Neighborhood Walkability Research Articles

A Framework for Measuring Neighborhood Walkability for Older Adults-A Delphi Consensus Study.

While mobility in older age is of crucial importance for health and well-being, it is worth noting that currently, there is no German language framework for measuring walkability for older adults that also considers the functional status of a person. Therefore, we combined the results of an expert workshop, a literature review, and a Delphi consensus survey. Through this, we identified and rated indicators relevant for walkability for older adults, additionally focusing on their functional status. The expert workshop and the review led to an extensive list of potential indicators, which we hope will be useful in future research. Those indicators were then adapted and rated in a three-stage Delphi expert survey. A fourth additional Delphi round was conducted to assess the relevance of each indicator for the different frailty levels, namely "robust," "pre-frail," and "frail." Between 20 and 28 experts participated in each round of the Delphi survey. The Delphi process resulted in a list of 72 indicators deemed relevant for walkability in older age groups, grouped into three main categories: "Built environment and transport infrastructure," "Accessibility and meeting places," and "Attractiveness and sense of security." For 35 of those indicators, it was suggested that functional status should be additionally considered. This framework represents a significant step forward in comprehensively covering indicators for subjective and objective walkability in older age, while also incorporating aspects of functioning relevant to older adults. It would be beneficial to test and apply the indicator set in a community setting.

Neighborhood Characteristics & Walking Behavior Among Adults with Arthritis: An NHIS Study.

This study investigated the association of perceived neighborhood qualities with likelihood of transit walking, leisure walking, neighborhood walking, and meeting physical activity (PA) recommendations among US adults with arthritis. This cross-sectional study utilized 2020 National Health Interview Survey data. Included participants were adults reporting clinician-diagnosed arthritis and who reported the ability to walk. Exposures of interest were perceived neighborhood attributes. Outcomes were transit walking, leisure walking, neighborhood walking, and meeting PA recommendations. Standardized mean difference percent (SMD%) was used to assess relationships between exposures and outcomes with SMD% >10% resulting in inclusion in final adjusted multivariate logistic regression models for odds of outcomes. All analyses were weighted to account for complex survey methodology. The analytic sample included 7,322 adults with arthritis. Fully adjusted logistic regression models showed presence of roads to walk on was associated with meeting PA recommendations (OR=1.26[95%CI=1.07-1.49]). Three attributes were positively associated with transit walking, while safety from crime was negatively associated (OR=2.33[95%CI=1.75-3.10], OR=1.49[95%CI=1.17-1.91], OR=1.67[95%CI=1.34-2.08]), OR=0.70[95%CI=0.53-0.92]). Roads to walk and places to walk and relax were associated with leisure and neighborhood walking (OR=1.46[95%CI=1.21-1.76], OR=1.56[95%CI=1.34-1.82], OR=1.58[95%CI=1.29-1.93], OR=1.63[95%CI=1.40-1.90], respectively). This study identified several neighborhood characteristics associated with higher likelihood of walking behaviors among adults with arthritis. Factors associated with walking behavior varied by type of walking. The shared correlates between leisure and neighborhood walking imply they occur in the same setting. Patients with arthritis may benefit from exercise recommendations that are informed by the presence or absence of facilitating infrastructure in their neighborhoods.

Everyday urbanism in Beijing’s edge cities: on spatial and experience patterns

ABSTRACT The concentration of people in mega agglomerations in China has been challenging urban governance to reduce daily commuting by planning and investing in new edge cities. The main objective of this paper is to investigate everyday urbanism in two recently developed edge cities in Beijing by considering spatial conditions as well as resulting activity and experience patterns. The applied mapping surveys include land use distributions and density calculations via evaluating GIS data as well as field observations to investigate the typical experiences of 32 representative neighborhood walks. One of the main findings is the overall dependency of neighborhoods on rigid grid planning defining urbanism with large block sizes, resulting in walking experiences with a majority being dominated by compound walls along main roads and only 15% of walks being experienced along active frontages despite rather high urban densities with up to 300 residents per hectare.

