Neighborhood Walkability Research Articles

Urban ecosystem services and climate change: a dynamic interplay

Urban ecosystems play a crucial role in providing a wide range of services to their inhabitants, and their functioning is deeply intertwined with the effects of climate change. The present review explores the dynamic interplay between urban ecosystem services and climate change, highlighting the reciprocal relationships, impacts, and adaptation strategies associated with these phenomena. The urban environment, with its built infrastructure, green spaces, and diverse human activities, offers various ecosystem services that enhance the wellbeing and resilience of urban dwellers. Urban ecosystems offer regulatory services like temperature control, air quality upkeep, and stormwater management, plus provisioning like food and water. They also provide cultural benefits, promoting recreation and community unity. However, climate change poses significant challenges to urban ecosystem services. Rising temperatures, altered precipitation patterns, and increased frequency of extreme weather events can disrupt the functioning of urban ecosystems, impacting the provision of services. Heatwaves and urban heat island effects can compromise human health and energy demands, while changes in rainfall patterns can strain stormwater management systems and lead to flooding. Moreover, climate change can disrupt biodiversity and ecological processes, affecting the overall resilience and sustainability of urban ecosystems. To address these challenges, cities are adopting various adaptation strategies that recognize the interdependence between urban ecosystems and climate change. Green infrastructure interventions, such as the creation of urban parks, green roofs, and community gardens, aim to mitigate the impacts of climate change by enhancing the regulation of temperature, improving air quality, and reducing stormwater runoff. Additionally, urban planning and design approaches prioritize compact and walkable neighborhoods, promoting public transportation and reducing reliance on fossil fuels. Furthermore, engaging communities in the management of urban ecosystems and climate change adaptation measures is crucial for ensuring equitable distribution of ecosystem services and building social resilience. Therefore, the review article highlights a comprehensive understanding of the dynamic interrelationship between urban ecosystem services and climate change and their implications. By recognizing and integrating the contributions of urban ecosystems, cities can develop sustainable and resilient strategies to mitigate and adapt to climate change, ensuring the wellbeing and habitability of urban environments for present and future generations.

Associations of the neighbourhood built and natural environment with cardiometabolic health indicators: A cross-sectional analysis of environmental moderators and behavioural mediators

BackgroundMost studies examining the effects of neighbourhood urban design on cardiometabolic health focused solely on the built or natural environment. Also, they did not consider the roles of neighbourhood socio-economic status (SES) and ambient air pollution in the observed associations, and the extent to which these associations were mediated by physical activity and sedentary behaviours. MethodsWe used data from the AusDiab3 study (N = 4141), a national cohort study of Australian adults to address the above-mentioned knowledge gaps. Spatial data were used to compute indices of neighbourhood walkability (population density, intersection density, non-commercial land use mix, commercial land use), natural environment (parkland and blue spaces) and air pollution (annual average concentrations of nitrogen dioxide (NO2) and fine particulate matter <2.5 μm in diameter (PM2.5)). Census indices were used to define neighbourhood SES. Clinical assessments collected data on adiposity, blood pressure, blood glucose and blood lipids. Generalised additive mixed models were used to estimate associations. ResultsNeighbourhood walkability showed indirect beneficial associations with most indicators of cardiometabolic health via resistance training, walking and sitting for different purposes; indirect detrimental associations with the same indicators via vigorous gardening; and direct detrimental associations with blood pressure. The neighbourhood natural environment had beneficial indirect associations with most cardiometabolic health indicators via resistance training and leisure-time sitting, and beneficial direct associations with adiposity and blood lipids. Neighbourhood SES and air pollution moderated only a few associations of the neighbourhood environment with physical activity, blood lipids and blood pressure. ConclusionsWithin a low-density and low-pollution context, denser, walkable neighbourhoods with good access to nature may benefit residents’ cardiometabolic health by facilitating the adoption of an active lifestyle. Possible disadvantages of living in denser neighbourhoods for older populations are having limited opportunities for gardening, higher levels of noise and less healthy dietary patterns associated with eating out.

