Socioeconomic differences in lack of recreational walking among older adults: the role of neighbourhood and individual factors.
BACKGROUND
People with a low socioeconomic status (SES) are more likely to be physically inactive than their higher status counterparts, however, the mechanisms underlying this socioeconomic gradient in physical inactivity remain largely unknown. Our aims were (1) to investigate socioeconomic differences in recreational walking among older adults and (2) to examine to what extent neighbourhood perceptions and individual cognitions regarding regular physical activity can explain these differences.


METHODS
Data were obtained by a large-scale postal survey among a stratified sample of older adults (age 55-75 years) (N = 1994), residing in 147 neighbourhoods of Eindhoven and surrounding areas, in the Netherlands. Multilevel logistic regression analyses assessed associations between SES (i.e. education and income), perceptions of the social and physical neighbourhood environment, measures of individual cognitions derived from the Theory of Planned Behaviour (e.g. attitude, perceived behaviour control), and recreational walking for >/=10 minutes/week (no vs. yes).


RESULTS
Participants in the lowest educational group (OR 1.67 (95% CI, 1.18-2.35)) and lowest income group (OR 1.40 (95% CI, 0.98-2.01)) were more likely to report no recreational walking than their higher status counterparts. The association between SES and recreational walking attenuated when neighbourhood aesthetics was included in the model, and largely reduced when individual cognitions were added to the model (with largest effects of attitude, and intention regarding regular physical activity). The assiation between poor neighbourhood aesthetics and no recreational walking attenuated to (borderline) insignificance when individual cognitions were taken into account.


CONCLUSIONS
Both neighbourhood aesthetics and individual cognitions regarding physical activity contributed to the explanation of socioeconomic differences in no recreational walking. Neighbourhood aesthetics may explain the association between SES and recreational walking largely via individual cognitions towards physical activity. Intervention and policy strategies to reduce socioeconomic differences in lack of recreational walking among older adults would be most effective if they intervene on both neighbourhood perceptions as well as individual cognitions.
Kamphuis
Carlijn Bm
CB
Department of Public Health, Erasmus University Medical Centre, P,O, Box 2040, 3000 CA Rotterdam, The Netherlands. c.kamphuis@scp.nl.
van Lenthe
Frank J
FJ
Giskes
Katrina
K
Huisman
Martijn
M
Brug
Johannes
J
Mackenbach
Johan P
JP