University of North Carolina study examines how trails and safe places to walk encourage more exercise and fitness walking.
By DAVID WILLIAMSON
Trails, streetlights and places where people can engage in physical activity all make a difference in how much they exercise, a new study suggests. When those community design amenities are unavailable, levels of physical activity are lower.
Conducted by researchers at the University of North Carolina at Chapel Hill and the N.C. Department of Health and Human Services, the study also showed access to trails and other places suitable for exercise to be especially important.
A report on the investigation appears in the September issue of the American Journal of Health Promotion, a special issue devoted to links between community and neighborhood design and health. Related articles are being published in the American Journal of Public Health, to be released simultaneously Thursday (Aug. 28) with support from the Robert Wood Johnson Foundation.
Authors of the UNC study are Dr. Sara L. Huston, research assistant professor of epidemiology at the UNCSchool of Public Health and cardiovascular epidemiologist with the N.C. DHHS's division of public health; Dr. Kelly R. Evenson, also research assistant professor of epidemiology at UNC; Philip Bors, project officer with the UNC-based Active Living by Design National Program Office; and Dr. Ziya Gizlice of the N.C. DHHS's Center for Health Statistics.
"Physical activity has been shown to improve health and reduce the risk of developing many chronic diseases, including cardiovascular disease, diabetes and some forms of cancer, three of the leading causes of death in the United States," said Huston. "Low levels of physical activity among U.S. adults have also been implicated in the ongoing national epidemic of obesity."
One recent study attributed more than 280,000 deaths in this country each year to people being overweight or obese, she said.
To examine possible links between neighborhood characteristics -- such as places where people can be physically active -- and how much exercise they get, researchers conducted a cross-sectional telephone survey, Huston said.
They called a sample of 1,796 randomly selected adults in North Carolina and asked 133 questions ranging from how much respondents exercised to what traffic was like in their neighborhoods and if there were sidewalks, trails for walking or biking and unattended dogs. Researchers focused on and called residents of Cabarrus, Henderson, Pitt, Robeson, Surry and Wake counties since those counties are widely separated and represent rural, suburban and urban areas.
"We found no association between leisure activity and unattended dogs and only a weak link with heavy traffic," Huston said. "Sidewalks appeared to make only a small positive difference, too.
"But people who reported having access to places for exercise of various kinds and those who reported neighborhood trails were significantly more likely to be getting the recommended amount of physical activity even after we took into account factors like race and years of education," she said.
One unique aspect of the study was its intentionally diverse population, the scientist said.
"We also found that blacks, American Indians and those with less education and lower household incomes were less likely to get the recommended amount of physical activity and reported generally less favorable neighborhood environments and less access to places for physical activity," Huston said.
A related study in September's issue of the American Journal of Health Promotion showed among other things that people who lived in sprawling areas walked less and were more likely than others to have high blood pressure and to be overweight or obese. Another reported how transportation decision-making can support public health objectives by reducing crashes and pollution and boosting exercise levels.
An investigation reported in the American Journal of Public Health revealed that U.S. pedestrians and cyclists were much more likely than those in Germany and Holland to be killed or injured and what can be done to reduce the toll. Others showed how managed urban and suburban development can reduce public and private costs and how better land use planning can reduce contamination of public water supplies from sources such as rain runoff.
"Our primary call to action is that we can create communities that encourage and support health-promoting behavior," said Dr. Richard Killingsworth, guest editor of the AJHP and director of Active Living by Design, a UNC-based public health effort.
The Robert Wood Johnson Foundation chose the UNC School of Public Health and Killingsworth's program to lead a multi-year, $16.5-million initiative to address such issues. The national initiative will establish innovative approaches to increase physical activity through community design, public policies and communications strategies that can become models for success nationwide.
School of Public Health Contact: Lisa Katz, (919) 966-7467
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Updated January 1, 2009