Measure Of Neighborhood Walkability Research Articles

The association between the Canadian active living environments index and glucose metabolism in a Canadian national population study

Biomarkers of glucose metabolism may reflect insulin resistance, a risk factor for diabetes and cardiovascular disease (CVD). Neighborhoods conducive to a physically active lifestyle have the potential to improve these biomarkers. We examined cross-sectional associations between walkability and blood biomarkers of glucose metabolism in 29,649 Canadian Health Measures Survey (CHMS) participants. We used generalized linear mixed models with sampling weights adjusted for province, participants’ age, sex, annual household income and educational attainment, cigarette smoking, environmental tobacco smoke, alcohol consumption, and exposure to ambient fine particulate air pollution (PM2.5). A higher value of the Canadian Active Living Environments Index, a measure of neighborhood walkability, equivalent to the magnitude of its interquartile range (IQR) of 2.4 was significantly associated with percentage differences of −0.48 (95% confidence interval (CI): 0.63, −0.32), −3.17 (95%CI: 5.27, −1.08), −3.88 (95%CI: 6.38, −1.38), and −3.36 (95%CI: 5.25, −1.47) in HbA1C, fasting insulin, HOMA-IR, and HOMA-β, respectively, for all CHMS participants. No significant effects were observed in those ≤16 years old. Canadians living in neighborhoods that facilitate active living have more favorable biomarkers of glucose metabolism, suggesting that the built environment has the potential to improve risk factors for diabetes and CVD in adults.

Long-Term Exposure to Walkable Residential Neighborhoods and Risk of Obesity-Related Cancer in the New York University Women's Health Study (NYUWHS).

Living in neighborhoods with higher levels of walkability has been associated with a reduced risk of obesity and higher levels of physical activity. Obesity has been linked to increased risk of 13 cancers in women. However, long-term prospective studies of neighborhood walkability and risk for obesity-related cancer are scarce. We evaluated the association between long-term average neighborhood walkability and obesity-related cancer risk in women. The New York University Women's Health Study (NYUWHS) is a prospective cohort with 14,274 women recruited between 1985 and 1991 in New York City and followed over nearly three decades. We geocoded residential addresses for each participant throughout follow-up and calculated an average annual measure of neighborhood walkability across years of follow-up using data on population density and accessibility to destinations associated with geocoded residential addresses. We used ICD-9 codes to characterize first primary obesity-related cancers and employed Cox proportional hazards models to assess the association between average neighborhood walkability and risk of overall and site-specific obesity-related cancers. Residing in neighborhoods with a higher walkability level was associated with a reduced risk of overall and site-specific obesity-related cancers. The hazards ratios associated with a 1-standard deviation increase in average annual neighborhood walkability were 0.88 (95% CI: 0.85, 0.93) for overall obesity-related cancer, 0.89 (95% CI: 0.84, 0.95) for postmenopausal breast cancer, 0.82 (95% CI: 0.68, 0.99) for ovarian cancer, 0.87 (95% CI: 0.76, 0.99) for endometrial cancer, and 0.68 (95% CI: 0.49, 0.94) for multiple myeloma, adjusting for potential confounders at both the individual and neighborhood level. The association between neighborhood walkability and risk of overall obesity-related cancer was stronger among women living in neighborhoods with higher levels of poverty compared with women living in areas with lower poverty levels (). Our study highlights a potential protective role of neighborhood walkability in preventing obesity-related cancers in women. https://doi.org/10.1289/EHP11538.

