Samantha Foster

The built environment, neighborhood crime and constrained physical activity: An exploration of inconsistent findings

OBJECTIVES Personal safety is commonly cited in qualitative research as a barrier to local walking, yet the relationship between safety and constrained physical activity has received mixed support in quantitative studies. This paper reviews the quantitative evidence to date, seeking to explain the inconsistencies, and offers recommendations for future research. METHODS A social-ecological framework was adopted to explore the evidence linking crime-related safety, and factors that influence real and perceived safety, with constrained physical activity. RESULTS Perceived safety tends to affect the physical activity of groups already known to exhibit greater anxiety about crime; and some elements of the built environment that influence safety appear to constrain physical activity. However the evidence is somewhat inconsistent, and this may be partly attributed to measurement limitations. Many studies employ generic safety measures that make implicit references to crime or use composite variables that lack specificity. Physical activity outcomes also require consideration, as only activities occurring locally outdoors are likely to be affected by neighborhood crime. CONCLUSIONS Further research is required to tease out associations between real and perceived crime-related safety and physical activity, ideally employing behaviour and crime-specific measures, and addressing the moderating role of the social and built environments.

City planning and population health: a global challenge

Significant global health challenges are being confronted in the 21st century, prompting calls to rethink approaches to disease prevention. A key part of the solution is city planning that reduces non-communicable diseases and road trauma while also managing rapid urbanisation. This Series of papers considers the health impacts of city planning through transport mode choices. In this, the first paper, we identify eight integrated regional and local interventions that, when combined, encourage walking, cycling, and public transport use, while reducing private motor vehicle use. These interventions are destination accessibility, equitable distribution of employment across cities, managing demand by reducing the availability and increasing the cost of parking, designing pedestrian-friendly and cycling-friendly movement networks, achieving optimum levels of residential density, reducing distance to public transport, and enhancing the desirability of active travel modes (eg, creating safe attractive neighbourhoods and safe, affordable, and convenient public transport). Together, these interventions will create healthier and more sustainable compact cities that reduce the environmental, social, and behavioural risk factors that affect lifestyle choices, levels of traffic, environmental pollution, noise, and crime. The health sector, including health ministers, must lead in advocating for integrated multisector city planning that prioritises health, sustainability, and liveability outcomes, particularly in rapidly changing low-income and middle-income countries. We recommend establishing a set of indicators to benchmark and monitor progress towards achievement of more compact cities that promote health and reduce health inequities.

Taking up cycling after residential relocation: Built environment factors

BACKGROUND To successfully stimulate cycling, it is necessary to understand the factors that facilitate or inhibit cycling. Little is known about how changes in the neighborhood environment are related to changes in cycling behavior. PURPOSE This study aimed to identify environmental determinants of the uptake of cycling after relocation. METHODS The RESIDential Environment Project (RESIDE) is a longitudinal natural experiment of people moving into new housing developments in Perth (Western Australia). Self-reported usual transport and recreational cycling behavior, as well as self-reported and objective built environmental factors were measured before and after residential relocation. Participants who did not usually cycle at baseline in 2003-2004 were included in the study. Logistic regression models were used to relate changes in built environmental determinants to the probability of taking up cycling after relocation (2005-2006). Analyses were carried out in 2010-2011. RESULTS At baseline, 90% (n=1289) of the participants did not cycle for transport and 86% (n=1232) did not cycle for recreation. After relocation, 5% of the noncyclists took up transport-related cycling, and 7% took up recreational cycling. After full adjustment, the uptake of transport-related cycling was determined by an increase in objective residential density (OR=1.54, 95% CI=1.04, 2.26) and self-reported better access to parks (OR=2.60, 95% CI=1.58, 4.27) and other recreation destinations (OR=1.57, 95% CI=1.12, 2.22). Commencing recreational cycling mostly was determined by an increase in objective street connectivity (OR=1.20, 95% CI=1.06, 1.35). CONCLUSIONS Changes in the built environment may support the uptake of cycling among formerly noncycling adults.

Access to alcohol outlets, alcohol consumption and mental health

The objective of this study was to investigate residential exposure to alcohol outlets in relation to alcohol consumption and mental health morbidity (anxiety, stress, and depression). This was a cross-sectional study of 6,837 adults obtained from a population representative sample for the period 2006–2009 in Perth, Western Australia. The number of alcohol outlets was ascertained for a 1600 m service area surrounding the residential address. Zero-inflated negative binomial and logistic regression were used to assess associations with total alcohol consumption, harmful alcohol consumption (7–10 drinks containing 10 g of alcohol for men, 5–6 drinks for women) and medically diagnosed and hospital contacts (for anxiety, stress, and depression), respectively. The rate ratio for the number of days of harmful consumption of alcohol per month and the number of standard drinks of alcohol consumed per drinking day was 1.06 (95% CI: 1.02, 1.11) and 1.01 (95% CI: 1.00, 1.03) for each additional liquor store within a 1600 m service area, respectively. The odds ratio of hospital contact for anxiety, stress, or depression was 1.56 (95% CI: 0.98, 2.49) for those with a liquor store within the service area compared to those without. We observed strong evidence for a small association between residential exposure to liquor stores and harmful consumption of alcohol, and some support for a moderate-sized effect on hospital contacts for anxiety, stress, and depression.

Quality of Public Open Spaces and Recreational Walking.

OBJECTIVES We examined associations between specific public open space (POS) attributes and recreational walking to local POS. METHODS Between October 2004 and December 2006, 1465 adults of the RESIDential Environments Project, conducted in Perth, Australia, reported whether they walk to a POS for recreation. For each participant, we identified all open spaces larger than 0.8 hectares within 1.6 kilometers from home. On the basis of field audit data, we created 3 scores (presence, count, size-weighted presence) for 19 specific open space attributes. RESULTS With logistic regression analyses, we found that walking to a POS was associated with the presence of gardens, grassed areas, walking paths, water features, wildlife, amenities, dog-related facilities, and off-leash areas for dogs. It was also associated with the highest number of these attributes in a single open space, but not with the total number of attributes in all POSs within 1.6 kilometers of home. CONCLUSIONS Building 1 high-quality local park may be more effective in promoting recreational walking than is providing many average-quality parks.