Neighborhood walkability and cardiometabolic disease in Texas.

Cardiometabolic diseases (CMDs) affect significant numbers of adults in the United States, with 11% diagnosed with diabetes and 10% with cardiovascular diseases. Walking plays a crucial role in reducing health risks, particularly obesity and diabetes. We aim to explore the association between neighborhood walkability and CMD measures in Texas, while controlling for age, sex, racial/ethnic background, and family history of diabetes. We collected 1994 observations for the year 2019, merging data from the Texas Behavioral Risk Factor Surveillance System and the Environmental Protection Agency. We employed multilevel linear regression and multilevel logistic regression analyses to assess the association between CMD measures and neighborhood walkability. Our findings revealed that higher neighborhood walkability is significantly associated with a lower body mass index (BMI) (β = - 0.28, CI - 0.45 to - 0.10) and a reduced risk of diabetes (OR 0.93, CI 0.86-0.99), indicating that when walkability increases by one unit, an individual's BMI decreases by 0.28 kg/m and the odds of having diabetes decrease by 7%. We also found that African Americans living in communities with lower walkability scores compared to other racial/ethnic groups. Our findings highlight the need for urban planning policies promoting walkable neighborhoods, suggesting community-based approaches to health promotion.