Walking-friendly built environments and objectively measured physical function in older adults

BackgroundFew studies have examined the associations between urban design attributes and older adults’ physical function. Especially, it is not well known how built-environment attributes may influence physical function in Asian cities. The aim of this study was to examine associations between objectively measured environmental attributes of walkability and objectively assessed physical function in a sample of Japanese older adults. MethodsCross-sectional data collected in 2013 from 314 older residents (aged 65–84 years) living in Japan were used. Physical function was estimated from objectively measured upper- and lower-body function, mobility, and balance by a trained research team member. A comprehensive list of built-environment attributes, including population density, availability of destinations, intersection density, and distance to the nearest public transport station, were objectively calculated. Walk Score as a composite measure of neighborhood walkability was also obtained. ResultsAmong men, higher population density, availability of destinations, and intersection density were significantly associated with better physical function performance (1-legged stance with eyes open). Higher Walk Score was also marginally associated with better physical function performance (1-legged stance with eyes open). None of the environmental attributes were associated with physical function in elderly women. ConclusionOur findings indicate that environmental attributes of walkability are associated with the physical function of elderly men in the context of Asia. Walking-friendly neighborhoods can not only promote older adults’ active behaviors but can also support their physical function.

Is Seoul Walkable? Assessing a Walkability Score and Examining Its Relationship with Pedestrian Satisfaction in Seoul, Korea

Studies have assessed neighborhood walkability responding to increasing interest in academics, practitioners, and policy makers. While Walk Score is a well-operationalized and efficient measure of neighborhood walkability, it is not supported in the Asian context. We thus developed a “Walkability Score” for use in Seoul, South Korea, following the Walk Score algorithm and then conducted a logistic regression for a satisfied versus dissatisfied binary outcome in order to conduct an empirical test. Results showed a significant association between Walkability Score and pedestrian satisfaction. We also explored sample locations and found some discrepancies between Walkability Score and the degree of pedestrian satisfaction. While some sample locations near parks, and rivers and waterfront spaces (but without destinations for walking trips such as banking or shopping) revealed low Walkability Scores, the degree of pedestrian satisfaction was relatively high in these areas. Some samples located in residential areas with well-designed sidewalks and greenery revealed relatively high pedestrian satisfaction, but Walkability Scores were insufficient. This study’s Walkability Score was somewhat valid for approaching the issue, but further research is needed to complete this measure, especially in high-density areas with well-equipped pedestrian infrastructures (e.g., crosswalks, pedestrian streets).

Development of a Neighborhood Walkability Index for Studying Neighborhood Physical Activity Contexts in Communities across the U.S. over the Past Three Decades.

To examine how urban form shapes physical activity and health over time, a measure of neighborhood walkability is needed that can be linked to cohort studies with participants living across the United States (U.S.) that have been followed over the past decades. The Built Environment and Health-Neighborhood Walkability Index (BEH-NWI), a measure of neighborhood walkability that can be calculated for communities across the United States between 1990 and 2015, was conceptualized, developed, and tested using data from the New York City Tri-State Area. BEH-NWI measures were created for 1990 and 2010 using historical data on population density, street intersection density, density of rail stops, and density of pedestrian trip generating/supporting establishments. BEH-NWI scores were calculated for 1-km buffers around the 1990 residences of NYU Women's Health Study (NYUWHS) participants and NYC Department of Health and Mental Hygiene's Physical Activity and Transit (PAT) survey participants enrolled in 2011. Higher neighborhood BEH-NWI scores were significantly associated with greater self-reported walking per week (+ 0.31 MET-hours/week per unit BEH-NWI, 95% CI 0.23, 0.36) and lower body mass index (- 0.17 BMI units per unit BEH-NWI, 95% - 0.23, - 0.12) among NYUWHS participants. Higher neighborhood BEH-NWI scores were associated with significantly higher accelerometer-measured physical activity among PAT survey participants (39% more minutes of moderate-intensity equivalent activity/week across the interquartile range of BEH-NWI, 95% CI 21%, 60%). The BEH-NWI can be calculated using historical data going back to 1990, and BEH-NWI scores predict BMI, weekly walking, and physical activity in two NYC area datasets.

Examining the relationships between walkability and physical activity among older persons: what about stairs?

