Gullón Pedro, Bilal Usama, Cebrecos Alba, Badland Hannah M, Galán Iñaki, Franco Manuel
Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.
Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, 28029, Spain.
Int J Health Geogr. 2017 Jun 6;16(1):21. doi: 10.1186/s12942-017-0095-7.
Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics.
All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts.
Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on.
Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas.
先前的研究发现地区层面的社会经济地位（SES）与步行便利性之间存在复杂关系。这些研究未纳入社区动态因素。我们的目的是研究西班牙马德里市地区层面的SES与步行便利性之间的关联，并评估社区动态因素的潜在效应修正作用。
纳入马德里市所有普查区（n = 2415）。地区层面的SES通过4个领域（教育、财富、职业和生活条件）的7项指标的综合指数来衡量。计算了两个社区动态因素：以过去10年教育水平变化为代理变量的绅士化，以及以该地区住房单元建设中位数年份为代理变量的社区年龄。步行便利性通过4项指标（居住密度、人口密度、零售目的地和街道连通性）的综合指数来衡量。我们使用具有随机截距的线性混合模型对这种关联进行建模。
地区层面的SES与步行便利性呈显著负相关。SES较低的地区步行便利性最高。对于教育水平有所提高的地区，这种模式并不成立，在这些地区这种关联不明显（SES较高时步行便利性没有降低）。此外，这种关联在新建地区有所减弱：在1975年之前建成的地区关联更强，在1975年至1990年之间建成的地区较弱，而在1990年以后建成的地区则不明显。
在马德里，社区社会经济地位较高的地区步行便利性较低。这种步行便利性方面的劣势在新建或绅士化的地区并不存在。