Correlation of the Walk Score and Environmental Perceptions with Perceived Neighborhood Walkability: The Quantile Regression Model Approach

The walk score, which is widely used as an index of walkability, does not include pedestrian’s perception, so there is a limit to explaining the level of perceived walkability in a neighborhood. The purpose of this study is to examine how an objectively measured walk score and subjectively measured environmental perceptions correlate with perceived neighborhood walkability. This study conducted a survey on 371 participants aged 18 or older living in Daegu, South Korea to examine perceived neighborhood walkability and perception of the built environment. We measured the walk score based on participants’ location using a geographic information system. We used the quantile regression model, whereby we investigated the effects of explanatory variables (e.g., the walk score, perceptions of the built environment) by classifying perceived neighborhood walkability by quantile into Q10, Q25, Q50, Q75, and Q90. The walk score had a positive association with people with low perceived neighborhood walkability (Q10), but a negative association with people with high perceived neighborhood walkability (Q90). Regarding views of the built environment, in most quantiles, people perceived the environment as walkable if there were abundant green spaces and diverse alternative routes. Conversely, odors, smoke, hills, and stairs impeded walkability. This indicates that along with an objective walkability index, perceptions of the built environment play an important role in determining perceived neighborhood walkability. This implies that our results can help identify appropriate policies to promote walkability for citizens.

The Governance of Traffic Noise Impacting Pedestrian Amenities in Melbourne Australia: A Critical Policy Review.

By identifying a unified aim of Federal, State, and Local government authorities to deliver healthier, more liveable urban spaces and enable walkable neighbourhoods in Melbourne, Australia, questions emerge regarding noise data collection methods and the policies that aim to protect pedestrian areas from potential increases in urban traffic noise. It highlights a missed opportunity to develop strategies that provide explicit guidance for designing more compact urban forms without diminishing pedestrian amenities. This study investigates the governance of traffic-induced noise pollution and its impact on pedestrian amenities in Melbourne, Australia. It aims to identify the government bodies best positioned to protect pedestrians from noise pollution and evaluate the strategic justification for reducing traffic noise to enhance urban walkability. This research employs a semi-systematic policy selection method and a hybrid critique and review method to evaluate the multidisciplinary governance frameworks engaged in the management and mitigation of traffic noise in Melbourne. Key findings reveal that while traffic noise poses significant health risks, current policies overlook its impact on pedestrian amenities in urban areas. This study emphasises the benefits of qualitative and subjective noise data collection to inform policy-makers of the pedestrian aural experience and impacts. Discussion points include noise management strategies and the value of implementing metropolitan-scale noise-mapping to illustrate the impact of noise rather than quantities of sound. The conclusions demonstrate that there is strategic justification for managing traffic-induced noise pollution to protect pedestrian areas within international, federal, and state government policies and implicit rationale at a local level.

Insights from neighbourhood walking interviews using the Living Environments and Active Aging Framework (LEAAF) in community-dwelling older adults

We aimed to understand whether neighbourhood characteristics are associated with movement and social behaviors using walking interviews with 28 community-dwelling older adults (aged 65+). Results indicated support for each component and each relationship in our proposed “Living Environments and Active Aging Framework”. Additional themes such as neighbourhoods with children, moving to neighbourhoods with opportunities for social activity and movement, and lingering effects of pandemic closures provided novel insights into the relationship between the living environment (neighbourhood) and active aging. Future work exploring sex and gender effects on these relationships, and work with equity-deserving groups is needed.

Beyond “buzz”: knowledge interactions, innovation, and neighborhood characteristics

Abstract We examine the link between neighborhood characteristics, the importance of knowledge exchange, and firm innovation in Montreal. To this end we combine two sources of data: place-of-residence census data from Statistics Canada and the results of an original firm survey. Through principal component analysis and subsequent clustering, we define five types of neighborhoods. The results revealed that firms assign higher importance to local knowledge exchange when located in dense, walkable neighborhoods with higher educated residents. Knowledge exchange, both local and global, correlates with incremental and radical innovation. Moreover, firms are innovative in any neighborhood, provided they engage in knowledge exchange.