BackgroundWalkability is considered an important dimension of healthy communities. However, variable associations between measures of walkability and physical activity have been observed, particularly among older persons. Given the challenges older persons may have navigating stairs on walking routes, the presence of stairs may be an explanatory factor for these mixed associations. The purposes of this scoping review were to determine whether studies examining the relationship between walkability and physical activity included items that assessed stairs and what relationships were found.MethodsSystematic reviews were identified by entering search terms into five database search engines. Eligibility criteria were: a) published between 2008 and 2017, b) examined the relationship between walkability and physical activity, c) included a focus on persons aged 65 years and older, and d) written in English. The full articles for all primary studies included in eligible systematic reviews were then retrieved. Duplicates were removed. Information about where the study took place, walkability measures used, types of walkability data obtained (objective and/or subjective) and questions asked about stairs were extracted from the full text articles.ResultsEleven systematic reviews were identified; seven were eligible. After removing duplicates, 289 primary studies remained for review. Measures of neighborhood walkability were present in 205 studies; a minority (n = 5, 2.4%) included items about stairs. No information was obtained on the structural features of the stairs.ConclusionsThe presence of stairs may deter older persons (and others) from walking outdoors. Standard measures to document the presence and characteristics of stairs, and sampling approaches to select stairs for assessment are needed. The inclusion of these measures would augment the utility and comparability of studies examining relationships between walkability and physical activity and better inform planning and policy decisions.

Validity of Walk Score® as a measure of neighborhood walkability in Japan.

Objective measures of environmental attributes have been used to understand how neighborhood environments relate to physical activity. However, this method relies on detailed spatial data, which are often not easily available. Walk Score® is a free, publicly available web-based tool that shows how walkable a given location is based on objectively-derived proximity to several types of local destinations and street connectivity. To date, several studies have tested the concurrent validity of Walk Score as a measure of neighborhood walkability in the USA and Canada. However, it is unknown whether Walk Score is a valid measure in other regions. The current study examined how Walk Score is correlated with objectively-derived attributes of neighborhood walkability, for residential addresses in Japan.Walk Scores were obtained for 1072 residential addresses in urban and rural areas in Japan. Five environmental attributes (residential density, intersection density, number of local destinations, sidewalk availability, and access to public transportation) were calculated using geographic information systems for each address. Pearson's correlation coefficients between Walk Score and these environmental attributes were calculated (conducted in May 2017).Significant positive correlations were observed between Walk Score and environmental attributes relevant to walking. Walk Score was most closely associated with intersection density (r = 0.82) and with the number of local destinations (r = 0.77).Walk Score appears to be a valid measure of neighborhood walkability in Japan. Walk Score will allow urban designers and public health practitioners to identify walkability of local areas without relying on detailed geographic data.

Neighborhood Environment and Disparities in Health Care Access Among Urban Medicare Beneficiaries With Diabetes: A Retrospective Cohort Study.

Older adults’ health is sensitive to variations in neighborhood environment, yet few studies have examined how neighborhood factors influence their health care access. This study examined whether neighborhood environmental factors help to explain racial and socioeconomic disparities in health care access and outcomes among urban older adults with diabetes. Data from 123 233 diabetic Medicare beneficiaries aged 65 years and older in New York City were geocoded to measures of neighborhood walkability, public transit access, and primary care supply. In 2008, 6.4% had no office-based “evaluation and management” (E&M) visits. Multilevel logistic regression indicated that this group had greater odds of preventable hospitalization in 2009 (odds ratio = 1.31; 95% confidence interval: 1.22-1.40). Nonwhites and low-income individuals had greater odds of a lapse in E&M visits and of preventable hospitalization. Neighborhood factors did not help to explain these disparities. Further research is needed on the mechanisms underlying these disparities and older adults’ ability to navigate health care. Even in an insured population living in a provider-dense city, targeted interventions may be needed to overcome barriers to chronic illness care for older adults in the community.

