Abstract
BackgroundWalking for transport can contribute to the accrual of health-enhancing levels of physical activity in elders. Identifying destinations and environmental conditions that facilitate this type of walking has public health significance. However, most findings are limited to Western, low-density locations, while a larger proportion of the global population resides in ultra-dense Asian metropolises. We investigated relationships of within-neighborhood objectively-measured destination categories and environmental attributes with walking for transport in 484 elders from an ultra-dense metropolis (Hong Kong).MethodsWe estimated relationships of diversity (number of different types) and prevalence of within-neighborhood destination categories (environmental audits of 400 m buffers surrounding residential addresses) with transport-related walking (interviewer–administered questionnaire) in 484 Chinese-speaking elders able to walk unassisted and living in 32 neighborhoods stratified by socio-economic status and transport-related walkability. We examined the moderating effects of safety and pedestrian infrastructure-related neighborhood attributes on destination-walking associations.ResultsParticipants reported on average 569 and 254 min/week of overall and within-neighborhood walking for transport, respectively. The prevalence of public transit points and diversity of recreational destinations were positively related to overall walking for transport. The presence of a health clinic/service and place of worship, higher diversity in recreational destinations, and greater prevalence of non-food retails and services, food/grocery stores, and restaurants in the neighborhood were predictive of more within-neighborhood walking for transport. Neighborhood safety-related aspects moderated the relationship of overall walking for transport with the prevalence of public transit points, this being positive only in safe locations. Similar moderating effects of safety-related attributes were observed for the relationships of within-neighborhood walking for transport with diversity of recreational and entertainment destinations. Pedestrian-infrastructure attributes acted as moderators of associations of within-neighborhood walking for transport with prevalence of commercial destination categories. Composite destinations indices consisting of destination categories related to the specific measures of walking were positively associated with walking for transport.ConclusionsThe availability of both non-commercial and commercial destinations may promote within-neighborhood walking for transport, while recreational facilities and public transit points may facilitate overall walking for transport. However, destination-rich areas need to also provide adequate levels of personal safety and a physically-unchallenging pedestrian network.
Highlights
Walking for transport can contribute to the accrual of health-enhancing levels of physical activity in elders
To address the research gaps outlined above, this study examined associations of objectively-measured prevalence and diversity of nine destination categories with overall and within-neighborhood walking for transport in Chinese elders residing in Hong Kong, an ultra-dense metropolis [10,11,12]
It was hypothesized that (1) compared to overall walking for transport, within-neighborhood walking for transport would be more strongly positively associated with each destination measure, with the exception of public transit points, which may facilitate walking outside the neighborhood [3]; (2) more favorable levels of neighborhood safety and pedestrian infrastructure would strengthen the positive associations of destination measures with overall and within-neighborhood walking for transport; (3) diversity measures of non-commercial destinations providing relatively uniform services would be more strongly related to walking than their respective prevalence measures, and the opposite would hold for commercial destinations
Summary
Walking for transport can contribute to the accrual of health-enhancing levels of physical activity in elders. The ability to walk to and from places depends on the availability and accessibility of relevant destinations It is, important to identify destinations that can potentially contribute to increased levels of walking for transport in elders and, identify environmental conditions that facilitate or hinder walking to such destinations. A handful of studies reported positive associations with diversity of land uses, access to commercial services, and/or public transit points [3,4,5,6] Some of these studies were entirely based on self-reports, while others used very generic objective measures of access to services (e.g., urbanization level) providing insufficient information on the categories of destinations (e.g., recreational or retail) that may matter to elders
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