Joint associations of neighbourhood walkability and greenery with walking among middle-aged and older adults: Findings from diverse urban settings in Australia

There is evidence that neighbourhood walkability and greenery are associated with walking, but less is known about their joint associations. We investigated this using data from the AusDiab3 study (2011/12) with 3032 adults (mean age 60 years). Two-level logistic regression models were used with binary walking outcomes. There was an inverse relationship (r = −0.5) between walkability (a composite measure of residential, destinations and intersections densities) and greenery (the size of densely vegetated areas). However, both walkability and greenery were independently positively associated with odds of walking. Regarding joint associations, in low-walkability neighbourhoods, greenery was positively associated with walking. In high-walkability neighbourhoods, greenery was not associated with walking.

Exploring the group heterogeneity in the impact of social cohesion on the walking frequency of older adults in China.

Walkable neighborhoods are closely related to an increase in walking frequency and the strengthening of social cohesion. These factors, in turn, contribute to lower BMI and other positive health-related outcomes. However, with a rapid increase in aging populations in China and the fact that women are facing more challenges than men as they age, especially mobility challenges because they tend to live longer leading to probabilities to become widowed. Nevertheless, less attention has been paid to understanding the gender difference between these relationships. Based on a survey of 533 older adults in Dalian, China, this study tried to investigate the intertwined relationship between perceived walkability, social cohesion, walking frequency, and BMI. A Structural Equation Model (SEM) and multiple-group analysis were applied to test the proposed framework. First, results show that gender differences existed among the above interrelationships, and the most substantial gender gap was found in effects of social cohesion on BMI. Second, perceived walkability only has a direct effect (0.149) on walking frequencies for female seniors. Third, although the relationships between perceived walkability and BMI are not directly related in both male and female models, the indirect connection (-0.053) is substituted for female seniors. Besides, the inhibiting effect of walking on BMI, which is -0.511, is also valid for female seniors. Finally, in terms of the role of social cohesion, both the positive impacts of perceived walkability on it (0.225 for males and 0.325 for females) and its promoting effects on walking have been confirmed in male (0.142) and female models (0.103). The negative direct effect of social cohesion on BMI (-0.083) is only confirmed in male seniors. Insights derived from this analysis can help bring forward gender-specific interventions to build a more inclusive walkable and social environment to improve the mobility and physical health of older adults.

Arabic translation, cultural adaptation, and pre-testing of neighborhood environment walkability scale for adults-abbreviated (NEWS-A): Arabic NEWS-A

BackgroundImproving neighborhood walkability is critical for sustainable and livable urban development and is associated with increased physical activity. The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) is a tool for assessing neighborhood walkability among adults. Currently, no Arabic version is available for this important walkability scale.ObjectiveTo translate the NEWS-A to Arabic, culturally adapt, and pre-test it for adults.MethodsThe NEWS-A was translated and culturally adapted using Cross-cultural Survey Guidelines and then pre-tested using 65 households selected randomly from the neighborhoods of three districts in Riyadh. After answering the survey, 55 participants took part in a semi-structured cognitive interview, which sought their understanding of the words in the Arabic questionnaire, the clarity of each item, and their suggestions for improvement.ResultsTranslation and adaptation of NEWS-A to Arabic resulted in adding two items (mosque and healthcare center) to section B of the scale (stores, facilities, and other things in your neighborhood) and one related item to section C (access to services). The total individual items became 57 instead of the original 54 items in the English version. Also, we added “ATM machine” to item 14 (Bank/credit union) in section B. In addition, the overall results of the cognitive interview showed that most of the participants understood the intended meaning of the questionnaire (99.5%). Further, 99.8% of the respondents stated that the items were not difficult to comprehend, while 100% of the sample indicated that the sentences were comfortable and not sensitive to them.ConclusionTranslating, adapting, and pre-testing the NEWS-A resulted in retaining all the original items and adding three additional items. The Arabic NEWS-A provides an important tool for future research on neighborhood environment walkability among adults.

