Health Effects of Neighborhood Walkability on Chinese Adults: Analysis of an Existing Longitudinal Cohort

Project: Research

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AimThe overall aim of this proposed project is to investigate the effects of neighbourhood walkability on various health outcomes in a longitudinal cohort consisting of 0.6 million Chinese adults.Project backgroundMore than 25% of the global population does not participate in sufficient physical activity (PA). Although the health benefits of PA are well documented, few strategies are available to improve PA levels. Recently, good walkability has been proposed as a broad strategy for improving the PA levels in different populations. However, little is known about the association between walkability and health. Few studies have explored the health benefits of neighbourhood walkability, especially in the context of Asian regions with high population densities. The existing studies have generally focused on limited health outcomes. Moreover, multiple and complex pathways link walkability to various health outcomes. Although PA is considered as the major mediator of the association between walkability and health, the magnitude of this mediation is unclear and other potential mediators remain to be explored.Project descriptionWe propose to investigate this important public health concern by analysing data from an existing longitudinal cohort. This cohort database contains information from 1.44 million medical examination records of 0.62 million individuals during the 1996–2017 period. Demographic, socio-economic, lifestyle, residential address and PA information was collected during each medical examination. In our previous research, we additionally obtained data on the participants’ vital statuses and air pollution exposure (including PM2.5, nitrogen dioxide and ozone). We will assess the three dimensions of walkability—point of interest, transit point access and topographical impedance to walking—using open-source GIS data. A Cox regression model will be used to analyse data corresponding to dichotomous health outcomes (mortality and morbidities), while a generalised linear mixed model will be used to analyse data for continuous health outcomes (e.g., lung function, blood pressure and glucose levels). Mediation analyses will be used to examine the mediating effects of PA, air pollution and social inequality on the associations between walkability and various health outcomes.Significance of the projectThe World Health Organisation has identified physical inactivity as a leading cause of the global disease burden. Neighbourhood walkability is a crucial factor in promoting PA within a population on a broader scale. An improved understanding of the health effects of walkability would have enormous implications for the development of health guidelines and urbanised policies, especially in areas with high population densities. 


Project number9043482
Grant typeGRF
Effective start/end date1/01/21 → …