Validation of Walk Score® for Estimating Neighborhood Walkability: An Analysis of Four US Metropolitan Areas

The built environment (BE) has been associated with health outcomes in prior studies. Few have investigated the association between neighborhood walkability, a component of BE, and hypertension. We examined the association between neighborhood walkability and incident hypertension in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Walkability was measured using Street Smart Walk Score based on participants' residential information at baseline (collected between 2003 and 2007) and was dichotomized as more (score ≥70) and less (score <70) walkable. The primary outcome was incident hypertension defined at the second visit (collected between 2013 and 2017). We derived risk ratios (RR) using modified Poisson regression adjusting for age, race, sex, geographic region, income, alcohol use, smoking, exercise, BMI, dyslipidemia, diabetes, and baseline blood pressure (BP). We further stratified by race, age, and geographic region. Among 6,894 participants, 6.8% lived in more walkable areas and 38% (N = 2,515) had incident hypertension. In adjusted analysis, neighborhood walkability (Walk Score ≥70) was associated with a lower risk of incident hypertension (RR [95%CI]: 0.85[0.74, 0.98], P = 0.02), with similar but non-significant trends in race and age strata. In secondary analyses, living in a more walkable neighborhood was protective against being hypertensive at both study visits (OR [95%CI]: 0.70[0.59, 0.84], P < 0.001). Neighborhood walkability was associated with incident hypertension in the REGARDS cohort, with the relationship consistent across race groups. The results of this study suggest increased neighborhood walkability may be protective for high blood pressure in black and white adults from the general US population.

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Neighborhood walkability and risk of gestational diabetes

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000938 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000938

Author(s):

Simone Kew ◽

Chang Ye ◽

Sadia Mehmood ◽

Anthony J Hanley ◽

Mathew Sermer ◽

...

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Insulin Resistance ◽

Insulin Sensitivity ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Maternal Risk ◽

Neighborhood Walkability ◽

Walk Score

ObjectiveHigher neighborhood walkability has been associated with a lower risk of type 2 diabetes mellitus (T2DM) by promoting greater physical activity (thereby reducing weight and lowering insulin resistance). However, it is not known if walkability may similarly reduce maternal risk of gestational diabetes mellitus (GDM), which arises in the setting of the severe physiologic insulin resistance of pregnancy. Indeed, the insulin resistance of pregnancy is primarily driven by placental hormones and not maternal weight gain. Thus, we sought to evaluate the impact of neighborhood walkability on maternal risk of GDM and the pathophysiologic determinants thereof (insulin sensitivity and pancreatic beta-cell function).MethodsIn this study, 1318 women reported their pregravid physical activity (Baecke questionnaire) while undergoing an oral glucose tolerance test (OGTT) at mean 29.3 weeks’ gestation. The OGTT identified 290 women with GDM and enabled assessment of insulin sensitivity and beta-cell function. Based on their residential Walk Score, the women were stratified into the following four established categories of neighborhood walkability: car dependent (n=328), somewhat walkable (n=315), very walkable (n=406), and walker’s paradise (n=269).ResultsThere was a progressive increase in pregravid total physical activity (p=0.002), non-sport leisure-time activity (p=0.009) and sport activity (p=0.01) across the walkability groups (from car dependent to somewhat walkable to very walkable to walker’s paradise), coupled with a concomitant decline in pre-pregnancy body mass index (p=0.007). However, in pregnancy, the groups did not differ in gestational weight gain (p=0.80). Moreover, the walkability groups also did not differ in mean adjusted insulin sensitivity, beta-cell function, or glycemia on the antepartum OGTT. On logistic regression analysis, Walk Score did not predict GDM (OR=1.001, 95% CI 0.995 to 1.007).ConclusionNeighborhood walkability is not a significant determinant of maternal risk of GDM. Thus, in contrast to T2DM, the effect of neighborhood design on incidence of GDM will be comparatively modest.

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Active and Fit Communities. Associations between Neighborhood Walkability and Health-Related Fitness in Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17041131 ◽

2020 ◽

Vol 17 (4) ◽

pp. 1131

Author(s):

Gavin R. McCormack ◽

Levi Frehlich ◽

Anita Blackstaffe ◽

Tanvir C. Turin ◽

Patricia K. Doyle-Baker

Keyword(s):