Do pedestrian safety improvements affect older adults' health and social outcomes equitably? A quasi experiment in Singapore

IntroductionPedestrian-friendly neighborhoods are believed to encourage greater social participation, community engagement, and sense of social inclusion, which are important to older individuals at higher risk of being socially isolated. However, most studies on neighborhood walkability, social participation and social inclusion are cross-sectional, making it difficult to robustly establish causal links. Much research on neighborhood walkability is also based in North America and Europe, leaving a knowledge gap on the impact of walkability within other geographic contexts. Furthermore, there is a lack of empirical evidence about whether benefits from traffic calming schemes are distributed equitably. To reduce these empirical gaps, our study capitalises on a ‘quasi-experiment’ to estimate the impact of an infrastructure-focused pedestrian safety program “Silver Zones' in Singapore, a highly urbanised city state in Southeast Asia with an aging population. MethodsThis study utilises panel data from a high-frequency internet-based survey of older adults that has been administered from 2015 till present. We examine how changes in older residents' residential proximity to Silver Zones relate to changes in their social and health outcomes. We also test whether the relationship between Silver Zones and older individuals' health and social participation outcomes might be moderated by age and socioeconomic class. Finally, we interpret these findings in view of participants’ perceptions of Silver Zones. Results and conclusionWe find that the oldest participants with low SES -- a particularly vulnerable subgroup -- experienced negative changes after the opening of Silver Zones near them, as did those classified as mid SES. In contrast, our findings suggest that new Silver Zones might have a positive effect on older adults of high SES. These findings suggest that there might be inequities in the impact of pedestrian safety programs on residents' social outcomes. Additionally, while our findings were statistically significant, they also suggest that Silver Zones’ contribution to changes in participant outcomes were relatively small, which might be due to a mismatch between perceptions of Silver Zones, actual exposure, and participant outcomes. Our findings underscore the need for more outreach and publicity campaigns around pedestrian safety initiatives, as well as the importance of going beyond self-reported perceptions when assessing the success of pedestrian safety schemes like the Silver Zones.

Neighborhood environment, socioeconomic conditions, and intergenerational mobility

Intergenerational mobility (IM) has recently generated significant attention. However, the mechanisms of IM, including the neighborhood effects, are still not well understood. This research aims to advance the research on IM by emphasizing the role of neighborhood environments and their mediating effects in the United States. Our results suggest that childhood neighborhood conditions significantly affect IM, and IM is determined by childhood physical and socioeconomic status (SES) or conditions and outmigration. Specifically, we find that natural and built environments affect IM indirectly through neighborhood SES, and, therefore, the effect of SES has been overestimated. Moreover, there are complex pathways linking neighborhood SES to IM. A dense, mixed-use, and walkable neighborhood may show lower IM because such neighborhoods usually have higher concentrations of poor people and single parents. We also find that outmigration is a pathway to IM. Desirable childhood neighborhood environments and high outmigration returns lead to higher IM in rural areas than in urban areas, and also higher IM in the West North Central region than in the East South Central and South Atlantic regions, although these regions have similarly low SES. Our study highlights the significant effects of the neighborhood environment on IM.

How do urban design elements shape residential neighborhood walkability? Emerging evidence and implications from metropolitan Lagos

How do urban design elements shape residential neighborhood walkability? Emerging evidence and implications from metropolitan Lagos

Self-perceptions of aging, physical activity, and depressive symptoms in older community residents with varied neighborhood walkability in Taiwan

BackgroundPrior research has identified the mediating effect of physical activity in the relationship between self-perceptions of aging and physical health. However, this impact on mental health is unknown, and the influence of environmental contexts proposed by ecological models in this regard remains largely unexplored. Therefore, this study aimed to investigate the role of physical activity in the relationship between self-perceptions of aging and depressive symptoms in older adults, and compare the impact across four levels of neighborhood walkability.MethodsA sample of 1,055 community-dwelling older adults aged 65 or above was obtained through random-digit-dialing computer-assisted telephone interviewing. The individual’s neighborhood walkability was calculated using Walk Score®, and categorized into four levels: car-dependent, somewhat walkable, very walkable, and walker’s paradise. Partial least squares structural equation modelling was employed.ResultsWe found that more positive self-perceptions of aging were associated with fewer depressive symptoms and a mediation effect of physical activity in this relationship. Among the four levels of neighborhood walkability, the mediation effect of physical activity was only statistically significant in the lowest level (car-dependent). The findings supported our hypotheses regarding the mediating effect of self-perceptions of aging on depressive symptoms via physical activity. Neighborhood walkability might potentially influence the mediating role of physical activity.ConclusionsThis study emphasizes key areas on intervention programs and policy formulation to promote mental health in older adults.

