The Relationship between Physical Activity and the Objectively-Measured Built Environment in Low- and High-Income South African Communities.

Moses Isiagi,Kufre Joseph Okop,Estelle Victoria Lambert

doi:10.3390/ijerph18083853

Abstract

There is limited data concerning the built environment and physical activity (PA) in a country with a history of sociopolitically motivated, spatial and economic disparities. We explored the extent to which objectively measured attributes of the built environment were associated with self-report or device-measured PA in low- and high-socioeconomic status (SES) communities. Methods: In a convenient sample of residents (n = 52, aged 18–65 years) from four urban suburbs in low- and high-income settings near Cape Town, South Africa, self-reported transport- and leisure-time PA, and device-measured moderate-to-vigorous PA (MVPA) data were collected. Built environment constructs derived from individual-level street network measures (1000 m buffer, ArcGIS, 10.51) were obtained. We assessed PA between four groups, based on income and GIS walkability (derived by a median split, low or high SES and low or high walkable). Results: No relationships between self-reported MVPA and GIS-measured walkability were found. Only intersection density was significantly, inversely associated with moderate and total MVPA (rho = −0.29 and rho = −0.31, respectively, p < 0.05). In the high SES group, vigorous PA was inversely associated with intersection density (rho = −0.39, p < 0.05). Self-report transport PA differed between groups (p < 0.013). Conclusions: Results suggest that the construct of walkability may relate to volitional (leisure) and utilitarian (transport) PA differently, in highly inequitable settings.

Highlights

The burden of physical inactivity is substantial in the country of South Africa [1] as it grapples with a concomitant rise in non-communicable diseases (NCDs), exacerbated by so-called “modifiable risk factors” including physical inactivity, unhealthy eating and overweight, smoking and an excessive alcohol intake [2]
This study examined the differences in self-reported physical activity and device-measured physical activity (MVPA), in groups apportioned according to income and Geographic Information Systems (GIS) measured walkability within a 1000 m buffer
The results of this study showed a mismatch between physical activity and the objectively measured attributes of the built environment that have been previously associated with “walkability”, largely in high-come countries

Summary

Introduction

The burden of physical inactivity is substantial in the country of South Africa [1] as it grapples with a concomitant rise in non-communicable diseases (NCDs), exacerbated by so-called “modifiable risk factors” including physical inactivity, unhealthy eating and overweight, smoking and an excessive alcohol intake [2]. There is growing recognition of the ecological, environmental and social determinants of NCDs, which are not under the control of the individual [3]. Economic and spatial inequalities in South Africa have contributed to the disproportionately high burden of NCDs among disadvantaged persons [4] despite social grants and remittances targeting these groups, post 1994 after democracy [5]. The monetary and spatial inequality trends in South Africa may only be addressed through policy interventions and solutions, targeting issues of social and environmental justice [3]. The ecological model provides a framework to understand these interventions. This is based on a premise that healthy behaviors are shaped at both individual and

Methods

Results

Discussion

Conclusion