Next Article in Journal
Social Capital and Mental Health in Rural and Urban China: A Composite Hypothesis Approach
Next Article in Special Issue
Children’s Transport Built Environments: A Mixed Methods Study of Associations between Perceived and Objective Measures and Relationships with Parent Licence for Independent Mobility in Auckland, New Zealand
Previous Article in Journal
Associations between Green Building Design Strategies and Community Health Resilience to Extreme Heat Events: A Systematic Review of the Evidence
Previous Article in Special Issue
Walk Score® and Its Associations with Older Adults’ Health Behaviors and Outcomes
Article Menu
Issue 4 (February-2) cover image

Export Article

Open AccessArticle

Area-Level Walkability and the Geographic Distribution of High Body Mass in Sydney, Australia: A Spatial Analysis Using the 45 and Up Study

1
The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia
2
Illawarra Shoalhaven Local Health District, Public Health Unit, Warrawong, NSW 2502, Australia
3
University of Wollongong, School of Medicine, Wollongong, NSW 2522, Australia
4
Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
5
The University of Sydney, University Centre for Rural Health, Rural Clinical School—Northern Rivers, Sydney, NSW 2006, Australia
6
Ingham Institute, University of New South Wales, Sydney, NSW 2052, Australia
7
Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(4), 664; https://doi.org/10.3390/ijerph16040664
Received: 16 December 2018 / Revised: 7 February 2019 / Accepted: 19 February 2019 / Published: 24 February 2019
  |  
PDF [2497 KB, uploaded 25 February 2019]
  |     |  

Abstract

Improving the walkability of built environments to promote healthy lifestyles and reduce high body mass is increasingly considered in regional development plans. Walkability indexes have the potential to inform, benchmark and monitor these plans if they are associated with variation in body mass outcomes at spatial scales used for health and urban planning. We assessed relationships between area-level walkability and prevalence and geographic variation in overweight and obesity using an Australian population-based cohort comprising 92,157 Sydney respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. Individual-level data on overweight and obesity were aggregated to 2006 Australian postal areas and analysed as a function of area-level Sydney Walkability Index quartiles using conditional auto regression spatial models adjusted for demographic, social, economic, health and socioeconomic factors. Both overweight and obesity were highly clustered with higher-than-expected prevalence concentrated in the urban sprawl region of western Sydney, and lower-than-expected prevalence in central and eastern Sydney. In fully adjusted spatial models, prevalence of overweight and obesity was 6% and 11% lower in medium-high versus low, and 10% and 15% lower in high versus low walkability postcodes, respectively. Postal area walkability explained approximately 20% and 9% of the excess spatial variation in overweight and obesity that remained after accounting for other individual- and area-level factors. These findings provide support for the potential of area-level walkability indexes to inform, benchmark and monitor regional plans aimed at targeted approaches to reducing population-levels of high body mass through environmental interventions. Future research should consider potential confounding due to neighbourhood self-selection on area-level walkability relations. View Full-Text
Keywords: body mass; disease mapping; geographic variation; obese; overweight; spatial analysis; walkability body mass; disease mapping; geographic variation; obese; overweight; spatial analysis; walkability
Figures

Graphical abstract

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Mayne, D.J.; Morgan, G.G.; Jalaludin, B.B.; Bauman, A.E. Area-Level Walkability and the Geographic Distribution of High Body Mass in Sydney, Australia: A Spatial Analysis Using the 45 and Up Study. Int. J. Environ. Res. Public Health 2019, 16, 664.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top