Physical Activity ◽

Resistance Training ◽

Built Environment ◽

Muscular Strength ◽

Neighborhood Walkability ◽

Walk Score ◽

Health Related ◽

Neighborhood Built Environment ◽

Health Related Fitness ◽

Fitness Levels

There are many health benefits of regular physical activity and improving physical fitness levels can reduce the risk of chronic disease. Accumulating evidence suggests the neighborhood built environment is important for supporting physical activity; however, few studies have investigated the contribution of the neighborhood built environment to fitness levels. We examined the associations between objectively-determined and self-reported neighborhood walkability and overall and specific components of perceived health-related fitness (cardiorespiratory, muscular strength, and flexibility) in a random sample of 592 adults from two areas of Calgary (Canada). Participants provided complete data to an online questionnaire capturing perceived cardiorespiratory fitness (CRF), muscular strength (MST), flexibility, moderate-to-vigorous intensity physical activity (MVPA), resistance training, and sociodemographic characteristics. The questionnaire also captured participant’s perceptions of their neighborhood’s walkability (Physical Activity Neighborhood Environment Scale; PANES) and the physical activity supportiveness of neighborhood parks (Park Perceptions Index; PPI). Objectively-measured neighborhood walkability was estimated using Walk Score®. The average (SD) age of participants was 46.6 (14.8) years and 67.2% were female. Participants, on average, participated in at least 30-minutes of MVPA on 3.4 (2.1) days/week and undertook resistance training 2.0 (1.8) days/week. Adjusting for covariates, Walk Score® was not associated with any fitness outcomes. Adjusting for covariates, the PANES index was positively associated (p < 0.05) with CRF, MST, flexibility, and overall fitness and the PPI was positively associated (p < 0.05) with all fitness outcomes except MST. Our findings provide novel preliminary evidence suggesting the neighborhood built environment may be important for supporting higher health-related fitness levels in adults.

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Determining If Walkability and Bikeability Indices Reflect Pedestrian and Cyclist Safety

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198120931844 ◽

2020 ◽

Vol 2674 (9) ◽

pp. 767-775

Author(s):

Ahmed Osama ◽

Maria Albitar ◽

Tarek Sayed ◽

Alexander Bigazzi

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Crashes ◽

Crash Risk ◽

Spatial Effects ◽

Perceived Safety ◽

Crash Data ◽

Neighborhood Walkability ◽

Walk Score ◽

Objective Risk ◽

The City

Walkability and bikeability indices are used to succinctly quantify how conducive an environment is to walking and cycling, often including factors related to comfort and perceived safety. The potential assumption that “walkable” and “bikeable” mean safe for walking and cycling (i.e., the association with objective safety or crash risk) has not yet been examined. This study investigates the association between two widely used measures (walk score and bike score) and pedestrian and cyclist crashes in Vancouver, Canada, to determine whether more walkable and bikeable areas of the city are also safer for walking and biking, after controlling for exposure. Multivariate Bayesian crash models with random and spatial effects are developed for pedestrian–motor-vehicle and cyclist–motor-vehicle crashes in 134 traffic analysis zones using 5 years of crash data with walking, cycling, and motor-vehicle traffic volume controls for exposure. Results indicate that areas of the city with higher walkability and bikeability can be potentially associated with greater pedestrian and cyclist crash risk, respectively, even after controlling for exposure. While the clear answer is that neighborhood walkability and bikeability does not indicate safety for pedestrians and cyclists, questions remain as to whether they should, and if so, how they could be modified to better incorporate objective risk.

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Do Walking-Friendly Built Environments Influence Frailty and Long-Term Care Insurance Service Needs?

Sustainability ◽

10.3390/su13105632 ◽

2021 ◽

Vol 13 (10) ◽

pp. 5632

Author(s):

Seigo Mitsutake ◽

Tatsuro Ishizaki ◽

Yuri Yokoyama ◽

Mariko Nishi ◽

Mohammad Javad Koohsari ◽

...

Keyword(s):

Older Adults ◽

Long Term Care ◽

Educational Status ◽

Community Dwelling ◽

Service Needs ◽

Term Care ◽

Neighborhood Walkability ◽

Walk Score ◽

Long Term Care Insurance

Our study examined the associations between neighborhood walkability, frailty, and the incidence of long-term care insurance (LTCI) service needs using a prospective cohort survey in a suburban town in Japan. The final sample for analyses comprised 2867 community-dwelling older adults (mean age: 73.0 years). Neighborhood walkability was measured using the Walk Score®. A total of 387 participants (13.5%) exhibited frailty. The odds of frailty, adjusted for the covariates (sex, age, educational status, marital status, residential status, employment status, subjective economic status) among participants who lived in somewhat walkable/very walkable areas, was 0.750 (95% Confidence Interval, CI: 0.597–0.943) versus those who lived in car-dependent areas. During the 23-month follow-up, 102 participants needed LTCI services (19.0 per 1000 person-years), 41 of whom (21.0 per 1000 person-years) lived in car-dependent areas, and 61 of whom (17.9 per 1000 person-years) lived in somewhat walkable/very walkable areas. As compared with participants who lived in car-dependent areas, the incidence of LTCI service needs was not significantly lower than that of those who lived in somewhat walkable/very walkable areas. Walk Score® can provide the critical information for the strategies to improve walkability and prevent older adults’ frailty in less walkable areas, contributing to achieving the United Nation’s Sustainable Development Goals (SDGs).

