Abstract
OBJECTIVES: To estimate the associations of neighbourhood walkability (based on Geographic Information System (GIS)-derived measures of street connectivity, land use mix, and population density and the Walk Score) with self-reported utilitarian walking and accelerometer-assessed daily steps in Canadian adults. DESIGN: A cross-sectional analysis of data collected as part of the Canadian Health Measures Survey (2007-2009). SETTING: Home neighbourhoods (500 m polygonal street network buffers around the centroid of the participant's postal code) located in Atlantic Canada, Québec, Ontario, the Prairies and British Columbia. PARTICIPANTS: 5605 individuals participated in the survey. 3727 adults (≥18 years) completed a computer-assisted interview and attended a mobile clinic assessment. Analyses were based on those who had complete exposure, outcome and covariate data (n=2949). MAIN EXPOSURE MEASURES: GIS-derived walkability (based on land use mix, street connectivity and population density); Walk Score. MAIN OUTCOME MEASURES: Self-reported utilitarian walking; accelerometer-assessed daily steps. RESULTS: No important relationship was observed between neighbourhood walkability and daily steps. Participants who reported more utilitarian walking, however, accumulated more steps (<1 h/week: 6613 steps/day, 95% CI 6251 to 6975; 1 to 5 h/week: 6768 steps/day, 95% CI 6420 to 7117; ≥6 h/week: 7391 steps/day, 95% CI 6972 to 7811). There was a positive graded association between walkability and odds of walking ≥1 h/week for utilitarian purposes (eg, Q4 vs Q1 of GIS-derived walkability: OR=1.66, 95% CI 1.31 to 2.11; Q3 vs Q1: OR=1.41, 95% CI 1.14 to 1.76; Q2 vs Q1: OR=1.13, 95% CI 0.91 to 1.39) independent of age, sex, body mass index, married/common law status, annual household income, having children in the household, immigrant status, mood disorder, perceived health, ever smoker and season. CONCLUSIONS: Contrary to expectations, living in more walkable Canadian neighbourhoods was not associated with more total walking. Utilitarian walking and daily steps were, however, correlated and walkability demonstrated a positive graded relationship with utilitarian walking.