Public Open Spaces and Leisure-Time Walking: A Longitudinal Study With Brazilian People in the COVID-19 Pandemic.

Abstract

To examine whether changes in public open spaces (POS) were associated with leisure-time walking (LTW) between 2014 and 2021. The sample comprised a prospective cohort of individuals living in São Paulo City, Brazil. The baseline sample was collected in 2014/2015 (4042 people aged 12y or older) and the second wave in 2020/2021 (1431 people aged 18y or older, 35.4% of total). Changes in POS scores in 500-m network buffers were based on household address, including positive or negative maintenance and increases or decreases in parks, public squares, and bike paths between 2015 and 2020. The International Physical Activity Questionnaire was used to evaluate LTW in the baseline and second wave. To examine the association of LTW with changes in POS, we used multilevel models in 4 levels: health administration areas, census tracts, individuals, and observations of individuals. The exposure was the POS tertiles, and the outcome was LTW. Changes in LTW prevalence were observed in both periods and according to POS tertiles distributions. When adjusted for time (baseline/second wave), gender, education, and age, the highest POS tertile was significantly associated with a high likelihood for LTW (odds ratio = 1.44; 95% confidence interval, 1.03-2.02). The results showed that people in São Paulo who lived within 500-m buffers with the highest access to POS were more likely to practice LTW between 2014/2015 and 2020/2021. These results have important implications for policies that were implemented in 2014, including the New Master Plan to contribute to São Paulo's good ranking among healthy cities.