The Association of Built Environment and Physical Activity in Older Adults: Using a Citywide Public Housing Scheme to Reduce Residential Self-Selection Bias

Previous studies have documented numerous health benefits of conducting regular physical activity among older adults. The built environment is believed to be a key factor that can hinder or facilitate daily physical activity, such as walking and exercising. However, most empirical studies focusing on environment-physical activity associations exhibited residential self-selection bias with cross-sectional research design, engendering doubts about the impact of built environment on physical activity. To reduce this bias, we assessed physical activity behaviors of 720 Hong Kong older adults (≥65 years) residing in 24 public housing estates. The Hong Kong public housing scheme currently provides affordable rental flats for 2.1 million people or approximate 30% of total population. The applicants were allocated to one of 179 housing estates largely by family size and flat availability. Built environment characteristics were measured following the ‘5Ds’ principle: (street network) design, (land-use) diversity, density, distance to transit, and destination accessibility. Multilevel mixed models were used to explore the associations between the built environment and the different domains of physical activity (transportation walking, recreational walking, and recreational moderate-to-vigorous physical activity (MVPA) while controlling for potential estate-level socioeconomic and individual confounders. We found that transportation walking was positively associated with the number of bus stops and the presence of Mass Transit Railway (MTR) stations. Recreational MVPA was positively related to the number of recreational facilities. However, land-use mix was negatively related to transportation walking, recreational walking, and recreational MVPA. The findings of this study support a threshold effect in the environment-physical activity associations. Furthermore, large-scale public housing schemes involving random or semi-random residence assignment in many cities may provide opportunities to explore built environments and physical activity behavior, with the potential to overcome residential self-selection bias.

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Research on the Difference Between Recreational Walking and Transport Walking Among the Elderly in Mega Cities With Different Density Zones: The Case of Guangzhou City

Frontiers in Public Health ◽

10.3389/fpubh.2021.775103 ◽

2021 ◽

Vol 9 ◽

Author(s):

Peng Zang ◽

Hualong Qiu ◽

Fei Xian ◽

Xiang Zhou ◽

Shifa Ma ◽

...

Keyword(s):

Physical Activity ◽

Land Use ◽

Built Environment ◽

Older People ◽

Street Connectivity ◽

Guangzhou City ◽

Normalised Difference Vegetation Index ◽

Land Use Mix ◽

Recreational Walking ◽

Intersection Density

Walking is the easiest method of physical activity for older people, and current research has demonstrated that the built environment is differently associated with recreational and transport walking. This study modelled the environmental characteristics of three different building density zones in Guangzhou city at low, medium, and high densities, and examined the differences in walking among older people in the three zones. The International Physical Activity Questionnaire (IPAQ) was used to investigate the recreational and transport walking time of older people aged 65 years and above for the past week, for a total of three density zones (N = 597) and was analysed as a dependent variable. Geographic Information Systems (GIS) was used to identify 300, 500, 800, and 1,000 m buffers and to assess differences between recreational and transport walking in terms of the built environment [e.g., land-use mix, street connectivity, Normalised Difference Vegetation Index (NDVI) data]. The data were processed and validated using the SPSS software to calculate Pearson's correlation models and stepwise regression models between recreation and transit walking and the built environment. The results found that land use mix and NDVI were positively correlated with transport walking in low-density areas and that transport walking was negatively correlated with roadway mediated centrality (BtE) and Point-of-Interest (PoI) density. Moreover, recreational walking in medium density areas was negatively correlated with self-rated health, road intersection density, and PoI density while positively correlated with educational attainment, population density, land use mix, street connectivity, PoIs density, and NDVI. Transport walking was negatively correlated with land-use mix, number of road crossings while positively correlated with commercial PoI density. Street connectivity, road intersection density, DNVI, and recreational walking in high-density areas showed negative correlations. Moreover, the built environment of older people in Guangzhou differed between recreational and transport walking at different densities. The richness of PoIs has different effects on different types of walking.

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Residential self-selection bias in the estimation of built environment effects on physical activity between adolescence and young adulthood

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/1479-5868-7-70 ◽

2010 ◽

Vol 7 (1) ◽

pp. 70 ◽

Cited By ~ 63

Author(s):

Janne Boone-Heinonen ◽

David K Guilkey ◽

Kelly R Evenson ◽

Penny Gordon-Larsen

Keyword(s):

Physical Activity ◽

Built Environment ◽

Selection Bias ◽

Young Adulthood ◽

Environment Effects ◽

Self Selection ◽

Adolescence And Young Adulthood

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Non-Linear Effects of the Built Environment and Social Environment on Bus Use among Older Adults in China: An Application of the XGBoost Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18189592 ◽

2021 ◽

Vol 18 (18) ◽

pp. 9592

Author(s):

Lanjing Wang ◽

Chunli Zhao ◽

Xiaofei Liu ◽

Xumei Chen ◽

Chaoyang Li ◽

...

