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A Disadvantaged Advantage in Walkability: Findings from Socioeconomic and Geographic Analysis of National Built Environment Data in the United States.
King, K. AND P. Clarke. A Disadvantaged Advantage in Walkability: Findings from Socioeconomic and Geographic Analysis of National Built Environment Data in the United States. AMERICAN JOURNAL OF EPIDEMIOLOGY. Johns Hopkins Bloomberg School of Public Health, 181(1):17-25, (2015).
In the last two decades there has been an increasing interest in understanding the role of the built environment for healthier lifestyles. Broadly speaking, the built environment refers to the aesthetic, physical and functional qualities of land use patterns as well as buildings and streetscapes that together provide opportunities for physical activity and active transport (1). A sizeable literature documents a relationship between urban form and physical activity, such as a street connectivity pattern that fosters walking (2-5), access to recreational spaces (6-9), and nearby commercial destinations that are easy to walk to (10-13). Large areas that are devoted almost exclusively to residential land use have fewer near destinations and are therefore characterized by less walking and biking and more use of cars and other forms of passive transport. Neighborhood designs that allocate significant amounts of space to parking and land use patterns where commercial destinations are not integrated with residential land use, such as those found in conventional suburban designs, encourage the use of personal vehicles rather than public transportation or walking. Thus by influencing physical activity, land use patterns may contribute to population weight gain and obesity (2, 14) and other conditions linked to physical activity such as depression (15) and inflammation (16). Promotion of low-cost physical activities such as walking among disadvantaged persons is seen as one route to reducing health disparities. Simple interventions such as sidewalk and bike lane construction, as well as larger scale changes to urban transit patterns, are a major policy priority for health policy researchers (2, 17, 18).
Urban form-the structure of the built environment-can influence physical activity, yet little is known about how walkable design differs according to neighborhood sociodemographic composition. We studied how walkable urban form varies by neighborhood sociodemographic composition, region, and urbanicity across the United States. Using linear regression models and 2000-2001 US Census data, we investigated the relationship between 5 neighborhood census characteristics (income, education, racial/ethnic composition, age distribution, and sex) and 5 walkability indicators in almost 65,000 census tracts in 48 states and the District of Columbia. Data on the built environment were obtained from the RAND Corporation's (Santa Monica, California) Center for Population Health and Health Disparities (median block length, street segment, and node density) and the US Geological Survey's National Land Cover Database (proportion open space and proportion highly developed). Disadvantaged neighborhoods and those with more educated residents were more walkable (i.e., shorter block length, greater street node density, more developed land use, and higher density of street segments). However, tracts with a higher proportion of children and older adults were less walkable (fewer street nodes and lower density of street segments), after adjustment for region and level of urbanicity. Research and policy on the walkability-health link should give nuanced attention to the gap between persons living in walkable areas and those for whom walkability has the most to offer.