These streets are made for walking

Highest neighbourhood walkability scores associated with lowest incidences of diabetes and obesity

August 2, 2016

Canada is facing an obesity crisis. In 2014, 61.8% of Canadian men (8.2 million) and 46.2% of Canadian women (6.1 million) were classified as being obese or overweight and more than 2 million Canadians over the age of 12 were living with diabetes. These very serious conditions have been linked to equally serious complications such as cardiovascular disease and foot ulcers.
Source: Statistics Canada

These days, more and more people are choosing alternative modes of transportation like walking, bicycling, skateboarding and roller-blading as a way to keep active and to get around. As the popularity of non-vehicular transportation grows, city planners and public health policy makers have begun to take notice.

CIHR-funded researchers, Drs. Maria Creatore and Gillian Booth, at the Li Ka Shing Knowledge Institute at St. Michael's Hospital, recently published a study that examines the relationship between walkable neighbourhoods and health.

According to the Canadian Physical Activity Guidelines, a minority (15%) of Canadian adults meet the minimum daily recommended levels of physical activity.
Source: Canadian Physical Activity Guidelines: Canadian Society for Exercise Physiology, 2013

Drs. Creatore and Booth looked at whether neighbourhoods that favour pedestrian traffic and promote walking are producing healthier residents.

The team analyzed data collected from 2001 to 2012. It covered 8,777 neighbourhoods in southern Ontario, home to more than 7 million residents. Close to 3 million adults aged 30-64, an age group known to experience a rapid increase in obesity and diabetes rates, were studied using data from administrative health care databases.

Additional information on body weight was collected from approximately 33,000 adults who participated in Statistics Canada's Canadian Community Health Survey. The study also included information on the residents' ethnicity and neighbourhood income.

Dr. Creatore was the lead epidemiologist on the study.
Photo courtesy of Dr. Creatore.

Dr. Booth was the principal investigator on the study.
Photo courtesy of Dr. Booth.

An important element identified in the study was a neighbourhood's walkability factor, meaning how easy is it is for pedestrians to get around. This includes street connectivity, the types and frequency of intersections and access to key destinations like workplaces, schools, shops, libraries, pharmacies, and other essential services.

Their study found that highly walkable neighbourhoods had a lower number of overweight and obese people and a lower incidence of diabetes. Neighbourhoods with the best health outcomes were those in which walking and cycling were higher and vehicular use was lower.

Dr. Creatore and Booth's work is helping to usher in the shift to more walkable neighbourhoods.

Dr. Gillian Booth explains

Health researchers from across the country have been working tirelessly to find new and innovative ways to combat conditions like diabetes that are linked to inactivity and obesity. Dr. Gillian Booth, senior researcher and principal investigator on the walkability study, joined CIHR for a podcast to discuss the study's results and their significance in more depth.

Transcript

Mr. David Coulombe: This is David Coulombe for CIHR's Health Research in Action News. 

Can where we live have an impact on our health? Well, a team of Canadian researchers funded by the Canadian Institutes of Health Research studied more than three million people in close to 9,000 neighbourhoods in Ontario and their conclusions, I must say, are fascinating.

So to learn more about this study, my guest today is Dr. Gillian Booth, senior author and a CIHR-funded researcher.

Thanks for joining us, Dr. Booth.

Dr. Gillian Booth: Thank you for having me.

Mr. David Coulombe: Maybe the first question is what have you found exactly?

Dr. Gillian Booth: Well, we found that the most walkable neighbourhoods in Southern Ontario cities had a 10% lower prevalence of overweight and obesity than less walkable neighbourhoods, and they also had less numbers of new cases of diabetes in the population. And not only were the rates better in those neighbourhoods that were more walkable, but they also had better trends over time. So rates of overweight and obesity were more stable and the numbers of new cases in the population were actually falling in the most walkable neighbourhoods, whereas we found that rates of obesity were still rising in less walkable communities.

Mr. David Coulombe: Give us some examples of an unhealthy urban environment.

Dr. Gillian Booth: From our research, we found that neighbourhoods that were less healthy were ones that were more dependent on cars, so more suburban areas where it's a lot harder to walk places. There are not a lot of destinations you can walk to, and those areas were also showing lower rates of walking, cycling and lower rates of transit use as well.

Mr. David Coulombe: So following your findings, how could communities adapt to those results?

Dr. Gillian Booth: Well, there's a number of things that can happen in terms of community development. So we could build neighbourhoods differently. We can make neighbourhoods that are designed around pedestrians and allow for walking and cycling and other physical activities and less around cars. That's one thing we can do.

We can also look at trying to make existing neighbourhoods better in terms of walking and transportation. We could expand public transit, and there's a huge move to do that right now in Southern Ontario. We can look at some of these changes in neighbourhood design, zoning and transit access that would make it a lot easier for people to incorporate physical activity in their daily lives.

Mr. David Coulombe: So we could easily say that your findings in Ontario could adapt to other cities in other provinces in Canada?

Dr. Gillian Booth: Absolutely.

Mr. David Coulombe: What are the next steps, Dr. Booth?

Dr. Gillian Booth: Well, we're conducting research, funded by CIHR, to look at what would be the best steps for policy makers in terms of designing neighbourhoods to be better able to support health. Whether it's determining how walkable neighbourhoods are, whether it's accessing or increasing parks in the neighbourhoods, whether it's expanding transit or doing all of those things altogether are going to have the biggest benefit or the biggest impact on health in terms of downstream health outcomes and cost to the health system. So that's one of the things that we're doing.

Mr. David Coulombe: Dr. Booth, that's all the time we have. Thanks so much for joining us.

Dr. Gillian Booth: Thank you so much for having me.

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