The influence of the urban built environment on utilitarian walking and body mass index: Trip diary and longitudinal studies of Canadians

There is growing interest in developing livable cities with neighbourhoods that encourage active living. The urban built environment including land use, amenities and transportation systems is increasingly expected to provide a variety of benefits including neighborhood walking-friendliness. To date, there have been few long term studies with large population samples that have assessed the relationships between walking-friendliness of places and the level of utilitarian walking (i.e., walking for a specific purpose such as to go to work or to school) in people. Most research to date has relied on cross-sectional study designs and the conclusions of many existing studies are invariably limited owing to problems of self-selection of motivated walkers into walking-friendly neighbourhoods. This dissertation addresses some of the methodological limitations in this research area by measuring utilitarian walking using geographic information system-based estimates in a cross-sectional approach, and by geocoding respondents of a population-based longitudinal survey for quasi-experimental designs to assess the role of urban built environments on utilitarian walking and body weight. My dissertation has produced three key findings: 1. Montreal residents were able to achieve the recommended 30 minutes of physical activity each working day by commuting to work using public transportation. This benefit was greatest for suburban residents who walked approximately 35 to 50 minutes per day to and from commuter train stations, the majority of whom were affluent. Transportation system characteristics had greater influences on walking to public transport than did neighbourhood physical characteristics. 2. Canadians who were exposed over time to highly walkable urban neighbourhoods were more likely to engage in moderate and high utilitarian walking than Canadians with less exposure to highly walkable neighbourhoods. A unit increase in the probability of spending more time in the fourth Walk Score® quartile neighborhoods increased the probability of moderate (increase of 4.0%, 95% C.I. 2.9%, 5.1%) and high utilitarian walking (increase of 7.7%, 95% C.I. 5.8%, 9.7%) compared to those spending the same time in low walkable neighbourhoods (first Walk Score® quartile neighbourhoods). Canadians who moved from neighbourhoods that were less walking-friendly to neighbourhoods of a higher walkability, were 59% (95% CI 3 %-146%) more likely to increase their utilitarian walking than those who moved to neighbourhoods with a similar walkability level. 3. Trajectories of body mass index (BMI - a measure of body weight adjusted for height) of Canadian men varied according to the friendliness of the urban built environment for walking, even after controlling for individual characteristics that influence body weight. Moving to more walkable neighbourhoods (2 Walk Score® quartiles higher), was associated with approximately a one unit (kg/m2) decrease in BMI for men (95% C.I. -1.7,-0.3). There was no detectable influence of neighbourhood walkability on body weight for women. Improving public transport service reliability and neighbourhood walkability have potential to increase utilitarian walking and decrease body mass index in populations, even for those who are otherwise inactive in their leisure time. Planning to construct walkable communities supported by reliable public transport should be considered among public health policies to promote utilitarian walking and reduce overweight and obesity.

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