Association Between Active Living Environments and Hospitalization for All-Causes and Cardiometabolic Disease
Bibliographic record
Abstract
IntroductionNeighbourhoods have the potential to influence population-wide modifiable risk factors such as physical inactivity and obesity. Built environments that encourage active living hold promise as a policy lever for reducing health care burden, particularly that related to cardiometabolic disease. Objectives and ApproachWe examined the role of active living environments on hospitalization risk, frequency, and cumulative length of stay for all-causes and cardiometabolic diseases. The linked dataset is a combination of survey data from Canadian respondents aged 45+, records from a national census of acute hospitalizations, and the Canadian Active Living Environment (Can-ALE) - a 5-class measure of how conducive one’s neighbourhood is to active living based on street connectivity, points of interest, and population density. We modelled the risk of all-cause and cardiometabolic hospitalizations for respondents living in more and less favourable environments using logistic regression. Frequency and cumulative length of stay were modelled using truncated negative binomial regression. Models were adjusted for individual-level factors and proximity to a hospital. An offset variable was included to account for different follow-up times. Results232,000 respondents were included with a mean follow-up time of 5.37 years. Those living in progressively more favourable active living environments (classes 2, 3, 4, and 5) exhibited incrementally lower risk of hospitalization compared to those living in the least favourable (class 1). Relative to respondents living in the least favourable environments (class 1), odds ratios were 0.84 (95% CI 0.76-0.93) for all-cause hospitalization and 0.80 (95% CI 0.68-0.93) for cardiometabolic hospitalization for respondents living in the most favourable environments (class 5). There was little evidence of similar associations for hospitalization frequency and cumulative length of stay. Conclusion / ImplicationsLiving in neighbourhoods that are more conducive to active living are associated with lower risk of all-cause and cardiometabolic hospitalization.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".