with other attributes of the built environment—urban densities, land-use mixes, accessibility, and proximity to transit—are associated with walking and cycling behavior as well as Ciclovía participation. We find that whereas road facility designs, like street density, connectivity, and proximity to Ciclovía lanes, are associated with physical activity, other attributes of the built environment, like density and land-use mixtures, are not. This is likely because most neighborhoods in built-up sections of Bogotá evolved during a time when non-automobile travel reigned supreme, meaning they are uniformly compact, mixed in their land-use composition, and have comparable levels of transport accessibility. Thus facility designs are what sway nonmotorized travel, not generic land-use attributes of neighborhoods.

Neighborhood environments and physical activity among adults in 11 countries.

BACKGROUND Understanding environmental correlates of physical activity can inform policy changes. Surveys were conducted in 11 countries using the same self-report environmental variables and the International Physical Activity Questionnaire, allowing analyses with pooled data. METHODS The participating countries were Belgium, Brazil, Canada, Colombia, China (Hong Kong), Japan, Lithuania, New Zealand, Norway, Sweden, and the U.S., with a combined sample of 11,541 adults living in cities. Samples were reasonably representative, and seasons of data collection were comparable. Participants indicated whether seven environmental attributes were present in their neighborhood. Outcomes were measures of whether health-related guidelines for physical activity were met. Data were collected in 2002-2003 and analyzed in 2007. Logistic regression analyses evaluated associations of physical activity with environmental attributes, adjusted for age, gender, and clustering within country. RESULTS Five of seven environmental variables were significantly related to meeting physical activity guidelines, ranging from access to low-cost recreation facilities (OR=1.16) to sidewalks on most streets (OR=1.47). A graded association was observed, with the most activity-supportive neighborhoods having 100% higher rates of sufficient physical activity compared to those with no supportive attributes. CONCLUSIONS Results suggest neighborhoods built to support physical activity have a strong potential to contribute to increased physical activity. Designing neighborhoods to support physical activity can now be defined as an international public health issue.

Built environment attributes and walking patterns among the elderly population in Bogotá.

BACKGROUND There is increasing evidence that the built environment has an influence on physical activity; however, little is known about this relationship in developing countries. PURPOSE This study examined the associations between attributes of the built environment and walking patterns among the elderly. METHODS A multilevel cross-sectional study was conducted in 2007. Fifty neighborhoods were selected and 1966 participants aged > or =60 years were surveyed. Objective built environment measures were obtained in a buffer of 500 m using GIS. Environmental perceptions were assessed via questionnaire. RESULTS People who lived in areas with middle park area (4.53%-7.98% of land) were more likely to walk for at least 60 minutes during a usual week (prevalence OR [POR]=1.42, 95% CI=1.02, 1.98). Those who lived in areas with the highest connectivity index (1.81-1.99) were less likely to report walking for at least 60 minutes (POR=0.64, 95% CI=0.44, 0.93). Participants who reported feeling safe or very safe from traffic were more likely to report walking for at least 60 minutes (POR=1.50, 95% CI=1.11, 2.03). The presence of Ciclovía (recreational program) was marginally associated with having walked at least 150 minutes in a usual week (POR=1.29, 95% CI=0.97, 1.73). CONCLUSIONS This study showed that certain built and perceived environment characteristics were associated with walking among older adults living in Bogotá. Further studies should be conducted to better understand the potential influence of the built environment on physical activity among the elderly population in the context of Latin American cities.