The obesogenic environment and incident cardiovascular disease in The Maastricht Study

Abstract Background The built environment has been identified as an upstream determinant of cardiovascular disease (CVD) in which neighborhood walkability and healthy food environments may promote increased physical activity and healthier dietary intake. Our aim is to determine if these neighborhood environments are associated with decreased incidence. Methods Data from 6,563 participants of The Maastricht Study and Geoscience and Health Cohort Consortium between the ages of 40-75 without history of CVD were analyzed. Objective walkability was measured by the 7-component Dutch Walkability Index while the food environment was an aggregate score of available food outlets, within 1000m Euclidian buffers around residential addresses of participants. Perceived walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. Incident CVD was obtained from a follow-up questionnaire. A Cox regression analysis was performed with CVD morbidity time to event outcomes adjusting for demographic and socioeconomic covariates. Results Over a median follow-up of 7.2 years (1.0-12.0 years), 975 cases were reported. The most walkable neighborhoods were not associated with incident CVD for both perceived (HR: .80; 95% CI = .64, 1.00) and objective (HR: 1.14; 95% CI = .91, 1.43) neighborhood environment measures compared to those living in the least walkable neighborhoods. When considering individual CVD conditions, participants had statistically significant lower incidence of peripheral vascular disease in the highest perceived walkable neighborhoods (HR: .57; 95% CI = .41, .78). The healthiest food environments (HR: .84; 95% CI = .66, 1.06) were not related to incident CVD. Conclusions Objectively measured walkability and neighborhood food environment were not associated with overall incident CVD with participants in our study. We found perceived neighborhood walkability to be associated with lower incident peripheral vascular disease. Key messages • Research on the obesogenic environment should additionally be carried out in other regions to gain additional understanding of its effect on cardiovascular disease. • Further study on the impact of walkable environments on individuals with peripheral vascular disease should be considered to understand its effect with this population.

Healing Obesity with health-promoting environments – can interventions in Urban Policies bring health benefits?

Abstract Obesity is a complex chronic disease associated with numerous health and social consequences. In 90% of cases, obesity is multifactorial, with a basis in a discrepancy between energy intake and consumption, but also caused by endocrine, psychological factors, environment, improper diet, physical inactivity, and lifestyle. The environment where people live and work must provide opportunity for enough physical activity to prevent obesity. The availability of fitness parks, bike paths, and publicly accessible swimming pools are the many possibilities that a positive and encouraging environment could provide. Urban areas demand publicly accessible places for physical activity. At the same time, it is important to motivate citizens in urban areas to increase their physical activity, because of a predominantly sedentary lifestyle. If the city's urban and health policies promote a healthy lifestyle, for example encouraging cycling and walking by providing infrastructure that will allow for a greater percentage of people to engage daily in physical activity. A healthy-behaviors-promoting environment is important to combat obesity (walkable neighborhood, green space, safe cycling, healthy food availability). A variety of policy strategies are available to create an active and safe environment: 1) increasing green and blue areas in urban settings: to promote recreation and relaxation; 2) promoting cycling and walking as a form of active mobility; 3) reducing or banning of public advertising of unhealthy food, while promoting healthy nutrition and increase of markets with healthy food; 4) encouraging socialization through sport, etc. Providing a healthy and safe environment is necessary to curb the obesity epidemic. Numerous interventions aimed at implementing a plan to change the environment and create a safe and stimulating environment for children and adults are needed.

Neighborhood Features and Cognitive Function: Moderating Roles of Individual Socioeconomic Status

Introduction: There is an interest in exploring the associations between neighborhood characteristics and individual cognitive function; however, little is known about whether these relationships can be modified by individual socioeconomic status, such as educational attainment and income. Methods: Drawing from the 2010-2018 Health and Retirement Study (HRS), this study analyzed 10,621 older respondents (aged 65+) with a total of 33,931 person-waves. These respondents did not have dementia in 2010 and stayed in the same neighborhood throughout the study period. Cognitive function was measured with a 27-point indicator biennially, and neighborhood characteristics (i.e., walkability, concentrated disadvantage, and social isolation) were assessed in 2010. All analyses were performed in 2023. Results: Cognitive function is positively associated with neighborhood walkability and negatively related to concentrated disadvantage, suggesting that exposures to these neighborhood characteristics have long-lasting impacts on cognitive function. Furthermore, individual socioeconomic status modifies the relationship between neighborhood characteristics and cognitive function. Compared with those graduating from college, respondents without a bachelor's degree consistently have lower cognitive function but the educational gap in cognitive function narrows with increases in walkability (b=-0.152, SE=0.092), and widens when neighborhood concentrated disadvantage (b=0.212, SE=0.070) or social isolation (b=0.315, SE=0.125) rises. The income gap in cognitive function shrinks with increases in walkability (b=-0.063, SE=0.027). Conclusions: The moderating role of socioeconomic status indicates that low-socioeconomic status older adults who also live in disadvantaged neighborhoods face a higher risk of poor cognitive function. Low-education and low-income aging adults may have the most to gain from investments to improve neighborhood characteristics.

The relationship of single-family detached house prices with neighborhood walkability and disaster risk.

