Associations between the built environment and physical activity among adults with low socio-economic status in Canada: a systematic review

Jennifer E Vena,Gavin R Mccormack,Paul E Ronksley,Anna Consoli,Christine M Friedenreich,Chelsea D Christie

doi:10.17269/s41997-020-00364-9

Jennifer E Vena, Gavin R Mccormack + Show 4 more

Open Access

https://doi.org/10.17269/s41997-020-00364-9

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Abstract

ObjectiveTo synthesize literature on the associations between the built environment and physical activity among adults with low socio-economic status (SES) in Canada.MethodsUsing a pre-specified study protocol (PROSPERO ID: CRD42019117894), we searched seven databases from inception to November 2018, for peer-reviewed quantitative studies that (1) included adults with low SES living in Canada and (2) estimated the association between self-reported or objectively measured built characteristics and self-reported or objectively measured physical activity. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Findings were synthesized using a narrative approach.SynthesisOf the 8338 citations identified by our search, seven studies met the inclusion criteria. Most studies included adults living in one province (Alberta, British Columbia, Ontario, or Quebec), with one study including a national sample. All studies were cross-sectional, and none controlled for residential self-selection. Sampling designs and data collection strategies were heterogeneous. Sample sizes ranged between 78 and 37,241 participants. Most studies measured SES using household income. Street connectivity, greenness, destination density, and walkability were positively associated with physical activity. Relative to the objectively measured built environment, associations between the self-reported built environment and physical activity were less consistent. Studies were of fair to good quality.ConclusionFindings suggest that the neighbourhood built environment is associated with physical activity among adults with low SES in Canada. More rigorous study designs are needed to determine whether or not the built environment and physical activity are causally related within this vulnerable population.

Highlights

Low levels of physical activity are associated with an increased risk of adverse health conditions, including cardiovascular diseases, hypertension, overweight and obesity, type II diabetes, depression, and some cancers (Lim et al 2012; Fogelholm 2010; Warburton and Bredin 2017)
Despite the risks associated with low physical activity, fewer than one in five adults meet the Canadian physical activity guidelines related to aerobic physical activity (≥ 150 min of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 min or more; Colley et al 2018; Tremblay et al 2011)
Consistent with previous reviews on the built environment and physical activity among general adult populations (Hajna et al 2015; Ding et al 2018; Farkas et al 2019), we found objectively measured street connectivity, greenness, density of destinations, and overall walkability were positively associated with physical activity among adults with low socio-economic status (SES)

Summary

Introduction

Low levels of physical activity are associated with an increased risk of adverse health conditions, including cardiovascular diseases, hypertension, overweight and obesity, type II diabetes, depression, and some cancers (Lim et al 2012; Fogelholm 2010; Warburton and Bredin 2017). Despite the risks associated with low physical activity, fewer than one in five adults meet the Canadian physical activity guidelines related to aerobic physical activity (≥ 150 min of moderate- to vigorous-intensity aerobic physical activity per week, in bouts of 10 min or more; Colley et al 2018; Tremblay et al 2011)

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Discussion

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