High neighborhood walkability linked with lower rates of obesity and diabetes

1. Neighborhoods with the highest degree of walkability had the lowest rates of obesity and diabetes.

2. Rates of walking, cycling, and public transit use were significantly higher and car use was lowest in the most walkable neighborhoods.

Evidence Rating Level: 2 (Good)

Study Rundown: It is well known that rates of obesity and diabetes remain high despite public health efforts to improve diet and exercise. The neighborhood a person lives in can have a large influence on the amount of daily exercise a person performs. The purpose of this study was to determine whether more walkable neighborhoods were associated with a slower increase in rates of overweight, obesity, and diabetes. In a study of over 8700 Canadian neighborhoods that were ranked by their walkability, the prevalence of overweight and obesity was 10% lower in the neighborhoods ranked in the top quintile of walkability compared to those in the lowest quintile. The incidence of diabetes was similarly lower in the top quintile of walkability. Furthermore, rates of walking, cycling, and public transit use were significantly higher in the top quintile of walkability and the rate of car use lowest.

Overall, this study suggests that neighborhoods with higher levels of walkability were associated with decreased rates of overweight, obesity, and diabetes. The study benefited by analyzing a large array of neighborhoods, but all were located in Ontario, Canada, limiting generalizability. Additionally, there were certainly unaccounted variables, other than walkability, that would likely influence the outcomes, such as occupation.

Click to read the study in JAMA

Relevant Reading: Physical activity in relation to urban environments in 14 cities worldwide: a cross-sectional study

In-Depth [prospective study]: This study assessed 8770 neighborhoods in Ontario, Canada and ranked each based on their walkability score. These neighborhoods were ranked and classified into quintiles, with quintile 5 defined as the most walkable areas. Rates of overweight, obesity, and diabetes were determined from the Canadian Community Health Survey. The prevalence of overweight and obesity in 2001 was lower in quintile 5 vs. quintile 1 (43.3% vs. 53.5%, p < 0.001). The adjusted diabetes incidence was also lowest in quintile 5 at 7.7/1000 persons in 2001 and decreased to 6.2/1000 persons in 2012 (absolute change -1.5; 95%CI -2.6 to -0.4). Furthermore, rates of walking, cycling, and public transit use were significantly higher in the top quintile of walkability and the rate of car use lowest.

Image: PD

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