People's preferences regarding their neighborhood environment can vary depending on their socioeconomic status and the cities where they live. This study aims to discern the relationship between neighborhood environment factors and single-family detached house sales by sale price and by central and noncentral cities. We analyzed sale prices in the Tokyo Metropolitan Area from 2015 to 2020. The neighborhood environment was assessed using flood/sediment risk and neighborhood walkability measured by net residential density, intersection density, and facility density (walking opportunity). Flood and sediment risk is a major concern that restricts the available land and is included as a negative aspect of the neighborhood environment, taking the topographic features into consideration. A comparison of the results showed that the preference for neighborhood walkability varies by socioeconomic status as well as by target cities. For most facility types, the number of walking opportunities within walking distance from houses was found to be positively related to the sale price of single-family detached houses in all quantiles. The relationship of house price with population and intersection density was found to vary depending on the price level, with a negative relationship with the sale price of relatively more expensive houses being exhibited. People who considered buying houses with relatively higher sale prices were found to devalue houses located in flood/sediment-hazardous areas more. However, it was also found that the negative relationship was slightly mitigated in the highest quantile of sale prices for houses in areas with a moderate flood risk (maximum flooding depth: 3-5 m). Plains near rivers with amenities offer high walkability but pose a flood risk, resulting in a trade-off between flood risk and neighborhood walkability. The findings suggest the use of indices representing diverse preferences in accordance with the target socioeconomic status when policymakers assess the neighborhood environment.

Culture and Walkability: Ethnicity, Neighborhood Walkability, and House Price

Culture and Walkability: Ethnicity, Neighborhood Walkability, and House Price

Measuring walkability and bikeability for health equity and intervention research: a scoping review

ABSTRACT The purpose of this study was to describe self-report and audit-based measurement tools of neighbourhood walkability and bikeability for health equity and intervention research. We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We searched MEDLINE via PubMed, Embase, Web of Science, and SPORTDiscus with full text via EBSCO in March 2022. We extracted data from a total of 35 papers which reported on 23 self-report and 15 audit-based measures assessing walkability and bikeability. Studies spanned multiple regions including Africa, America, Australia, and Europe, but most were conducted in the United States (n = 15), followed by Australia (n = 6). The most used self-report measure was the Neighbourhood Environment Walkability Scale (NEWS), while the audit tools Pedestrian Environment Data Scan and Bridge the Gap Street Segment Tool were each used in two studies. The priority populations most often studied were residents of low socio-economic status/high disadvantage neighbourhoods, racialized groups, women, youth, older adults, and rural populations. Ultimately, there is no one tool that can be recommended for use in all contexts and with all priority populations; rather, tools may require adaptations to specific contexts and populations of interest.

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.

Exposure to Neighborhood Walkability and Residential Greenness and Incident Fracture

Emerging studies have suggested that environmental factors are associated with fracture. However, little is known about the association of neighborhood walkability and residential greenness with fracture. To investigate the association of long-term exposure to walkability and greenness with incident fracture and explore the potential interaction effect. This cohort study recruited participants aged 40 years or older in Ningbo, China from June 2015 to January 2018. Participants were observed for outcomes through February 2023, with data analysis conducted in March 2023. Neighborhood walkability was measured by a modified walkability calculation method according to a walk score tool. Residential greenness was assessed by satellite-derived normalized difference vegetation index (NDVI) within a 1000-m buffer. Incident fracture was ascertained according to International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes via the Yinzhou Health Information System. Cox proportional hazards models were fit, with age as time scale to estimate the associations of walkability and greenness with fracture. Potential effect modification was explored by covariates, as well as the interactive effect of walkability and greenness. A total of 23 940 participants were included in this study with 13 735 being female (57.4%). The mean (SD) age at baseline was 63.4 (9.4) years. During a follow-up period of 134 638 person-years, 3322 incident fractures were documented. In the full adjusted model, every IQR increment in neighborhood walkability and residential greenness was associated with a hazard ratio (HR) of 0.88 (95% CI, 0.83-0.92) and 0.84 (95% CI, 0.80-0.89), respectively, for fracture. Furthermore, the association of greenness and fracture was greater with an increase in walkability. The HR (Q4 vs Q1) for greenness was 0.62 (95% CI, 0.46-0.82) in neighborhoods with the highest quartile of walkability. This population cohort study suggested that long-term exposure to neighborhood walkability and residential greenness were both associated with lower risk of incident fracture. The benefits of greenness increased in more walkable areas.

