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What is already known on this subject?
What does this study add?

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Evidence from large, population-based studies about the association between neighbourhood walkability and the prevalence of obesity is limited.

Data and methods

The study population consisted of 106,337 people aged 20 or older living in urban and suburban Ontario, who participated in the National Population Health Survey and the Canadian Community Health Survey from 1996/1997 to 2008. Based on their postal code, individuals were grouped into one of five walkability categories, ranging from very car-dependent to “Walker’s Paradise,” according to the Street Smart Walk Score®, a composite measure of neighbourhood walkability. Logistic regression models, adjusted for demographic, socioeconomic and lifestyle characteristics, were used to estimate odds ratios relating neighbourhood walkability to overweight/obesity and physical activity.


Compared with residents of “Walker’s Paradise” areas, those in very car-dependent areas had significantly higher odds of being overweight or obese. Despite similar levels of leisure physical activity among residents of all walkability areas, those in “Walker’s Paradise” areas reported more utilitarian walking and weighed, on average, 3.0 kg less than did those in very car-dependent areas.


Living in a low-walkability area is associated with a higher prevalence of overweight/obesity. Neighbourhood walkability is related to the frequency of utilitarian walking.


Obesity, overweight, physical activity, walkability


The rising prevalence of obesity in Canada has led researchers to examine not only individual behaviours, but also, environmental factors that may be contributing to the increase. Interest is growing in potential effects of the built environment, notably, neighbourhood walkability, on the risk of obesity and related diseases. [Full Text]


Maria Chiu (maria.chiu@ices.on.ca), Baiju R. Shah, Laura C.Maclagan, Mohammad-Reza Rezai, Peter C. Austin and Jack V. Tu are with the Institute for Clinical Evaluative Sciences, Toronto, Ontario. Baiju R. Shah, Peter C. Austin and Jack V. Tu are also with the University of Toronto.

What is already known on this subject?

  • People in highly walkable neighbourhoods are more likely than those in less walkable areas to engage in utilitarian physical activity such as walking or cycling to work or school.
  • Studies of the relationship between neighborhood walkability and obesity have been relatively small and limited in their ability to adjust for important confounders.

What does this study adds?

  • This is the largest population-based study to examine neighbourhood walkability and overweight/obesity in Canada.
  • The odds of overweight/obesity were higher among people living in lower walkability areas, compared with those in higher walkability areas.
  • Dose-response relationships emerged between Street Smart Walk Score® categories and utilitarian physical activity, as well as the prevalence of overweight/obesity.
  • These associations persisted when confounders such as age, sex, income, education, race/ethnicity, alcohol consumption, diet, smoking and leisure physical activity were taken into account.
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