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

Preventive Medicine Reports ◽

10.1016/j.pmedr.2018.01.001 ◽

2018 ◽

Vol 9 ◽

pp. 114-117 ◽

Cited By ~ 24

Author(s):

Mohammad Javad Koohsari ◽

Takemi Sugiyama ◽

Tomoya Hanibuchi ◽

Ai Shibata ◽

Kaori Ishii ◽

...

Keyword(s):

Neighborhood Walkability ◽

Walk Score

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Neighborhood Walkability and Walking for Transport Among South Asians in the MASALA Study

Journal of Physical Activity and Health ◽

10.1123/jpah.2015-0266 ◽

2016 ◽

Vol 13 (5) ◽

pp. 514-519 ◽

Cited By ~ 11

Author(s):

Elizabeth A. Kelley ◽

Namratha R. Kandula ◽

Alka M. Kanaya ◽

Irene H. Yen

Keyword(s):

Physical Activity ◽

South Asian ◽

Asian American ◽

South Asians ◽

The United States ◽

Men And Women ◽

South Asian American ◽

Neighborhood Walkability ◽

Asian Men ◽

Walk Score

Background:The neighborhood built environment can have a strong influence on physical activity levels, particularly walking for transport. In examining racial/ethnic differences in physical activity, one important and understudied group is South Asians. This study aims to describe the association between neighborhood walkability and walking for transport among South Asian men and women in the United States in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study.Methods:A cross-sectional study was conducted in 2014 using the baseline dataset of the MASALA study (N = 906). Mean age was 55 years old and 54% of the sample was male. Weekly minutes spent walking for transport was assessed using a questionnaire adapted from the Cross-Cultural Activity Participation Study. Neighborhood walkability was measured using Walk Score, a composite index of walkability.Results:After adjusting for covariates, with each 10-point increase in Walk Score, South Asian American men engaged in 13 additional minutes per week of walking for transport (P = .008). No association was observed between walkability and walking for transport in South Asian American women.Conclusions:Results provide new evidence for how the effects of environmental influences on walking for transport may vary between South Asian men and women.

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Walk Score™ As a Global Estimate of Neighborhood Walkability

American Journal of Preventive Medicine ◽

10.1016/j.amepre.2010.07.007 ◽

2010 ◽

Vol 39 (5) ◽

pp. 460-463 ◽

Cited By ~ 172

Author(s):

Lucas J. Carr ◽

Shira I. Dunsiger ◽

Bess H. Marcus

Keyword(s):

Global Estimate ◽

Neighborhood Walkability ◽

Walk Score

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

Sustainability ◽

10.3390/su11246915 ◽

2019 ◽

Vol 11 (24) ◽

pp. 6915 ◽

Cited By ~ 4

Author(s):

Eun Jung Kim ◽

Jaewoong Won ◽

Jiyeong Kim

Keyword(s):

Logistic Regression ◽

Empirical Test ◽

Test Results ◽

Binary Outcome ◽

Residential Areas ◽

Policy Makers ◽

Neighborhood Walkability ◽

Efficient Measure ◽

Walk Score ◽

Asian Context

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).

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Neighborhood Walkability and Crime: Does the Relationship Vary by Crime Type?

Environment and Behavior ◽

10.1177/0013916520921843 ◽

2020 ◽

pp. 001391652092184

Author(s):

Narae Lee ◽

Christopher Contreras

Keyword(s):

Los Angeles ◽

Low Income ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Crime Patterns ◽

Linear Effect ◽

Neighborhood Walkability ◽

Point Increase ◽

Walk Score ◽

Crime Types

We draw on theoretical insights from criminology in using the Walk Score index to analyze walkability’s relationship to spatial crime patterns on Los Angeles city blocks. Results from our first set of negative binomial regression models show that walkability had an especially strong linear effect on robbery rates: a 24% increase in the robbery rate accompanied a 10-point increase in Walk Score on a block, controlling for the effects of local businesses and sociodemographic characteristics. Our second set of models reveals that walkability exerted variable nonlinear influences on spatial crime patterns. Our final set of models suggests that the walkability–crime relationship might depend on neighborhood social organization: When walkability is high, low-income blocks might experience sharp rises in rates of predatory violence as compared with more advantaged blocks. This research highlights the importance of considering the mechanisms involved in walkability’s impact on the spatial distribution of individual crime types.

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