Neighborhood walk score and selected Cardiometabolic factors in the French RECORD cohort study

BackgroundWalkable neighborhoods are purported to impact a range of cardiometabolic outcomes through increased walking, but there is limited research that examines multiple cardiometabolic outcomes. Additionally, few Walk Score (a novel measure of neighborhood walkability) studies have been conducted in a European context. We evaluated associations between neighborhood Walk Score and selected cardiometabolic outcomes, including obesity, hypertension and heart rate, among adults in the Paris metropolitan area.Methods and resultsWe used data from the second wave of the RECORD Study on 5993 participants recruited in 2011–2014, aged 34–84 years, and residing in Paris (France). To this existing dataset, we added Walk Score values for participants’ residential address. We used multilevel linear models for the continuous outcomes and modified Poisson models were used for our categorical outcomes to estimate associations between the neighborhood Walk Score (both as a continuous and categorical variable) (0–100 score) and body mass index (BMI) (weight/height2 in kg/m2), obesity (kg/m2), waist circumference (cm), systolic blood pressure (SBP) (mmHg), diastolic blood pressure (DBP) (mmHg), hypertension (mmHg), resting heart rate (RHR) (beats per minute), and neighborhood recreational walking (minutes per week). Most participants lived in Walker’s Paradise (48.3%). In multivariate models (adjusted for individual variables, neighborhood variables, and risk factors for cardiometabolic outcomes), we found that neighborhood Walk Score was associated with decreased BMI (β: -0.010, 95% CI: -0.019 to −0.002 per unit increase), decreased waist circumference (β: -0.031, 95% CI: -0.054 to −0.008), increased neighborhood recreational walking (β: +0.73, 95% CI: +0.37 to +1.10), decreased SBP (β: -0.030, 95% CI: -0.063 to −0.0004), decreased DBP (β: -0.028, 95% CI: -0.047 to −0.008), and decreased resting heart rate (β: -0.026 95% CI: -0.046 to −0.005).ConclusionsIn this large population-based study, we found that, even in a European context, living in a highly walkable neighborhood was associated with improved cardiometabolic health. Designing walkable neighborhoods may be a viable strategy in reducing cardiovascular disease prevalence at the population level.

Neighborhood Walkability and Adiposity in the Women's Health Initiative Cohort.

Neighborhood environments may play a role in the rising prevalence of obesity among older adults. However, research on built environmental correlates of obesity in this age group is limited. The current study aimed to explore associations of Walk Score, a validated measure of neighborhood walkability, with BMI and waist circumference in a large, diverse sample of older women. This study linked cross-sectional data on 6,526 older postmenopausal women from the Women's Health Initiative Long Life Study (2012-2013) to Walk Scores for each participant's address (collected in 2012). Linear and logistic regression models were used to estimate associations of BMI and waist circumference with continuous and categorical Walk Score measures. Secondary analyses examined whether these relationships could be explained by walking expenditure or total physical activity. All analyses were conducted in 2015. Higher Walk Score was not associated with BMI or overall obesity after adjustment for sociodemographic, medical, and lifestyle factors. However, participants in highly walkable areas had significantly lower odds of abdominal obesity (waist circumference >88 cm) as compared with those in less walkable locations. Observed associations between walkability and adiposity were partly explained by walking expenditure. Findings suggest that neighborhood walkability is linked to abdominal adiposity, as measured by waist circumference, among older women and provide support for future longitudinal research on associations between Walk Score and adiposity in this population.

Perceived and Objective Measures of Neighborhood Walkability and Physical Activity among Adults in Japan: A Multilevel Analysis of a Nationally Representative Sample.

Although associations between a person’s neighborhood and their health have been studied internationally, most studies have been limited to a few cities or towns. Therefore, we used a nationally representative sample to explore whether perceived and objective neighborhood walkability was associated with the physical activity of residents. Data were analyzed from the Japanese General Social Surveys of 2010 (n = 2395; 1114 men and 1281 women). Perceived walkability was scored using factor analysis for the respondents’ perceptions of neighborhood conditions, while objective walkability was measured using the geographic information system approach. Finally, multilevel logistic regression analysis was performed to examine whether neighborhood walkability was associated with the frequency of leisure-time physical activity (LTPA) among respondents. We found that perceived walkability was positively associated with the frequency of LTPA (odds ratio of the highest quartile was 1.53 (1.14–2.05) compared with the lowest quartile); however, objective walkability showed no association. When stratified by gender, an association between perceived walkability and LTPA was observed among women, but only a marginally significant association was present between objective walkability and LTPA among men. We conclude that the association between neighborhood walkability and LTPA can be partially generalized across Japan.