Redefining active mobility from spatial to social in Singapore

IntroductionWalking is an active mobility option with health and social benefits. Many cities including Singapore are expanding pedestrian infrastructure and creating walkable neighbourhoods. But the connection of neighbourhood walkability and walking behaviour among residents, especially older adults remains less examined. The aim of this study is to examine the relationship between everyday walking behaviours and neighbourhood design characteristics. MethodsUtilising generative focus group discussions with 12 participants, including older adults, this exploratory research collected personal and collective stories on residents' walks around Singapore's high-rise, high-density public housing neighbourhoods of Tampines Town, including their attitudes, aversions, and aspects of environmental barriers and enablers for walking. ResultsAll 12 participants had walked in their neighbourhoods during the 7 days preceding the focus group discussion. A key motivation for walking in the neighbourhood was everyday life activities and needs, such as to get out of the house, walking for food, groceries, work, exercise, and health, reinforcing the pivotal role of these opportunities in residents’ active mobility life space and the availability and accessibility to these local facilities. Drawing on their everyday lived experiences, participants shared their conception of walkable neighbourhood, the adequacy of neighbourhood places for walking, the environmental barriers and enablers. Older participants spoke about walkable environments helping them to reach essential destinations safely every day and contributing to not only their physical health but also social and mental health (through contact with nature and interaction with neighbours and others within the neighbourhood). Where they would walk is often influenced by their perception of the place, sense of safety, and the presence/absence of services. ConclusionsThe findings lend local priorities for walkable neighbourhoods based on what residents think and blending social consensus. The policy implication is a need to consider both place enhancement and people's experience, including experiential micro-social and psychological aspects and their interlinkages when designing inclusive walkable neighbourhood.

Associations of neighborhood social cohesion and changes in BMI-The Maastricht Study.

The role of the social environment can facilitate positive health outcomes through active community engagement, normalization of healthy behaviors, and stress buffering. We aim to examine the associations of neighborhood social cohesion with changes in BMI over time. A total of 7641 participants from The Maastricht Study between the ages of 40 and 75 years were analyzed. Weight and height were measured at baseline, and weight was self-reported annually up to 10 years of follow-up (median = 4.7 years). Perceived social cohesion was obtained by questionnaire. Home addresses for each participant were linked to geographic information system data from the Geoscience and Health Cohort Consortium to create neighborhood exposure variables including area level social cohesion, neighborhood walkability, and food environment within a 1000 m Euclidian buffer. Linear regression analyses were performed with BMI adjusted for socioeconomic variables. A mixed model analysis was carried out to examine changes in BMI. Living in the highest quartile area of individually perceived social cohesion was associated with lower BMI (Q4 B: -.53; 95% CI = -.79, -.28) compared to the lowest quartile. Similar findings were discovered using the area level measure (Q4 B: -.97; 95% CI = -1.29, -.65). There was no longitudinal association between social cohesion and BMI. Neighborhood social cohesion was associated with lower BMI classifying it as an obesogenic area characteristic that influences weight, independent of conventional built environment features.

Neighbourhood walkability and body mass index in children: Evidence from the Millennium Cohort Study in Wales

BackgroundOverweight and obesity in children continues to increase. Yet, the role of active transport, namely walking, in mitigating these trends remains unclear. This study examined the cross-sectional association between walkability and children's Body Mass Index (BMI) and how this varies by socio-economic and lifestyle characteristics. MethodsWe analysed BMI for 14-year-old children living in Wales from the UK Millennium Cohort Study. Children were categorised as healthy weight, overweight or obese using the British 1990 cut-off points. Walkability was assessed using the Wales Active Living Environments (Wal-ALE) database, categorised as 1 (least walkable environments) to 5 (most walkable environments). We applied multinomial logistic regression analysis and adjusted for ethnicity, having a limiting longstanding illness, parental BMI, socio-economic circumstances, and lifestyle characteristics. ResultsChildren were more likely to be obese if they lived in areas classed as more walkable in unadjusted analysis [Relative Risk Ratio (RRR) = 1.72 (95%CI = 1.15–2.58)] and following adjustment for ethnicity, limiting longstanding illness and parental BMI [RRR = 1.83 (95%CI = 1.12–3.00)]). Significant associations remained even after further adjustment for lifestyle characteristics and socio-economic circumstances [RRR = 1.76 (95%CI = 1.05–2.96)]. Further, children were more likely to be obese if their parents were overweight or obese and if they were living in poverty. Children were less likely to be obese if they spent 3 or more days per week in moderate-to-vigorous physical activity (MVPA) and if they ate breakfast every day vs. some days or never. ConclusionFindings demonstrate that walkable environments are not associated with lower rates of obesity in children, indicating that the relationship between the built environment and child health is complex and requires further study.

