title: Walkability and cardiometabolic risk factors: Cross-sectional and longitudinal associations from the Multi-Ethnic Study of Atherosclerosis.
abstract: We used data from 3227 older adults in the Multi-Ethnic Study of Atherosclerosis (2004-2012) to explore cross-sectional and longitudinal associations between walkability and cardiometabolic risk factors. In cross-sectional analyses, linear regression was used to estimate associations of Street Smart Walk Score® with glucose, triglycerides, HDL and LDL cholesterol, systolic and diastolic blood pressure, and waist circumference, while logistic regression was used to estimate associations with odds of metabolic syndrome. Econometric fixed effects models were used to estimate longitudinal associations of changes in walkability with changes in each risk factor among participants who moved residential locations between 2004 and 2012 (n=583). Most cross-sectional and longitudinal associations were small and statistically non-significant. We found limited evidence that higher walkability was cross-sectionally associated with lower blood pressure but that increases in walkability were associated with increases in triglycerides and blood pressure over time. Further research over longer time periods is needed to understand the potential for built environment interventions to improve cardiometabolic health.
authors.affiliation: Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States. Electronic address: maurerbraun@unc.edu.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Braun
authors.affiliation: Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Rodríguez
authors.affiliation: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Evenson
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
authors.forename: Jana A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.
authors.forename: Kari A
authors.initials: KA
authors.lastname: Moore
authors.affiliation: Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology / Q000208:ethnology*; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000208:ethnology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D016138:Walking / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol
keywords: Built environment; Cardiometabolic risk; Metabolic syndrome; Residential relocation; Walkability