Walk Score(TM), Perceived Neighborhood Walkability, and walking in the US.

To investigate both the Walk Score(TM) and a self-reported measure of neighborhood walkability ("Perceived Neighborhood Walkability") as estimators of transport and recreational walking among Americans. The study is based upon a survey of a nationally-representative sample of 1224 American adults. The survey gauged walking for both transport and recreation and included a self-reported measure of neighborhood walkability and each respondent's Walk Score(TM). Binary logistic and linear regression analyses were performed on the data. The Walk Score(TM) is associated with walking for transport, but not recreational walking nor total walking. Perceived Neighborhood Walkability is associated with transport, recreational and total walking. Perceived Neighborhood Walkability captures the experiential nature of walking more than the Walk Score(TM).

Rural Neighborhood Walkability: Implications for Assessment.

Physical activity levels, including walking, are lower in the southern U.S., particularly in rural areas. This study investigated the concept of rural neighborhood walkability to aid in developing tools for assessing walkability and to identify intervention targets in rural communities. Semi-structured interviews were conducted with physically active adults (n = 29) in rural Georgia. Mean age of participants was 55.9 years; 66% were male, 76% were white, and 24% were African American. Participants drew maps of their neighborhoods and discussed the relevance of typical domains of walkability to their decisions to exercise. Comparative analyses were conducted to identify major themes. The majority felt the concept of neighborhood was applicable and viewed their neighborhood as small geographically (less than 0.5 square miles). Sidewalks were not viewed as essential for neighborhood-based physical activity and typical destinations for walking were largely absent. Destinations within walking distance included neighbors' homes and bodies of water. Views were mixed on whether shade, safety, dogs, and aesthetics affected decisions to exercise in their neighborhoods. Measures of neighborhood walkability in rural areas should acknowledge the small size of self-defined neighborhoods, that walking in rural areas is likely for leisure time exercise, and that some domains may not be relevant.

Genetic and environmental influences on residential location in the US

We used a classical twin design and measures of neighborhood walkability and social deprivation, using each twin's street address, to examine genetic and environmental influences on the residential location of 1389 same-sex pairs from a US community-based twin registry. Within-pair correlations and structural equation models estimated these influences on walkability among younger (ages 18–24.9) and older (ages 25+) twins. Adjusting for social deprivation, walkability of residential location was primarily influenced by common environment with lesser contributions of unique environment and genetic factors among younger twins, while unique environment most strongly influenced walkability, with small genetic and common environment effects, among older twins. Thus, minimal variance in walkability was explained by shared genetic effects in younger and older twins, and confirms the importance of environmental factors in walkability of residential locations.