Keyword(s):

Older Adults ◽

Land Use ◽

Built Environment ◽

Social Environment ◽

Public Transport ◽

Dwelling Unit ◽

Bus Stop ◽

Environment Variable ◽

Non Linear ◽

Unit Density

Global aging has raised increasing concerns on the health and well-being of older adults. Public transport is a viable option to improve the mobility and quality of life among older adults. However, policies that promote the public transport use among older adults are rare. This study utilizes the eXtreme Gradient Boosting (XGBoost) decision tree to explore the non-linear associations of the built and social environment with bus use among older adults in China. The bus use of older adults was obtained from the Zhongshan Household Travel Survey (ZHTS) in 2012. Results show that non-linear relationships exist among all built environment and social environment characteristics. Within certain thresholds, the percentage of green space land use, land use mixture, bus-stop density, and dwelling unit density are positively related to bus use among older adults. Likewise, one social environment variable, the proportion of older adults in a neighborhood, is the key social environment variable. Furthermore, the dwelling unit density and proportion of older adults appear to have an inverse U-shaped relationship. Additionally, age, ownership of motorcycles, and distance from home to the nearest bus stop also show non-linearity. The findings presented in this paper facilitate effective planning interventions to promote bus use among older adults.

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Non-linear Relationships Between the Built Environment and Walking Frequency Among Older Adults in Zhongshan, China

Frontiers in Public Health ◽

10.3389/fpubh.2021.686144 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jiani Wu ◽

Chunli Zhao ◽

Chaoyang Li ◽

Tao Wang ◽

Lanjing Wang ◽

...

Keyword(s):

Older Adults ◽

Land Use ◽

Built Environment ◽

Green Space ◽

Additive Model ◽

Walking Behavior ◽

Old Adults ◽

Linear Relationships ◽

Walking Activity ◽

Non Linear

Aim: Promoting walking activity is an effective way to improve the health of older adults. Walking frequency is a critical component of walking behavior and an essential determinant of daily walking levels. To decipher the association between the built environment and walking frequency among older adults, this study's aims are as follows: (1) to empirically test whether non-linear relationships between the two exist, and (2) to identify the thresholds of the built environment characteristics that promote walking.Methods: The walking frequency of old adults was derived from the Zhongshan Household Travel Survey (ZHTS) in 2012. The sample size of old adults aged 60 or over was 4784 from 274 urban and rural neighborhoods. A semi-parametric generalized additive model (GAMM) is used to analyze the non-linear or non-monotonic relationships between the built environment and the walking frequency among older adults.Results: We found that non-linear relationships exist among five out of the six built environment characteristics. Within certain thresholds, the population density, sidewalk density, bus stop density, land use mixture, and the percentage of green space are positively related to older adults' walking trips. Furthermore, the land use mixture and the percentage of green space show an inverse “V”-shaped relationship.Conclusions: Built environment features can either support or hinder the walking frequency among older adults. The findings in the current study contribute to effective land use and transport policies for promoting active travel among older adults.

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THE BUILT ENVIRONMENT INFLUENCED THE INCIDENCE OF FALLS IN OLDER ADULTS LIVING IN THE UNDERSERVED COMMUNITY

Innovation in Aging ◽

10.1093/geroni/igz038.1076 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S292-S292

Author(s):

Rie Suzuki ◽

Jennifer Blackwood ◽

Shailee Shah ◽

Sabah Ganai ◽

Kimberly Warden

Keyword(s):

Physical Activity ◽

Older Adults ◽

Built Environment ◽

Walking Distance ◽

Health Clinic ◽

Cross Sectional Survey ◽

Eligibility Criteria ◽

Cross Sectional ◽

The Past ◽

Underserved Community

Abstract The built environment is commonly cited as a facilitator to local walking. Although health promotion programs targeting physical activity are available, few studies have investigated the associations of the perceived neighborhoods with the incidence of falls in the minority communities. Hence, the purpose of this preliminary study was to understand whether the perceived built environment influenced the fall experiences in older adults living in the underserved community. The preliminary cross-sectional survey was conducted at the regional health clinic in Flint, MI. Descriptive statistics and analysis of variance (ANOVA) were performed using SAS v8.4. The eligibility criteria included over 65 years old and Flint residents. Of 132 participants, the mean age was 69.75 (SD=5.00). The majority were female (68%), African Americans (80%), single, divorced or widowed (80%), and > GED (84%). The ANOVAs supported that “had fallen in the past year” was associated with “stores are within easy walking distance,” “easy to walk to a transit stop” and “there is a dirt strip that separates the streets from the sidewalks.” The fall experience was more likely to associate with the sedentary lifestyle and the comorbidities such as diabetes, fatigues, muscle spasms, and chronic pain. To summarize, the built environment increased the incidence of falls in the past year. Those who had fallen had poor health conditions. Further studies are needed for older adults to engage in physical activity. It is essential to develop the age-friendly support systems and accommodations to local walking in this community.

