Abstract
BackgroundEvidence concerning the relationship between objectively-measured attributes of the built environment with cardio-metabolic risk in populations from lower- and middle-income countries is lacking. In this paper, we describe the association between the objectively-measured built environment with body mass index, blood pressure and physical activity in adult South Africans.MethodsThis cross-sectional study included 341 adults aged ≥35 years drawn from the Cape Town arm of the Prospective Urban Rural Epidemiology (PURE) cohort study. All Cape Town PURE participants were invited to take part in the study. Actigraph GT3X accelerometer and Geographic Information Systems were used to measure physical activity and built environment attributes (community center, shopping center and taxi rank).ResultsIn age and sex adjusted models (reference 500 m), access to community centers (1000 m) was positively related to body mass index [beta 4.70 (95%CI: 2.06 to 7.34)] and diastolic blood pressure [4.97 (0.00 to 9.95)]. Distance from a community center (1600 m) was positively related to diastolic blood pressure [6.58 (1.57 to 11.58)] and inversely with moderate-to-vigorous physical activity [− 69.30 (− 134.92 to − 3.70)]. Distance to a shopping center (1600 m) was positively related to body mass index [4.78 (1.11 to 8.45)] and shopping center (1000 m) was positively related to systolic blood pressure respectively [76.99 (0.03 to 83.95)].ConclusionDistance to community and shopping centers were significantly associated with BMI, systolic, diastolic blood pressure and moderate-to-vigorous physical activity. Future research should include multiple aspects of built environment variables in order to provide for a broader understanding of their effect on cardiovascular risk profile of African populations.
Highlights
Evidence concerning the relationship between objectively-measured attributes of the built environment with cardio-metabolic risk in populations from lower- and middle-income countries is lacking
Rapid epidemiological shifts in population health and disease burden have been linked to changes in the built environment that may promote or adversely affect active transport, such as walking to and from places, because this has been associated with reduced risk of obesity, and non-communicable diseases (NCDs) [6,7,8]
Mean diastolic BP (DBP) was higher in female (85.3 ± 12.5) than in male (81.5 ± 12.6), t (339) = − 2.29, p = 0.047, d = 0.29
Summary
Evidence concerning the relationship between objectively-measured attributes of the built environment with cardio-metabolic risk in populations from lower- and middle-income countries is lacking. At least one study in a middle-income country has linked aspects of the neighborhood and built environment such as: water supply, garbage collection and street lighting to health status in older adults, [14] Both objective and subjective studies incorporating measures of the built environment are sparse [15] and those studies that have used them have shown mixed results in both low-income [16] and high-income countries [17]. It is unknown whether one measurement method is more effective than the other for assessing the neighborhood environment and its association with obesity, body mass index (BMI), hypertension and physical activity especially among South African adults
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