Physical Activity and Concordance between Objective and Perceived Walkability

The study's purpose was to investigate concordance between objective and perceived neighborhood walkability, their associations with self-reported walking and objective physical activity, and sociodemographic characteristics of individuals in neighborhoods with objectively assessed high walkability who misperceive it as low. In 1925 individuals age 20-66 yr of both high and low neighborhood walkability recruited from administrative areas in the city of Stockholm, Sweden, objective neighborhood walkability was assessed within a 1000-m radius of each individual's residential address using geographic information systems. Perceived walkability was based on the Neighborhood Environment Walkability Scale. Walking was assessed using the International Physical Activity Questionnaire, and total physical activity and moderate-to-vigorous physical activity (MVPA) were assessed by an accelerometer (ActiGraph). Sociodemographic characteristics were self-reported. Objective and perceived neighborhood walkability agreed in 67.0% of the individuals, with κ = 0.34 (95% confidence interval (CI) = 0.30-0.38). One-third of the individuals in neighborhoods with objectively assessed high walkability misperceived it as low. This nonconcordance was more common among older and married/cohabiting individuals. After adjustment for sociodemographic characteristics, high objective neighborhood walkability was associated with 35.0 (95% CI = 14.6-64.6) and 10.5 (95% CI = -5.2 to 28.5) more minutes per week of walking for transportation and leisure, respectively, and 2.8 (95% CI = 0.9-5.0) more minutes per day of MVPA. High perceived neighborhood walkability was associated with 41.5 (95% CI = 15.8-62.9) and 21.8 (95% CI = 2.8-40.0) more minutes per week of walking for transportation and leisure, respectively, and 1.7 (95% CI = -0.3 to 3.7) more minutes per day of MVPA. Objective and perceived neighborhood walkability both contribute to the amount of walking and objective physical activity. Both measures of neighborhood walkability may be important factors to target in interventions aiming at increasing physical activity.

Interaction of Perceived Neighborhood Walkability and Self-Efficacy on Physical Activity

Few social ecological studies have considered the joint effects of intrapersonal and environmental influences on physical activity. This study investigated the interaction of self-efficacy and perceived neighborhood walkability in predicting neighborhood-based physical activity and how this relationship varied by gender and body mass index. Data were derived from a cross-sectional investigation of environmental and psychosocial correlates of physical activity among adults (n = 585). Participants completed a detailed 7-day physical activity log booklet, along with a questionnaire that included measures of neighborhood walkability, self-efficacy, and several sociodemographic items. Factorial analysis of variance tests were used to examine the main effects of and interaction between walkability and self-efficacy. In predicting neighborhood-based physical activity, significant interactions were observed between self-efficacy and neighborhood walkability for females (but not for males) and for overweight/obese participants (but not for healthy weight individuals). Women and overweight/obese individuals with low self-efficacy demonstrated substantially greater physical activity when living in a high walkable neighborhood. Physical activity research and promotion efforts should take into account both environmental and personal factors and the interrelationships between them that influence active living.

Validation of Walk Scores and Transit Scores for estimating neighborhood walkability and transit availability: a small-area analysis

We investigated the validity of Walk Scores and Transit Scores from the Walk Score website using several objective geographic information systems (GIS) measures of neighborhood walkabiltiy and transit availability based on 400- and 800-m street network buffers. Address data come from the 2008 Boston Youth Survey Geospatial Dataset, a school-based sample of public high school students in Boston, MA with complete residential address information (n = 1,292). GIS data were used to create multiple objective measures of neighborhood walkability and transit availability. We also obtained Walk Scores and Transit Scores. We calculated Spearman correlations of Walk Scores and Transit Scores with the GIS neighborhood walkability/transit availability measures as well as Spearman correlations accounting for spatial autocorrelation. Several significant correlations were observed between Walk Score and 400-m buffer GIS measures of neighborhood walkability; all significant correlations were found for the 800-m buffer. All correlations between Transit Scores and GIS measures of neighborhood transit availability were also significant (all p < 0.0001). However, the magnitude of correlations varied by the GIS measure and neighborhood definition. Relative to the 400-m buffer, correlations for the 800-m buffer were higher. This study suggests that Walk Score is a good, convenient tool to measure certain aspects of neighborhood walkability and transit availability (such as density of retail destinations, density of recreational open space, intersection density, residential density and density of subway stops). However, Walk Score works best at larger spatial scales.

