Abstract
Access to public open space is important to increase leisure-time walking (LTW) in high-income countries, but there is little evidence in middle-income countries. We conducted a cross-sectional analysis to examine the relationship between LTW and the presence of different public open spaces (parks, bike paths, and squares) and the mix of these recreational destinations near the homes of adults participating in the Sao Paulo Health Survey (n = 3145). LTW was evaluated by a questionnaire. We delineated buffers (500, 1000, and 1500 m) from the geographic coordinates of the adults’ residential addresses using a geographic information system. We used multilevel logistic regression taking account of clustering by census tracts and households, and with adjustment for social, demographics, and health characteristics. The main results showed that the presence of at least two recreational destinations within a 500-m buffer of participants’ homes were associated with an increased odds of LTW compared with no destinations present (OR = 1.65; 95% CI 1.09–2.55). No associations were found for destinations further away. These results support actions outlined in the new urban plan for Sao Paulo city and could be used to highlight the importance access to a mix of public open spaces to promote physical activity in megacities of middle-income countries.
Highlights
Physical inactivity is a major global public health problem, considered a pandemic that is associated with early mortality and with high public health care costs, and is an economic burden [1,2,3].A publication with data from 142 countries showed that the cost to health care systems due to physical inactivity was about $53.8 billion in 2013, with 58% spent by the public sector [2]
The geocoding of residential addresses was undertaken for 2246 households and the final sample for this study was n = 3145 adults
This study showed that the presence of public squares, bike paths, and having at least two types of destinations within close proximity to people’s homes (i.e., a 500-m buffer) were associated with leisure-time walking in adults living in Sao Paulo
Summary
Physical inactivity is a major global public health problem, considered a pandemic that is associated with early mortality and with high public health care costs, and is an economic burden [1,2,3]. A publication with data from 142 countries showed that the cost to health care systems due to physical inactivity was about $53.8 billion in 2013, with 58% spent by the public sector [2]. Participation in physical activity— physical activity during leisure time—is associated. Res. Public Health 2017, 14, 553; doi:10.3390/ijerph14060553 www.mdpi.com/journal/ijerph
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