American Journal of Preventive Medicine
ArticlesPerceived and objective environmental measures and physical activity among urban adults
Introduction
Increasing population rates of physical activity has become a public health priority in the United States and abroad.1 The prevalence of diseases and adverse health conditions associated with physical inactivity has escalated in recent years.2 Despite 2 decades of national objectives to increase physical activity,1 U.S. trends in leisure-time physical activity have remained unchanged.3 Increases in the distance people travel to get to destinations and the amount of time people spend in their cars pinpoint specific challenges to increasing population rates of physical activity.4 These trends suggest the timeliness for examining important influences on the capacity of entire populations to engage in physical activity.1 Health experts are broadening their conceptualization of physical activity from leisure-time activity to active living, “a lifestyle or way of life that integrates physical activity into daily routines with the goal of accumulating at least 30 minutes of activity each day.”5 In addition, public health researchers and practitioners are turning upstream to social, physical, organizational, and political environments that promote or hinder physical activity behavior.6, 7 Several recent studies have highlighted regional or community environmental characteristics that have demonstrated associations with physical activity, for example less sprawl,8 greater neighborhood walkability,9, 10, 11 and more access to places for physical activity.12, 13, 14
This new emphasis on understanding how community environments impact active living has created a need to develop measures of environments and routine activities. The majority of public health studies have used self-report surveys to assess people’s perceptions of their environments.15 Urban planning studies of walking and bicycling for transportation, on the other hand, have relied on existing data sources to provide objective environmental measures, often with limited availability or flexibility of the content or scale of measurement.16, 17 Few studies have evaluated the effects of street-level (vs larger area-level) characteristics, policies, or practices occurring in an area of a few square miles that may include quality of sidewalks, safety from traffic, destinations, or physical disorder. In addition, most studies have assessed either leisure- or transportation-related physical activity, but not both.
This study examines the association between transportation and recreational physical activity and characteristics of the immediate neighborhood environment, measured simultaneously through self-report (perceived) and environmental audit (objective) methods18 in four urban settings.
Section snippets
Study design
Data for this cross-sectional study were collected between February and June 2003 in higher- and lower-income areas of St. Louis MO (representing a “low-walkable” city) and Savannah GA (representing a “high-walkable” city). The study areas were selected among census tracts in these two cities based on the following 2000 U.S. Census Bureau data: number of households, percentage of population below poverty in 1999 (lowest and highest decile), and area in square miles. The study areas, comprised
Results
The sample of adults living in the study areas was diverse with respect to age, race/ethnicity, and educational attainment, and slightly underrepresented men (Table 2). Respondents from the lower-income study areas tended to engage in more transportation activity than those from the higher-income areas, while Savannah respondents were more likely to meet recommendations for physical activity through recreational activity than St. Louis respondents.
Discussion
The results of this study of urban environments support some direct relationships between the environment and physical activity behavior. While both perceived and objective measures for the number of nonresidential destinations near respondents’ homes were strongly and consistently correlated with physical activity, measures from other domains yielded weaker and/or nonsignificant direct associations.
Having destinations within walking distance from homes emerged as the strongest correlate of
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