Perceived and objective neighborhood environment attributes and health related quality of life among the elderly in Bogotá, Colombia

This study examines associations between neighborhood environment attributes and health related quality of life (HRQOL) and self-rated health (SRH) among older adults (60 years and over) in Bogotá, Colombia. Perceived and objective neighborhood environmental characteristics were assessed in a cross sectional multilevel design with 1966 older adults within 50 neighborhoods. Outcome variables included HRQOL (physical and mental dimensions) and SRH measured with the Spanish version of the Short Form 8 (SF-8). Independent variables included perceived and objective neighborhood characteristics as well as self-reported levels of walking. Hierarchical linear and logistic regression models were used for the analysis. Among perceived neighborhood characteristics, safety from traffic was positively associated with both HRQOL dimensions and SRH. Having safe parks was positively associated with the mental dimension of HRQOL and with SRH. Street noise was negatively associated with both HRQOL dimensions. Regarding objective neighborhood characteristics, residing in areas with more than eight percent of land covered by public parks was positively associated with SRH. Objective and perceived neighborhood characteristics could provide insight into potential interventions among older adults from rapidly urbanizing settings in Latin America.

Nivel de actividad física global en la población adulta de Bogotá (Colombia). Prevalencia y factores asociados

Objetivo: Determinar la prevalencia de los grados de actividad fisica global en las personas de 18 a 65 anos de la ciudad de Bogota (Colombia) e identificar los factores asociados con la regularidad en la actividad. Metodos: Se realizo una encuesta poblacional, aplicada a 3.000 adultos residentes en la ciudad de Bogota durante el ano 2003, seleccionados en una muestra probabilistica multietapica. Los niveles de actividad fisica fueron determinados por medio de la version abreviada del IPAQ. La aplicacion de un modelo de regresion logistico permitio identificar los factores asociados con la regularidad en la actividad. Resultados: La prevalencia ajustada de personas regularmente activas fue del 36,8%. Despues del ajuste de las potenciales variables de confusion, las posibilidades de ser regularmente activo fueron mayores en los varones (odds ratio [OR] = 1,62; intervalo de confianza [IC] del 95%,1,31-2,01) y en personas con una autopercepcion del estado de salud buena o muy buena (OR = 1,87; IC del 95%, 1,41-2,49). Las posibilidades fueron menores en las personas de los grupos de edad de 30-49 y 50-65 anos (OR = 0,78; IC del 95%, 0,63-0,96 y OR = 0,60; IC del 95%, 0,43-0,82, respectivamente) y en aquellas cuya principal actividad en los ultimos 30 dias era buscar trabajo (OR = 0,71; IC del 95%, 0,51-0,97) o realizar labores del hogar (OR = 0,72; IC del 95%, 0,54-0,96). En las mujeres, a diferencia de los varones, los grupos de edad no tuvieron asociacion con la regularidad en la actividad. Conclusion: En este estudio se ponen de manifiesto diferencias entre los sexos en las prevalencias de los niveles de actividad fisica global y en sus factores asociados. En futuros trabajos se debera establecer, en el contexto de ciudades latinoamericanas, si es pertinente determinar, ademas de los grados de actividad fisica global, los indicadores especificos en cada dominio

Leisure-time physical activity among women in a neighbourhood in Bogotá, Colombia: prevalence and socio-demographic correlates

This study measured the prevalence of leisure-time physical activity in women from 18 to 69 years of age and identified correlated social factors in the neighborhood of Santafe, Bogotá, Colombia. Levels of physical activity were calculated through a population survey (n = 1,045). Logistic regression modeling identified factors associated with inactivity. Some 79.1% of respondents reported being inactive; 15.7% practiced physical exercise irregularly; and 5.2% regularly practiced physical exercise. After adjustment of covariates, physical inactivity was associated with not participating in recreational weekend activities on Sundays and not planning to lose weight. The results of this study show the high proportion of physically inactive women in a community in Bogotá Intervention strategies should be developed to reinforce recreational weekend activities on promoted by the municipality.

