Density, Destinations or Both? A Comparison of Measures of Walkability in Relation to Transportation Behaviors, Obesity and Diabetes in Toronto, Canada

The design of suburban communities encourages car dependency and discourages walking, characteristics that have been implicated in the rise of obesity. Walkability measures have been developed to capture these features of urban built environments. Our objective was to examine the individual and comb...

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Bibliographic Details
Published in:PloS one Vol. 9; no. 1; p. e85295
Main Authors: Glazier, Richard H., Creatore, Maria I., Weyman, Jonathan T., Fazli, Ghazal, Matheson, Flora I., Gozdyra, Peter, Moineddin, Rahim, Shriqui, Vered Kaufman, Booth, Gillian L.
Format: Journal Article
Language:English
Published: United States Public Library of Science 14.01.2014
Public Library of Science (PLoS)
Subjects:
Adolescent
Adult
Aged
Automotive parts
Availability
Behavior
Bicycles
Bicycling
Biology
Body weight
Built environment
Child
Child, Preschool
Density
Diabetes
Diabetes mellitus
Diabetes Mellitus - epidemiology
Diabetes Mellitus - physiopathology
Engineering
Female
Health aspects
Health surveys
Hospitals
Humans
Infant
Infant, Newborn
Knowledge
Land use
Male
Medicine
Middle Aged
Neighborhoods
Obesity
Obesity - epidemiology
Obesity - physiopathology
Ontario - epidemiology
Overweight
Population
Population Density
Public health
Public transportation
Residential density
Social and Behavioral Sciences
Studies
Suburban areas
Transportation - statistics & numerical data
Transportation industry
Transportation planning
Urban environments
Urban transportation
Walking
Young Adult
Ontario
Toronto Ontario Canada
Canada
ISSN:1932-6203, 1932-6203
Online Access:Get full text
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Summary:The design of suburban communities encourages car dependency and discourages walking, characteristics that have been implicated in the rise of obesity. Walkability measures have been developed to capture these features of urban built environments. Our objective was to examine the individual and combined associations of residential density and the presence of walkable destinations, two of the most commonly used and potentially modifiable components of walkability measures, with transportation, overweight, obesity, and diabetes. We examined associations between a previously published walkability measure and transportation behaviors and health outcomes in Toronto, Canada, a city of 2.6 million people in 2011. Data sources included the Canada census, a transportation survey, a national health survey and a validated administrative diabetes database. We depicted interactions between residential density and the availability of walkable destinations graphically and examined them statistically using general linear modeling. Individuals living in more walkable areas were more than twice as likely to walk, bicycle or use public transit and were significantly less likely to drive or own a vehicle compared with those living in less walkable areas. Individuals in less walkable areas were up to one-third more likely to be obese or to have diabetes. Residential density and the availability of walkable destinations were each significantly associated with transportation and health outcomes. The combination of high levels of both measures was associated with the highest levels of walking or bicycling (p<0.0001) and public transit use (p<0.0026) and the lowest levels of automobile trips (p<0.0001), and diabetes prevalence (p<0.0001). We conclude that both residential density and the availability of walkable destinations are good measures of urban walkability and can be recommended for use by policy-makers, planners and public health officials. In our setting, the combination of both factors provided additional explanatory power.
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Conceived and designed the experiments: RG MC JTW GF FM PG RM VKS GB. Analyzed the data: MC JTW PG RM. Wrote the paper: RG MC JTW GF GB. Critically revised article for important intellectual content: FM PG RM VKS.
Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0085295