Abstract
BackgroundStudies from Western countries reported a positive relationship between residential density (RD) and physical activity (PA) among adults. There was no such study from China, a rapidly-urbanizing country in the world. This study aimed to investigate the RD-PA association among urban adults in China.MethodsA multistage sampling approach was used to randomly select participants (aged 35–74 years old) in urban areas of Nanjing in 2017. The outcome variable was PA (dichotomized into “sufficient” or “insufficient”), while the independent variable was RD (tertiled into three sub-groups). Odds ratios (OR) and 95% confidence interval (CI) were computed to examine the RD-PA association using mixed-effects logistic regression models with adjustment for age, sex, nationality, marriage, educational attainment, employment status, body weight status, green space and neighborhood-level clustering effects.ResultsOf the 1568 eligible participants, 1551 were interviewed (response rate = 98.9%), with the mean age (standard deviation) of 54.7 (11.1) years old, and 46% of men. After adjustment for potential confounders and community-level clustering effects, participants lived in communities with higher (OR = 0.31, 95% CI = 0.21, 0.47) and middle (OR = 0.70, 95% CI = 0.50, 0.99) residential density were significantly less likely to achieve sufficient physical activity relative to their counterparts lived in the lower densed communities. Similar negative RD-PA association was examined for men or women, separately. The difference in the ORs between the middle and higher RD tertiles was also statistically significant (P < 0.01).ConclusionsA negatively gradient RD-PA association, independent of body weight status and green space, was observed among urban adults in regional China. It has public health implications for China to help residents’ promote and maintain physical activity through planning and constructing PA−/health-friendly built environment in future.
Highlights
Studies from Western countries reported a positive relationship between residential density (RD) and physical activity (PA) among adults
The mean age (Standard Deviation) was 54.7 (11.1) years old; 22.7% of participants obtained at least college level educational attainment; and 51.3% were with excess body weight (BMI = 24+)
For participants within different RD sub-groups, there was no significant difference between age-groups
Summary
Studies from Western countries reported a positive relationship between residential density (RD) and physical activity (PA) among adults. For China, the urbanization rate dramatically increased from 17.9% in 1978 to 57.4% in 2016 [1] Such rapid urbanization has Recently, neighborhood built environment (BE) attributes have been identified as influence factors for residents’ lifestyle/behavior and the related health conditions [4, 5]. Neighborhood built environment attributes involved in health-related studies generally refer to the physical environment developed and constructed for people to live in, mainly including the following four domains: residential. Density, land-use mix (street connectivity, transport, sidewalks, etc.), access to destinations and aesthetics [6, 7] Among those BE attributes, RD is a key feature that has comprehensive influence on residents’ physical activity and its related health consequences [8,9,10]
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