does walkability differ by area sociodemographic profile? a study of madrid city

Pedro Gullón1, Alba Cebrecos1,2, Xisca Sureda1, Usama Bilal1,3,

Julia Díez1, Francisco Escobar1,2, Manuel Franco1,3

1. Social and Cardiovascular Epidemiology Research Group, Universidad de Alcala, Madrid,

Spain

2. Department of Geology, Geography and Environment, Faculty of Biology, Chemistry and

Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.

3. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Does walkability differ by area

sociodemographic profile? A

study of Madrid City

http://hhhproject.eu

JUSTIFICATION

PHYSICAL ACTIVITY

CVD,

Weight

DM II

Breast cancer

Colon cancer

Osteoporosis

Falls

Mental diseases

0.68 increase in lifeexpectancy* (if allsedentarism is removed)

Source: blog “Bicicleta, ciudad y viajes”

http://bicicletasciudadesviajes.blogspot.com.es/2012/03/y-se-hizo-la-

luz.html

*Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases

worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012 Jul 21;380(9838):219-29. PubMed PMID: 22818936.

Pubmed Central PMCID: PMC3645500. Epub 2012/07/24. eng.


JUSTIFICATION

Physical activity population

approach: urban environment

Measuring urban environment:

“Subjective” methods

– Questionnaires (1)

– Interviews

“Objective” methods

– Official sources

(Geographical, Statistical)

– Systematic social

observation (2)

(1) Gullon P, Bilal U, Franco M. Physical activity environment measurement and same source bias. Gac Sanit. 2014 Jul-Aug;28(4):344-5.

(2) Gullón P, Badland HM, Alfayate S, Bilal U, Escobar F, Cebrecos A, Diez J, Franco M. Assessing Walking and Cycling Environments in

the Streets of Madrid: Comparing On-Field and Virtual Audits. J Urban Health. 2015 Oct;92(5):923-39


OBJECTIVE

To study the association between area-

level sociodemographic characteristics

and walkability in the city of Madrid


METHODS

2415 census sections

(~ US census block group)

Dependent variable:

• Walkability

Independient variables:

• % w/ Low education

• % Foreign-born

Source: Padron 2014 (municipal registry)


METHODS

𝑤𝑎𝑙𝑘𝑎𝑏𝑖𝑙𝑖𝑡𝑦 = 2 × 𝑐𝑜𝑛𝑛𝑒𝑐𝑡𝑖𝑣𝑖𝑡𝑦 + 𝐿𝑈𝑀 + (𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑑𝑒𝑛𝑠𝑖𝑡𝑦)

• Connectivity: Kernel density

• Land use mix (LUM)

𝐿𝑈𝑀 = −1(

𝑖=1

𝑛

𝑝𝑖 ×ln(𝑝𝑖)

ln(𝑛))

• Population density (pop/km2)

Statistical analysis: ANOVA & mixed-effects model withrandom intercept for district


RESULTS


RESULTS

-2,00

-1,50

-1,00

-0,50

0,00

0,50

1,00

1 2 3 4 5

Wal

kab

ility

Quintiles of % low education

Mean of walkability by quintiles of low education in 2415 census sections of Madrid


RESULTS

Quartiles of % of low education

Q1 (High Ed.) Q2 Q3 (ref) Q4 Q5 (Low Ed.)

Mean p Mean P Mean Mean P Mean p

Population density 22.6 <0.001 34.3 0.20 37.3 37.4 0.60 33.8 0.01

Land use mix 0.78 <0.001 0.77 <0.001 0.73 0.71 0.01 0.72 0.19

Connectivity 0.015 <0.001 0.019 <0.001 0.021 0.023 <0.001 0.023<0.001

Walkability -1.53 <0,001 -0.12 0.01 0,32 0.78 0.01 0.53 0.22


RESULTS


RESULTS

-2,00-1,50-1,00-0,500,000,501,001,502,002,50

1 2 3 4 5

Wal

kab

ility

Quintiles of % migrants

Mean of walkability by quintiles of % migrants living in the 2415 census sections of Madrid


RESULTS

Quartiles of % of foreign-born

Q1 (High Ed.) Q2 Q3 (ref) Q4 Q5 (Low Ed.)

Mean p Mean P Mean Mean P Mean p

Population density 25.4 <0.001 27.6 <0.001 32.9 36.1 <0.001 44.7<0.001

Land use mix 0.77 0.05 0.77 0.06 0.75 0.72 <0.001 0.71<0.001

Connectivity 0.15 <0.001 0.17 <0.001 0.20 0.22 <0.001 0.26<0.001

Walkability -1.43 <0.001 -0.98 <0.001 -0.11 0.6 <0.001 1.91<0.001


Walkability

% Low Ed

% Foreign-Born


DISCUSSION AND CONCLUSSIONS

• The relationship between area-educationlevel and walkability shows complexpatterns.

• Areas with more foreign-born populationhave a higher walkability index

• Urban policy to improve physical activity and reduce health inequalities should take into account specific sociodemographic characteristics when designing more walkable neighborhoods.


Thank You! Questions?