Abstract

Background

Two-thirds of Canadian adults and one-third of Canadian children and youth are overweight or obese. There is increased interest in identifying features of the built environment—such as walkability—that facilitate lifestyle habits associated with reduced obesity and improved health. The purpose of this study is to examine how the associations between walkability and both obesity and self-rated health vary by age in Canadians using a new walkability dataset.

Data and methods

The 2016 Canadian Active Living Environments (Can-ALE) database was attached to Canadian Health Measures Survey (CHMS; 2009 to 2015) data. Moderate-to-vigorous physical activity (MVPA), light physical activity (LPA) and step counts were measured in the CHMS using the Actical accelerometer (n = 10,852; ages 3 to 79). Body mass index (BMI) and waist circumference were measured in a mobile clinic. Self-rated general and mental health were assessed using a questionnaire.

Results

The percentage of adults aged 40 to 59 classified as overweight or obese was 28 percentage points lower in the most walkable Can-ALE category than in the least walkable category (49.1% vs. 77.5%, p < 0.0125). There was a significant downward linear trend in measured BMI and waist circumference across Can-ALE categories (from least to most walkable) for adults aged 18 to 59, but not for children and youth or older adults aged 60 to 79. MVPA was a significant mediating factor in the association between the Can-ALE index and BMI in adults aged 40 to 79 (and in the waist circumference of respondents aged 40 to 59). Young adults (aged 18 to 39) were more likely than older adults (aged 60 to 79) to report very good or excellent general health as walkability increased .

Interpretation

Using a new and freely-available Canadian walkability index, this study observed a positive association between walkability and both measured obesity and self-rated general health in adults. Walkability is one of many built environment characteristics that should be considered when trying to understand the relative contribution of the built environment to a person’s weight and overall health.

Keywords

exercise, walkability, built environment, walking, transportation

DOI: https://www.doi.org/10.25318/82-003-x201900900002-eng

Findings

Two-thirds of Canadian adults and one-third of Canadian children and youth are overweight or obese. The modest success of individual-level programs and interventions (i.e., healthy eating and physical activity) aimed at altering the behaviours that contribute to obesity has led to increased interest in changing the physical environment in a way that helps individuals make better lifestyle choices. The Chief Public Health Officer’s Report on the State of Public Health in Canada 2017, Designing Healthy Living, drew attention to the potential impact of using the built environment to help Canadians make healthier choices. Similarly, one of the key tenets of the Ottawa Charter for Health Promotion is the need to create supportive environments to help individuals respond to a rapidly changing environment and increasing urbanization. The activity friendliness of a neighbourhood is commonly assessed using walkability, which is a measure of how well a neighbourhood’s built form promotes walking and generally consists of multiple subcomponents, including proximity to destinations of interest (e.g., shops, services, workplaces, schools), street connectivity (number of intersections, route options, directness of routes) and residential density (which can support destinations of interest). The Canadian Active Living Environments (Can-ALE) database is a new geography-based set of measures that represents the active living friendliness of Canadian communities. [Full article]

Authors

Rachel C. Colley (rachel.colley@canada.ca), Tanya Christidis and Michael Tjepkema are with the Health Analysis Division, and Isabelle Michaud is with the International Cooperation and Methodology Innovation Centre at Statistics Canada, Ottawa, Canada. Nancy A. Ross is with the Geo-Social Determinants of Health Research Group in the Department of Geography at McGill University, Montréal, Quebec.

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What is already known on this subject?

  • Two-thirds of Canadian adults and one-third of Canadian children and youth are overweight or obese.
  • Altering the built environment in a way that helps individuals make better lifestyle choices has been identified as a population health strategy.
  • Walkability is positively associated with improved health and reduced obesity; however, the causal pathway is not clear.

What does this study add?

  • There were less overweight or obese adults in the most walkable type of neighbourhood than in the least walkable type.
  • The relationship between walkability and obesity was stronger in young adults than in youth or older adults.
  • Young adults were more likely than older adults to report very good or excellent general health as walkability increased.

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