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Built environment correlates of physical activity and sedentary behaviour in older adults: A comparative review between high and low-middle income countries

Health & Place ◽

10.1016/j.healthplace.2019.05.007 ◽

2019 ◽

Vol 57 ◽

pp. 277-304 ◽

Cited By ~ 7

Author(s):

Claire Cleland ◽

Rodrigo Siqueira Reis ◽

Adriano Akira Ferreira Hino ◽

Ruth Hunter ◽

Rogério César Fermino ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Built Environment ◽

Sedentary Behaviour ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Comparative Review

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Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01030-6 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Gerson Ferrari ◽

◽

André Oliveira Werneck ◽

Danilo Rodrigues da Silva ◽

Irina Kovalskys ◽

...

Keyword(s):

Physical Activity ◽

Land Use ◽

Built Environment ◽

Latin American ◽

Leisure Time ◽

Shopping Centers ◽

Domain Specific ◽

Land Use Mix ◽

Neighborhood Built Environment ◽

Latin American Countries

Abstract Background Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. Methods This study examined data from 8185 adults (aged 18–65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix–diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. Results Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. Conclusions Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA. Trial registration ClinicalTrials. Gov NCT02226627. Retrospectively registered on August 27, 2014.

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Everyday Walking Among Older Adults and the Neighborhood Built Environment: A Comparison Between Two Cities in North America

Frontiers in Public Health ◽

10.3389/fpubh.2020.564533 ◽

2020 ◽

Vol 8 ◽

Author(s):

Florian Herbolsheimer ◽

Atiya Mahmood ◽

Yvonne L. Michael ◽

Habib Chaudhury

Keyword(s):

Physical Activity ◽

Older Adults ◽

Population Density ◽

Built Environment ◽

Healthy Aging ◽

Cross Sectional ◽

Walking Behavior ◽

Metro Vancouver ◽

Walkable Neighborhood ◽

Neighborhood Built Environment

A walkable neighborhood becomes particularly important for older adults for whom physical activity and active transportation are critical for healthy aging-in-place. For many older adults, regular walking takes place in the neighborhood and is the primary mode of mobility. This study took place in eight neighborhoods in Metro Portland (USA) and Metro Vancouver (Canada), examining older adults' walking behavior and neighborhood built environmental features. Older adults reported walking for recreation and transport in a cross-sectional telephone survey. Information on physical activity was combined with audits of 355 street segments using the Senior Walking Environmental Audit Tool-Revised (SWEAT-R). Multi-level regression models examined the relationship between built environmental characteristics and walking for transport or recreation. Older adults [N = 434, mean age: 71.6 (SD = 8.1)] walked more for transport in high-density neighborhoods and in Metro Vancouver compared to Metro Portland (M = 12.8 vs. M = 2.2 min/day; p < 0.001). No relationship was found between population density and walking for recreation. Older adults spent more time walking for transport if pedestrian crossing were present (p = 0.037) and if parks or outdoor fitness amenities were available (p = 0.022). The immediate neighborhood built environment supports walking for transport in older adults. Comparing two similar metropolitan areas highlighted that high population density is necessary, yet not a sufficient condition for walking in the neighborhood.

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Eye-Level Street Greenery and Walking Behaviors of Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176130 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6130

Author(s):

Peng Zang ◽

Xuhong Liu ◽

Yabo Zhao ◽

Hongxu Guo ◽

Yi Lu ◽

...

Keyword(s):

Older Adults ◽

Land Use ◽

Population Density ◽

Built Environment ◽

Street Connectivity ◽

Design Consideration ◽

Methodological Limitation ◽

Urban Greenery ◽

The Relationship ◽

Walking Time

Evidence suggests that built environment characteristics affect older adults’ travel activity behaviors, e.g., walking and cycling, which have well-established health benefits. However, the relationship between urban greenery and walking behaviors remains unclear, partly due to methodological limitation. Previous studies often measured urban greenery from a bird’s eye perspective, which may mismatch with the pedestrian’s perception from the street. In this study, we measured greenery view index from eye-level streetscape photos retrieved from Baidu Street View, an online mapping service provider. Walking behaviors of 180 older adults in six neighborhoods were collected from questionnaires. We also measured land use diversity, pedestrian-oriented design (street connectivity), and population density—the three Ds of the built environment. Results show that street greenery view index contributes to walking time of older adults, suggesting street greenery should be taken into design consideration to promote walking behaviors of older adults.

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