Elsevier

Public Health

Volume 129, Issue 9, September 2015, Pages 1204-1210
Public Health

Original Research
Influence of urban neighbourhood environment on physical activity and obesity-related diseases

https://doi.org/10.1016/j.puhe.2015.06.002Get rights and content

Highlights

  • Walkable environment is associated with increased physical activity.

  • Walkable environment has a positive influence on hypertension and diabetes.

  • Walkable environment might be an important tool for health promotion in urban areas.

Abstract

Objectives

The impact of characteristics of neighbourhood environment on physical activity and obesity-related diseases is still the subject of debate. This study aimed to explore the impact of urban neighbourhood environment on physical activity and obesity-related diseases.

Study design

Cross-sectional study.

Methods

Individuals who participated in the 2009 national health-screening programme, submitted all necessary information, and had lived in Community 1 (Haengdang) or Community 2 (Ilsan) for at least 2 years (n = 16,178) were selected for inclusion in this study. Anthropometric measures were taken and physical activity was assessed using a short questionnaire.

Results

No significant difference in the trigger factors for walking, including the amount of neighbourhood park space, number of shopping malls, and distance between the community and shopping malls, was found between the two communities. However, Community 2 had a better street environment than Community 1. Participants who lived in Community 2 were more physically active [adjusted odds ratio (OR) 1.31, 95% confidence interval (CI) 1.16–1.48] and walked more regularly (adjusted OR 1.09, 95% CI 1.02–1.17) than participants who lived in Community 1, and were less likely to have abdominal obesity (adjusted OR 0.83, 95% CI 0.77–0.91), hypertension (adjusted OR 0.88, 95% CI 0.80–0.97) and diabetes (adjusted OR 0.86, 95% CI 0.75–0.99). However, the risk of dyslipidaemia, especially in terms of low-density lipoprotein cholesterol, was higher in Community 2.

Conclusions

These results suggest that a walkable environment has a positive influence on hypertension and diabetes, and physical activity is the possible mechanism for this association. A walkable environment may function as an important tool for health promotion in urban areas.

Introduction

Globally, obesity and obesity-related comorbidities including hypertension, diabetes mellitus and dyslipidaemia are increasing dramatically.1, 2, 3 In the US population, for example, recent data from the National Health and Nutritional Examination Survey show that the current prevalence of obesity and overweight in adults is approximately 68%.4 In Korea, the prevalence of obesity has increased annually. In 1998, the Korea National Health and Nutritional Examination Survey (KNHANES) data showed that 26.7% of Korean adults were obese, and the proportion had increased to 30.9% in 2007–2009.5 Unhealthy lifestyle is one of the main causes of these diseases. Physical activity, in particular, is believed to be an important determinant of health and body weight, but most people do not exercise regularly.6, 7

There is growing evidence that neighbourhood environment, such as green space, parks and pedestrian environment, is associated with physical activity and various health outcomes, especially obesity-related diseases.8, 9, 10, 11, 12 However, among the possible factors contributing to physical activity and obesity-related diseases, little is known about the urban neighbourhood environment, such as slopes or street patterns, and trigger factors that encourage residents to walk. Previous studies have focused on how individual elements of neighbourhood environment affect physical activity or health outcomes,13, 14, 15, 16 or how urbanization influences population health.17

It has been hypothesized that physical activity (walking, sports, etc.) is a possible mechanism that influences the relationship between neighbourhood environment and health outcomes.18 However, few studies have evaluated all the factors.

As such, this study aimed to explore the impact of urban neighbourhood environment on physical activity and obesity-related diseases.

Section snippets

Study population

Two representative urban neighbourhood communities were selected to compare the effect of neighbourhood environment on physical activity and health. The criteria for differentiating physical characteristics between the two neighbourhood communities included site planning concepts, development methods, housing types, street patterns, site slope and neighbourhood amenities, which were measured both quantitatively and qualitatively through site observation and geographic information system

Study characteristics

Sample descriptive characteristics by community are presented in Table 2. Of the 16,178 adults included in the study, 6303 lived in Community 1 and 9875 lived in Community 2. The proportion of males was 52.09% in Community 1 and 50.30% in Community 2 (P = 0.027). The average age was 47.50 years in Community 1 and 47.67 years in Community 2. Compared with Community 2, Community 1 had more residents in their twenties (9.61% vs 7.08%) and sixties (14.69% vs 9.77%), and fewer residents in their

Discussion

The results suggest that a walkable neighbourhood environment is associated with increased physical activity and walking, and decreased BMI, abdominal obesity and obesity-related diseases. Walkable environment was associated with abdominal obesity and the prevalence of hypertension and diabetes mellitus.

Previous studies found similar results for the association of neighbourhood environment with physical activity.25, 26, 27 However, it is not clear which environmental factors actually affect

Acknowledgements

The authors wish to thank all the participants in the 2009 national health-screening programme.

Ethical approval

The Research Ethics Board of Seoul National University hospital approved this study (IRB No. 1107-121-371).

Funding

This work was supported by the Research Affairs of Seoul National University and Seoul National University Research and Development Board Foundation, Korea (Grant Number: 800-20110045). This work was also partially supported by the National Research Foundation of Korea Grant funded by the Korean

References (38)

  • J. Wolch et al.

    Childhood obesity and proximity to urban parks and recreational resources: a longitudinal cohort study

    Health Place

    (2011)
  • W.J. Stronegger et al.

    Perceived characteristics of the neighborhood and its association with physical activity behavior and self-rated health

    Health Place

    (2010)
  • C. Erem et al.

    Prevalence of metabolic syndrome and associated risk factors among Turkish adults: Trabzon MetS study

    Endocrine

    (2008)
  • E.S. Ford et al.

    Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey

    JAMA

    (2002)
  • K.M. Flegal et al.

    Prevalence and trends in obesity among US adults, 1999–2008

    JAMA

    (2010)
  • S.W. Oh

    Obesity and metabolic syndrome in Korea

    Diabetes Metab J

    (2011)
  • E.M. Berke et al.

    Association of the built environment with physical activity and obesity in older persons

    Am J Public Health

    (2007)
  • D.A. Cohen et al.

    Contribution of public parks to physical activity

    Am J Public Health

    (2007)
  • CDC

    Surgeon general's report on physical activity and health

    JAMA

    (1996)
  • Cited by (0)

    g

    BeLong Cho and Sohyun Park equally contributed to the manuscript as corresponding author.

    h

    Hyejin Lee and Hyun-Mi Kang equally contributed to the manuscript as first author.

    View full text