"Can we walk?" Environmental supports for physical activity in India.
India is currently facing a non-communicable disease epidemic. Physical activity (PA) is a preventative factor for non-communicable diseases. Understanding the role of the built environment (BE) to facilitate or constrain PA is essential for public health interventions to increase population PA. The objective of this study was to understand BEs associations with PA occurring in two major life domains or life areas-travel and leisure-in urban India. Between December 2014 and April 2015, in-person surveys were conducted with participants (N=370; female=47.2%) in Chennai, India. Perceived BE characteristics regarding residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure for walking and bicycling, aesthetics, traffic safety, and safety from crime were measured using the adapted Neighborhood Environment Walkability Scale-India (NEWS-India). Self-reported PA was measured the International Physical Activity Questionnaire. High residential density was associated with greater odds of travel PA (aOR=1.9, 95% CI=1.2, 3.2). Land use mix-diversity was positively related to travel PA (aOR=2.1, 95%CI=1.2, 3.6), but not associated with leisure or total PA. The aggregate NEWS-India score predicted a two-fold increase in odds of travel PA (aOR=1.9, 95% CI=1.1, 3.1) and a 40% decrease in odds of leisure PA (aOR=0.6, 95% CI=0.4, 1.0). However, the association of the aggregated score with leisure PA was not significant. Results suggest that relationships between BE and PA in low-and-middle income countries may be context-specific, and may differ markedly from higher income countries. Findings have public health implications for India suggesting that caution should be taken when translating evidence across countries.
Brown School, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: d.adlakha@qub.ac.uk.
Deepti
D
Adlakha
Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA.
J Aaron
JA
Hipp
Brown School, Washington University in St. Louis, St. Louis, MO, USA; Prevention Research Center in St. Louis, Washington University in St. Louis, St. Louis, MO, USA; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Ross C
RC
Brownson
Brown School, Washington University in St. Louis, St. Louis, MO, USA; Prevention Research Center in St. Louis, Washington University in St. Louis, St. Louis, MO, USA.
Amy
A
A Eyler
Brown School, Washington University in St. Louis, St. Louis, MO, USA.
Carolyn
C
K Lesorogol
School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
Ramesh
R
Raghavan
D000328:Adult; D004779:Environment Design / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D006801:Humans; D007194:India; D007899:Leisure Activities; D008297:Male; D000073296:Noncommunicable Diseases / Q000517:prevention & control; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012449:Safety / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014195:Travel / Q000706:statistics & numerical data; D016138:Walking / Q000706:statistics & numerical data*
Active living; Built environment; India; Non-communicable diseases; Physical activity; Walkability