Television viewing and its association with overweight in Colombian children: results from the 2005 National Nutrition Survey: A cross sectional study

BackgroundThere has been an ongoing discussion about the relationship between time spent watching television and childhood obesity. This debate has special relevance in the Latin American region were the globalization process has increased the availability of screen-based entertainment at home. The aim of this study is to examine the association between television viewing and weight status in Colombian children.MethodsThis cross sectional investigation included children aged 5 to12 yrs from the National Nutrition Survey in Colombia (ENSIN 2005). Weight and height were measured in 11,137 children in order to calculate body mass index. Overweight was defined by international standards. Time spent viewing television was determined for these children through parental reports. Multiple logistic regression analyses were conducted for different subgroups and adjusted for potential confounders in order to study the association between television viewing and weight status in this population.ResultsAmong the surveyed children, 41.5% viewed television less than two hours/day; 36.8% between two and 3.9 hours/day and 21.7% four or more hours/day. The prevalence of overweight (obesity inclusive) in this population was 11.1%. Children who were classified as excessive television viewers (between two and 3.9 hours/day or 4 or more hours/day) were more likely to be overweight (OR: 1.44 95% CI: 1.41–1.47 and OR: 1.32 95% CI: 1.30–1.34, respectively) than children who reported to watch television less than 2 hours/day. Stratified analyses by age, gender and urbanization levels showed similar results.ConclusionTelevision viewing was positively associated with the presence of overweight in Colombian children. A positive association between urbanization level and television viewing was detected. Considering that the majority of Colombian children lives in densely populated cities and appear to engage in excessive television viewing these findings are of public health relevance for the prevention of childhood obesity.

Policy and Built Environment Changes in Bogotá and their Importance in Health Promotion

There is an increasing interest in establishing the influence of urban environments on health. The importance of changes to environmental policy in order to promote physical activity has been emphasized during recent years. Bogotá, the capital of Columbia, is recognized as a Latin American leader in its creation of a more activity friendly environment. The city has undergone a number of urban and social changes which have resulted in a positive effect on the recovery of public spaces, access to recreational facilities, and promotion of non-motorized and public transportation options. These changes may have enhanced perceptions of quality of life and facilitated increased physical activity. The experience of Bogotá could be used as a potential example for leaders of other cities to encourage similar programs.

Walking or Bicycling to School and Weight Status Among Adolescents From Montería, Colombia

BACKGROUND Active school transport (AST) is a recommended strategy to promote physical activity (PA) and prevent overweight (OW) in school-aged children. In many developing countries, such as Colombia, this association has not been well characterized. OBJECTIVE To determine the association between AST and weight status in a representative sample of adolescents from Montería, Colombia. METHODS Participants were 546 adolescents (278 boys) aged 11 to 18 years old from 14 randomly selected schools in Montería, Colombia in 2008. The PA module of the Global School Health Survey (GSHS-2007) was used to determine the prevalence of AST. To identify OW, participants were classified according to CDC 2000 criteria (BMI ≥85th percentile). Association between AST and OW was determined by binomial logistic regression. RESULTS Odds ratios adjusted for age, sex, location of school, compliance with PA, and screen time recommendations showed that adolescents who reported AST had a significantly lower likelihood to be OW compared with adolescents who reported nonactive transportation (OR = 0.5, 95% CI 0.3-0.8, P < .05). CONCLUSIONS These results support the importance of AST as a useful PA domain with potential implications for overweight prevention, in rapidly developing settings. Further epidemiologic and intervention studies addressing AST are needed in the region.

Household motor vehicle use and weight status among Colombian adults: are we driving our way towards obesity?

OBJECTIVE To determine the associations between household motor vehicle ownership and weight status among Colombian adults. METHODS Secondary analysis of data from the 2005 Demographic and HealthSurvey of Colombia. Height, weight and waist circumference were objectively measured in 49,079 adults, ages 18 to 64 that resided in urban settings. Abdominal obesity was defined as a waist circumference >80 cm in women and >90 cm in men. RESULTS Prevalence was 19.9% for motor vehicle ownership in household, 33.1% for BMI between 25 and 29.9 kg/m(2), 14.4% for BMI>30 kg/m(2), and 46% for abdominal obesity. Males reporting any household motor vehicle ownership were more likely to be overweight or obese, and to have abdominal obesity (p for genderexposure variables interaction=<0.001). CONCLUSIONS Household motor vehicle ownership is associated with overweight, obesity, and abdominal obesity among Colombian men but not women.