title: Neighborhood walkability: Differential associations with self-reported transport walking and leisure-time physical activity in Canadian towns and cities of all sizes.
abstract: OBJECTIVE
  To estimate associations between walkability and physical activity during transportation and leisure in a national-level population.
  
  
  METHODS
  Walkability was measured by Walk Score® (2012-2014) and physical activity by the Canadian Community Health Survey (2007-2012) for urban participants who worked or attended school. Multiple linear regression was done on the total study population, four age subgroups (12-17, 18-29, 30-64, 65+) and three population center subgroups (1000-29,999, 30,000-99,999, 100,000+).
  
  
  RESULTS
  151,318 respondents were examined. Comparing highest to lowest Walk Score® quintiles, covariate-adjusted energy expenditure on transport walking [95% confidence interval] was 0.17 [0.15, 0.18] kcal/kg/day higher in the total study population, and significantly higher in all age and population center subgroups. Leisure physical activity was lower in the age 18-29 subgroup (-0.28 [-0.43, -0.12]) and population centers 100,000+ subgroup (-0.10 [-0.18, -0.03]), but higher in the population centers 1000-29,999 subgroup (0.30 [0.12, 0.48]). Total physical activity was higher in the following subgroups: age 30-64 (0.19 [0.12, 0.26]), population centers 100,000+ (0.12 [0.04, 0.19]) and population centers 1000-29,999 (0.40 [0.20, 0.59]).
  
  
  CONCLUSIONS
  Walkability is associated with transport walking in all age groups and towns and cities of all sizes. Walkability's inverse associations with leisure physical activity among young adults and in large population centers may offset energy expenditure gains, while positive associations with leisure physical activity in small centers may add to energy expenditure.
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario M5G 1V2, Canada. Electronic address: justin.thielman@oahpp.ca.
authors.forename: Justin
authors.initials: J
authors.lastname: Thielman
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario M5G 1V2, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada. Electronic address: laura.rosella@utoronto.ca.
authors.forename: Laura
authors.initials: L
authors.lastname: Rosella
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario M5G 1V2, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada. Electronic address: ray.copes@oahpp.ca.
authors.forename: Ray
authors.initials: R
authors.lastname: Copes
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario M5G 1V2, Canada. Electronic address: michael.lebenbaum@hotmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Lebenbaum
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, Ontario M5G 1V2, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7, Canada; School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Toronto N2L 3G1, Canada. Electronic address: heather.manson@oahpp.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Manson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002170:Canada; D002648:Child; D003430:Cross-Sectional Studies; D004779:Environment Design; D015444:Exercise; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D057566:Self Report; D012931:Social Environment; D014505:Urban Population; D016138:Walking; D055815:Young Adult
keywords: Chronic disease; Cities; City planning; Environment; Environment design; Exercise; Sedentary lifestyle; Transportation; Urbanization; Walking