Abstract
BACKGROUND AND AIM: Neighbourhood walkability indices have been developed and linked to behavioral and health outcomes elsewhere in the world, but not yet in the Netherlands. We aimed to compose a theory-based walkability index for the Netherlands and elucidate its cross-sectional association with adults’ walking behaviours. METHODS: The Dutch walkability index consists of seven components: population density, retail- and service destination density, land-use mix, street connectivity, green space, sidewalk density and public transport density. These components were composed and aggregated to three Euclidean buffer sizes (150m, 500m and 1000m) around every postal code and to every administrative neighbourhood. The normalized walkability index is the sum of its componential z-scores and scaled between 0-100. Data on self-reported demographic characteristics and walking behaviors of adult participants (aged 18-65, n=15716) were extracted from the Dutch National Travel Survey 2017. Using censored regression analysis (tobit model) adjusted for individual and survey-related confounders, we assessed the association between walkability index and total time spent walking, for non-discretionary and discretionary purposes. The main association was also examined across various urbanization degrees, socioeconomic levels, age groups and sexes. RESULTS:In fully-adjusted models, a 1% increase in walkability was associated with 0.49 minutes increase in walking (95%CI: 0.4-0.58), corresponding to 37 meters (95%CI: 29-44). This association was consistent across buffer sizes and between discretionary and non-discretionary walking. Stratified results showed that associations for minutes of walking were stronger in rural (0.90, 95%CI: 0.54-1.26) compared to highly urbanized areas (0.41, 95%CI 0.23-0.59), for discretionary walking in females (0.53, 95%CI: 0.38-0.67), and non-discretionary walking in males (0.64, 95%CI: 0.44-0.84). CONCLUSIONS:The walkability index was associated with walking behaviours of people in the Netherlands, indicating its value for further use in the Netherlands. KEYWORDS: walkability, built environment, travel behaviours
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