Bicycle Use for Transport in an Australian and a Belgian City: Associations with Built-Environment Attributes

The walkability attributes of neighborhood environments (residential density, land use mixture, and connectedness of streets) have been found to be associated with higher rates of walking. However, relatively less is known about the associations of walkability attributes with bicycle use for transport. We examined the relationships between adults' bicycle use for transport and measures of neighborhood walkability in two settings: an Australian city (Adelaide) with low rates of bicycle use and a Belgian city (Ghent) with high rates of bicycle use. A total of 2,159 and 382 participants were recruited in Adelaide and Ghent, respectively. A walkability index was derived from objectively measured data in Adelaide, while a similar index was derived from perceived measures in Ghent. Logistic regression models were employed to examine associations of bicycle use with different levels of walkability. There were higher rates of bicycle ownership for Ghent compared to Adelaide participants (96% versus 61%), and there was a higher prevalence of bicycle use for transport for Ghent compared to Adelaide participants (50% vs. 14%). Despite the large differences in bicycle ownership and use, living in a high-walkable neighborhood was associated with significantly higher odds of bicycle use for transport in both cities, after adjusting for relevant confounding factors. Built-environment innovations that are increasingly being advocated by health authorities and transport planners, primarily to promote higher rates of walking for transport, should also impact positively on bicycle use.

Association Of Neighborhood Built And Social Environment And Depressive Symptoms Among Middle Aged And Older Adults

Current research suggests that neighborhoods with few socioeconomic resources and unsafe conditions impose constant stress on the inhabitants, which can lead to increased risks for poor mental health conditions such as depression. PURPOSE: To examine whether neighborhood walkability, socioeconomic status, and residents' perceptions of their neighborhood environment were associated with depressive symptoms among middle aged and older adults. METHODS: The study used a cross-sectional, multilevel design involving neighborhoods as the primary sampling unit and residents as the secondary unit. A Geographic Information System-based measure of neighborhood walkability was constructed in 120 randomly selected neighborhoods in Portland, Oregon, from which 1145 adult residents 51-76 years of age completed a neighborhood environment and health survey. Depressive symptomology defined by the Center for Epidemiologic Studies Depression Scale (CES-D) with a cut-off score of ≥10. Multilevel logistic regression analyses were used to examine level-specific and cross-level associations between neighborhood-level measures of walkability and socioeconomic status and residents' perceptions of neighborhood safety, aesthetics, and social cohesion, and depressive symptoms. RESULTS: High walkability and socioeconomically advantaged neighborhoods were associated with a reduced likelihood of depressive symptoms. However, residents of low-walkability neighborhoods whose perceived their neighborhood as safe and socially cohesive and those in socioeconomically disadvantaged neighborhoods who perceived their neighborhoods as safe and having good aesthetics were also less likely to have depressive symptoms. CONCLUSIONS: These findings provide new evidence of the importance of both the independent and joint influences of urban form and people's perceptions of the built and social environment to the development of depressive symptomatology. Promoting neighborhood built and social environments that are safe, pleasing, and cohesive may be an important intervention for enhancing residents' health and reducing the likelihood of developing depressive symptoms. Supported by NIH Grant R01 ES014252

Attributes of Environments Supporting Walking

This study established a framework to audit environments supporting walking in neighborhoods. Cross-sectional analysis using a telephone survey and 200 objective environmental variables. SETTING. Urbanized King County, WA. SUBJECTS. 608 randomly sampled adults. Measures. Walking measures constructed from survey questions; objective environmental measures taken from parcel-level databases in Geographic Information Systems. Multinomial models estimated the odds of people engaging in moderate walking (<149 min/wk) and in walking sufficiently to meet recommendations for health (150+ min/ wk), relative to not walking" and in walking sufficiently, relative to walking moderately. A base model consisted of survey variables, and final models incorporated both survey and environmental variables. RESULTS. Survey variables strongly associated with walking sufficiently to enhance health included household income, not having difficulty walking, using transit, perceiving social support for walking walking outside of the neighborhood, and having a dog (p < .01). The models isolated 14 environmental variables associated with walking sufficiently (pseudo R2 up to 0. 46). Measures of distance to neighborhood destinations dominated the results: shorter distances to grocery stores/markets, restaurants, and retail stores, but longer distances to offices or mixed-use buildings (p < .01 or .05). The density of the respondent's parcel was also strongly associated with walking sufficiently (p < .01). Conclusions. The study offered valid environmental measures of neighborhood walkability.