Neighborhood Walkability as a Predictor of Incident Hypertension in a National Cohort Study

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.

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

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.

Identification of the Proper Criteria Set for Neighborhood Walkability Using the Fuzzy Analytic Hierarchy Process Model: A Case Study in Jeddah, Saudi Arabia

Identifying the appropriate criteria for neighborhood walkability is crucial to improve walkability. This paper aims to identify the proper criteria set for neighborhood walkability using the fuzzy analytic hierarchy process model (FAHP) for the case of Jeddah city, a fast-growing city in Saudi Arabia. This paper strives to highlight the criteria and factors that influence Jeddah’s walkability with its populations’ help. A survey questionnaire was used first to gather data regarding people’s reasons for walking and the elements that encourage them to walk. Then the criteria were derived using the fuzzy analytic hierarchy process (FAHP) method. Results indicate that mosques were the most visited destinations, with over a 30% rate. Eighty-six percent of the criteria that determine a walkable neighborhood in Jeddah were physical environments alone. It was also revealed that the residents regarded walking as a leisure activity rather than a utilitarian. The results show the proposed method’s capability in providing proper neighborhood walkability criteria related to Jeddah’s context. The FAHP proves its use in various urban studies fields in transportation and validation of the walkability index; this paper proves it can also help develop new criteria for walkability measures.

Does neighborhood walkability affect ethnic diversity in Berlin? Insights from a spatial modeling approach

Prior research has reported that people living in more walkable places gain significant health, and environmental sustainability benefits. However, the positive impacts of walkable urbanism are not often inclusive and might affect minority groups. On this basis, this paper develops a composite GIS-based walkability measure (0-1) for Berlin metro area and investigates the association of walkable neighborhood design with ethnic diversity (i.e., Entropy Index). We explore this relationship by applying spatial regression models (i.e., OLS, GWR), while we control the effects of traffic-related air pollution (i.e., NO2), building height, and children density. Our findings suggest that for the total of 447 Berlin neighborhoods which were examined only one out of three had walkability scores greater than 0.5 as well as that community ethnic diversity is negatively related to walkability (β=-0.159, p<0.01).

Neighborhood Walkability and Housing Affordability among U.S. Urban Areas

With support and demand for walkable urban spaces on the rise, there has been growing concern among academics and practitioners of increasing exclusivity, particularly in amenity-rich areas. This study examines equity in neighborhood walkability from the perspective of housing affordability, asking whether more walkable urban neighborhoods have less affordable housing from the viewpoint of both neighborhood residents and households within the encompassing metropolitan region. While considering additional factors that may affect housing affordability, including coastal proximity, crime, rail access, housing age, housing size, and employment accessibility, the results indicate lower housing affordability primarily for renter households already living in walkable neighborhoods, but not for those looking to move to a more walkable neighborhood from within the same metropolitan area. Case studies of three large U.S. urban areas, Charlotte, NC, Pittsburgh, PA, and Portland, OR, highlight local variations in the walkability–housing affordability nexus.