Predictors of Physical Activity One Year After Moderate to Severe Traumatic Brain Injury.

To identify predictors of moderate to vigorous physical activity (MVPA) at 12-months post-moderate-severe traumatic brain injury (TBI). Setting: Four inpatient rehabilitation centers. Individuals enrolled in the TBI Model Systems with moderate to severe TBI, admitted to inpatient rehabilitation, and able to ambulate without physical assistance from another person. Prospective longitudinal cohort study. MVPA was measured by having participants wear an ActiGraph GT3X on their wrist for 7 consecutive days. We used multivariate regression to predict minutes per week of MVPA at 12months after TBI. Three classes of predictors were entered hierarchically-demographic and clinical variables (age, sex, body mass index, education, TBI severity, neighborhood walkability score, and self-reported preinjury physical activity [PA] level), baseline TBI-related comorbid conditions (eg, measures of sleep, pain, mood, fatigue, and cognition), and intention to exercise and exercise self-efficacy assessed approximately 1week after discharge from inpatient rehabilitation. 180 participants (ages 17.7-90.3years) were enrolled, and 102 provided at least 5days of valid accelerometer data at 12months. At 12months, participants recorded an average of 703 (587) minutes per week of MVPA. In univariate and multivariate analyses, age was the only significant predictor of 12-month MVPA (r =-0.52). A sharp decline in MVPA was observed in the tertile of participants who were over the age of 61. Older adults with TBI are at elevated risk of being physically inactive. Assuming PA may enhance health after TBI, older adults are a logical target for prevention or early intervention studies. Studies with longer outcomes are needed to understand the trajectory of PA levels after TBI.

Assessing the walkability of high-density neighborhoods: Development and reliability of the high-density environment assessment tool (HEAT)

BackgroundWalking is a widespread and multifaceted activity among residents in high-density cities, making assessing the neighborhood walking environments important. Existing tools for assessing walkability in high-density cities primarily focus on the immediate environment of sidewalks. However, an individual's walking behavior is influenced by environmental characteristics across multiple dimensions and scales. Consequently, based on a systematic analysis of the features of high-density cities, this study proposes the High-density Environment Assessment Tool (HEAT). This hybrid approach comprehensively assesses walkability in high-density cities by incorporating variables of neighborhood, segment (sidewalk), and crossing. MethodsThe HEAT consisted of three sections with 108 items. To validate the reliability and applicability, field tests were conducted in two 15-min walkable neighborhoods with different built environment contexts in Chongqing City, China. The neighborhood section was objectively assessed using ArcGIS Software. The segment section and crossing section were audited through systematic on-site observation. Four pairs of trained raters assessed all of the segments (n = 139) and crossings (n = 123) within the two neighborhoods. The inter-rater reliability of the repeated audit data was evaluated by Kappa/Weighted Kappa or Percentage Agreement values. A web-based application was used for data collection and input. ResultsFor the neighborhood section, 21 assessment items were included. For the segment and crossing sections, 87 assessment items were included for the reliability test, and 84 (96.6%) of the items indicated satisfying inter-rater reliability (with Kappa/Weighted Kappa value ≥ 0.4 or high Percentage Agreement). In addition, the audit of each segment and crossing sample was completed in an average of 7.9 and 1.8 min, respectively. ConclusionsThe results indicated that the HEAT was reliable and efficient. The HEAT provided an effective tool for assessing the walkability of the neighborhood built environment in high-density cities, thereby facilitating environmental interventions aimed at promoting walking activities.

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.