Associations between Resident Perceptions of the Local Residential Environment and Metabolic Syndrome

Katherine Baldock,Robert Adams,Mark Daniel,Natasha Howard,Neil Coffee,Anne Taylor,Graeme Hugo,Catherine Paquet

doi:10.1155/2012/589409

Abstract

A substantial body of research has arisen concerning the relationships between objective residential area features, particularly area-level socioeconomic status and cardiometabolic outcomes. Little research has explored residents' perceptions of such features and how these might relate to cardiometabolic outcomes. Perceptions of environments are influenced by individual and societal factors, and may not correspond to objective reality. Understanding relations between environmental perceptions and health is important for the development of environment interventions. This study evaluated associations between perceptions of local built and social environmental attributes and metabolic syndrome, and tested whether walking behaviour mediated these associations. Individual-level data were drawn from a population-based biomedical cohort study of adults in Adelaide, South Australia (North West Adelaide Health Study). Participants' local-area perceptions were analysed in cross-sectional associations with metabolic syndrome using multilevel regression models (n = 1, 324). A nonparametric bootstrapping procedure evaluated whether walking mediated these associations. Metabolic syndrome was negatively associated with greater local land-use mix, positive aesthetics, and greater infrastructure for walking, and was positively associated with greater perceived crime and barriers to walking. Walking partially mediated associations between metabolic syndrome and perceived environmental features. Initiatives targeting residents' perceptions of local areas may enhance the utility of environmental interventions to improve population health.

Highlights

The rising prevalence of cardiometabolic diseases, including type 2 diabetes and cardiovascular disease, presents a major international public health challenge for the 21st century [1]
Other studies have found that individual socioeconomic factors largely accounted for associations between area deprivation and coronary heart disease [69,70,71,72]
Research investigating cardiometabolic diseases in relation to features of environments other than socioeconomic status has evidenced a variety of associations

Summary

Introduction

The rising prevalence of cardiometabolic diseases, including type 2 diabetes and cardiovascular disease, presents a major international public health challenge for the 21st century [1]. Public health prevention efforts to combat these diseases have largely focused on identifying and reducing individuallevel risk factors, physical inactivity and poor nutrition. Such prevention strategies alone, have had poor utility against increasing morbidity and mortality attributable to cardiometabolic diseases at the population level [2, 3]. There is a growing recognition that strategies which target individual behaviours in addition to the context within which such behaviours arise can have the greatest public health impact [4] This has led to a rapidly increasing body of research on the role of residential, or local-area, environments in patterning cardiometabolic risk factors and subsequent disease. A growing body of evidence demonstrates relations between resident perceptions

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Conclusion