Association between racial residential segregation and walkability in 745 U.S. cities

Despite higher chronic disease prevalence, minoritized populations live in highly walkable neighborhoods in US cities more frequently than non-minoritized populations. We investigated whether city-level racial residential segregation (RRS) was associated with city-level walkability, stratified by population density, possibly explaining this counterintuitive association. RRS for Black-White and Latino-White segregation in large US cities was calculated using the Index of Dissimilarity (ID), and walkability was measured using WalkScore. Median walkability increased across increasing quartiles of population density, as expected. Higher ID was associated with higher walkability; associations varied in strength across strata of population density. RRS undergirds the observed association between walkability and minoritized populations, especially in higher population density cities.

A positive neighborhood walkability is associated with a higher magnitude of leisure walking in adults upon COVID-19 restrictions: a longitudinal cohort study

BackgroundPrevious cross-sectional and longitudinal observational studies revealed positive relationships between contextual built environment components and walking behavior. Due to severe restrictions during COVID-19 pandemic lockdowns, physical activity was primarily performed within the immediate living area. Using this unique opportunity, we evaluated whether built environment components were associated with the magnitude of change in walking activity in adults during COVID-19 restrictions.MethodsData on self-reported demographic characteristics and walking behaviour were extracted from the prospective longitudinal Lifelines Cohort Study in the Netherlands of participants ≥ 18 years. For our analyses, we made use of the data acquired between 2014–2017 (n = 100,285). A fifth of the participants completed the questionnaires during COVID-19 restrictive policies in July 2021 (n = 20,806). Seven spatial components were calculated for a 500m and 1650m Euclidean buffer per postal code area in GIS: population density, retail and service destination density, land use mix, street connectivity, green space density, sidewalk density, and public transport stops. Additionally, the walkability index (WI) of these seven components was calculated. Using multivariable linear regression analyses, we analyzed the association between the WI (and separate components) and the change in leisure walking minutes/week. Included demographic variables were age, gender, BMI, education, net income, occupation status, household composition and the season in which the questionnaire was filled in.ResultsThe average leisure walking time strongly increased by 127 min/week upon COVID-19 restrictions. All seven spatial components of the WI were significantly associated with an increase in leisure walking time; a 10% higher score in the individual spatial component was associated with 5 to 8 more minutes of leisure walking/week. Green space density at the 500m Euclidean buffer and side-walk density at the 1650m Euclidean buffer were associated with the highest increase in leisure walking time/week. Subgroup analysis revealed that the built environment showed its strongest impact on leisure walking time in participants not engaging in leisure walking before the COVID-19 pandemic, compared to participants who already engaged in leisure walking before the COVID-19 pandemic.ConclusionsThese results provide strong evidence that the built environment, corrected for individual-level characteristics, directly links to changes observed in leisure walking time during COVID-19 restrictions. Since this relation was strongest in those who did not engage in leisure walking before the COVID-19 pandemic, our results encourage new perspectives in health promotion and urban planning.

Prospective associations of neighborhood healthy food access and walkability with weight status in a regional pediatric health system

BackgroundMost neighborhood food and activity related environment research in children has been cross-sectional. A better understanding of prospective associations between these neighborhood environment factors and children’s weight status can provide stronger evidence for informing interventions and policy. This study examined associations of baseline and changes in neighborhood healthy food access and walkability with changes in children’s weight status over 5 years.MethodsHeight, weight, and home address were obtained for 4,493 children (> 75% were Black or Latinx) from primary care visits within a large pediatric health system. Eligible participants were those who had measures collected during two time periods (2012–2014 [Time 1] and 2017–2019 [Time 2]). Data were integrated with census tract-level healthy food access and walkability data. Children who moved residences between the time periods were considered ‘movers’ (N = 1052; 23.4%). Mixed-effects models, accounting for nesting of children within census tracts, were conducted to model associations of baseline and changes in the neighborhood environment variables with Time 2 weight status (BMIz and overweight or obese vs. healthy weight). Models adjusted for weight status and child and neighborhood sociodemographics at baseline.ResultsChildren living in a neighborhood with [ample] healthy food access at Time 1 had a lower BMIz at Time 2, regardless of mover status. A decrease in healthy food access was not significantly associated with children’s weight status at Time 2. Baseline walkability and improvements in walkability were associated with a lower BMIz at Time 2, regardless of mover status.ConclusionsFindings provide evidence that residing in a neighborhood with healthy food access and walkability may support a healthy weight trajectory in children. Findings on changes in the neighborhood environment suggested that improved walkability in the neighborhood may support children’s healthy weight. The greater and more consistent findings among movers may be due to movers experiencing greater changes in neighborhood features than the changes that typically occur within a neighborhood over a short period of time. Future research is needed to investigate more robust environmental changes to neighborhoods.

