Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada ; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada ; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada ; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada ; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
PLoS One. 2014 Jan 14;9(1):e85295. doi: 10.1371/journal.pone.0085295. eCollection 2014.
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.
社区的设计鼓励人们依赖汽车，而阻碍步行，这些特点与肥胖的增加有关。步行能力衡量标准已经开发出来，以捕捉城市建筑环境的这些特征。我们的目的是检验居住密度和可步行目的地的存在这两个步行能力衡量标准中最常用且最具潜在可修改性的组成部分与交通方式、超重、肥胖和糖尿病之间的单独和综合关联。我们研究了在加拿大 260 万人口的多伦多市，以前发表的步行能力衡量标准与交通行为和健康结果之间的关联，该研究使用了 2011 年的加拿大人口普查、交通调查、国家健康调查和经过验证的行政糖尿病数据库。我们用图形描述了居住密度和可步行目的地的可用性之间的相互作用，并使用一般线性模型进行了统计检验。与居住在步行能力较差地区的人相比，居住在步行能力较高地区的人步行、骑自行车或使用公共交通工具的可能性高出一倍以上，而开车或拥有车辆的可能性要小得多。居住在步行能力较差地区的人肥胖或患糖尿病的可能性增加了三分之一。居住密度和可步行目的地的可用性都与交通和健康结果显著相关。这两个措施水平较高的组合与步行或骑自行车（p<0.0001）和公共交通使用（p<0.0026）的最高水平以及汽车出行（p<0.0001）和糖尿病患病率（p<0.0001）的最低水平相关。我们得出的结论是，居住密度和可步行目的地的可用性都是衡量城市步行能力的良好指标，可供政策制定者、规划者和公共卫生官员使用。在我们的环境中，这两个因素的结合提供了额外的解释能力。
