Younkin Samuel, Fremont Henry, Bratburd Jennifer, De Los Santos Daritza, Patz Jonathan
Global Health Institute, University of Wisconsin-Madison, Madison, WI, 53726, USA.
Nelson Institute for Environmental Studies, University of Wisconsin-Madison, Madison, WI, 53726, USA.
Wellcome Open Res. 2024 Aug 5;8:266. doi: 10.12688/wellcomeopenres.19147.2. eCollection 2023.
The prevalence of chronic disease in the US adult population varies across socioeconomic groups in the USA where approximately six in 10 adults have a chronic condition. Walking or cycling reduces the risk to many of these diseases and is influenced by the built environment, accessibility, and safety.
We performed multivariate logistic and linear regression on the Health-Oriented Transportation model parameters using the 2009 and 2017 US National Household Transportation surveys, restricted to adults in major metropolitan areas. Model covariates included socioeconomic and environmental characteristics.
Using odds ratios (OR) adjusted for model covariates, we observe several significant variables in 2009 and 2017. Residents of households with no cars were more likely to walk or cycle than those with two cars; OR=5.4 (4.8, 6.0). Residents of households in a census block with population density greater than 2,5000 persons/square mile were more likely to walk or cycle than those with a population density of 2000-3999; OR=2.6 (2.3, 2.8). Individuals with a graduate or professional degree were more likely to walk or cycle than those with a high school degree; OR=2.1 (1.9, 2.2). Individuals that self-report as Black or African American, or Asian are less likely to walk or cycle than White; OR=0.60 (0.56, 0.66), OR=0.70 (0.65, 0.75). The proportional increase in all-cause mortality from estimated reductions in physical activity for African American, Asian, and Hispanic populations were 1.0%, 0.7%, 0.8%, respectively.
Access to automobiles and the surrounding population density are primary factors in the decision to walk or cycle. After adjusting for these and other factors, members of low-income, low-education, Black or African American, and Asian populations in US metropolitan areas are less likely to walk or cycle than high-income, high-education, or White populations and the discrepancy in physical activity is likely to contribute to health inequity.
美国成年人群体中慢性病的患病率在不同社会经济群体间存在差异，约十分之六的成年人患有慢性病。步行或骑自行车可降低患多种此类疾病的风险，且受建成环境、可达性和安全性的影响。
我们使用2009年和2017年美国国家家庭交通调查，对以健康为导向的交通模型参数进行多变量逻辑回归和线性回归，研究对象限于主要大都市地区的成年人。模型协变量包括社会经济和环境特征。
使用经模型协变量调整后的比值比（OR），我们在2009年和2017年观察到几个显著变量。无车家庭的居民比有两辆车家庭的居民更有可能步行或骑自行车；OR = 5.4（4.8，6.0）。人口密度大于2500人/平方英里的普查街区家庭的居民比人口密度为2000 - 3999人/平方英里的家庭居民更有可能步行或骑自行车；OR = 2.6（2.3，2.8）。拥有研究生或专业学位的个体比拥有高中学位的个体更有可能步行或骑自行车；OR = 2.1（1.9，2.2）。自我报告为黑人或非裔美国人或亚洲人的个体比白人步行或骑自行车的可能性更小；OR = 0.60（0.56，0.66），OR = 0.70（0.65，0.75）。非裔美国人、亚洲人和西班牙裔人群因估计的体力活动减少导致的全因死亡率的比例增加分别为1.0%、0.7%、0.8%。
汽车的可获得性和周边人口密度是决定步行或骑自行车的主要因素。在对这些及其他因素进行调整后，美国大都市地区低收入、低教育水平、黑人或非裔美国人以及亚洲人群比高收入、高教育水平或白人人群步行或骑自行车的可能性更小，体力活动方面的差异可能导致健康不平等。