Association between neighborhood walkability and chronic kidney disease: A longitudinal cohort study in Taiwan

Association between neighborhood walkability and chronic kidney disease: A longitudinal cohort study in Taiwan

Exposure to neighbourhood walkability and mortality: A longitudinal cohort study

Exposure to neighbourhood walkability and mortality: A longitudinal cohort study

Neighbourhood active living environment and obesity in adolescents using the Millennium Cohort Study

ObjectivesYouth obesity has increased substantially in recent decades; however, the potential role of the built environment in mitigating these trends is unclear. This study examines whether more walkable neighbourhoods are associated with lower levels of overweight/obesity for adolescents compared to less walkable neighbourhoods, after considering the potential role of socio-economic and lifestyle characteristics.&#x0D; MethodsWe examine overweight/obesity levels for all singleton 14 years-old children living in Wales, using the UK Millennium Cohort Study. Children are classified as healthy weight, overweight and obese using international age and sex adjusted cut-offs for body mass index (BMI). The built environment is assessed using the active living environments (ALE) index for 2017-2018 classified into 5 categories (1-low walkability and 5 – high walkability). We apply regression analysis and adjust for children characteristics (e.g., physical activity), parental socio-economic circumstances and lifestyle choices (e.g., maternal education, physical activity).&#x0D; ResultsWe assess the hypothesis that the built environment is associated with adolescents’ overweight/obesity levels and examine how much of this association could be modified by parental socioeconomic circumstances and lifestyle choices. The ALE index is higher in urban compared to rural areas. To capture variations in Wales’ population, we are conducting a stratified analysis to explore any differences on the association between ALE index and adolescents’ overweight/obesity by urban and rural areas. Accounting for the potential role of lifestyle and socio-economic characteristics is key for future research, as understanding the underlying pathways of this association is necessary to design effective interventions.&#x0D; ConclusionFindings can help us develop a better understanding of associations between the built environment and overweight/obesity status to inform evidence-based planning policy and practice strategies on how to modify the built environment to promote child health in future generations by increasing better opportunities for diet and activity.

How does the environment in and around the home impact social care and health outcomes for older people?

Reducing the burden of falls and fall-related admissions to hospital and care homes is an important policy area. Falls cause significant injury leading to a reduced quality of life. We wanted to know if the environment around people’s homes changes the risk of falls for older people in Wales.&#x0D; We linked routinely collected, anonymised health data on frailty, dementia, hospital admissions, care home admission, and A&amp;E attendance in the Secure Anonymised Information Linkage Databank. We also linked individual level demographic data and household level neighbourhood walkability and accessibility metrics detailing the built environment (e.g. access to services, greenspace). We capture change in the built environment and house moves between January 2010 and December 2017. Using unadjusted and adjusted cox regression models we will assess how the risk and severity of a fall changes in relation to the built environment.&#x0D; We have created a dynamic national e-cohort linking data on frailty, dementia, hospital admissions, care home admission, A&amp;E attendance and built environment measures for people living in Wales aged 60 and above between January 2010 and December 2017. At the conference we will report summary statistics for each quarter as well as the overall population. We will also report unadjusted cox model odds ratios, as well as fully adjusted models. We will adjust for age, sex, urbanicity (urban/rural), deprivation (WIMD), dementia diagnosis, and seasonal weather trends. We will also report odds ratios for our stratification analysis where we will investigate whether associations vary by urbanicity and deprivation.&#x0D; With an aging population, it is becoming more important to help the current and future older population age healthily, preventing adverse health outcomes before they happen. This research will help guide policy and resource allocation to support people staying at home and have a more fulfilling life for longer.

Neighborhood Walkability Influences Walking: Findings From A Longitudinal Residential Relocation Study

Neighborhood Walkability Influences Walking: Findings From A Longitudinal Residential Relocation Study

Association Of Perceived And Objective Neighborhood Walkability With Accelerometer Measured Physical Activity And Sedentary Time

Association Of Perceived And Objective Neighborhood Walkability With Accelerometer Measured Physical Activity And Sedentary Time

The perceived neighborhood walking environment and self-reported sleep health in a nationally representative sample of the United States.

Neighborhood environment can influence sleep health; yet, there is a lack of data on specific environment features in nationally representative samples. We used the 2020 National Health Interview Survey to determine associations between perceived built and social environment factors related to pedestrian access (walking paths, sidewalks), amenities (shops, transit stops, entertainment/services, places to relax), and unsafe walking conditions (traffic, crime) and self-reported sleep duration and disturbances. Places to relax and pedestrian access were associated with better sleep health while unsafe walking conditions were associated with worse sleep health. Access to amenities (shops, transit stops, entertainment venues) had null associations with sleep health.