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Introduction: Despite the accumulating Canadian evidence regarding the relations between urban form and health behaviours, less is known about the associations between urban form and health conditions. Our study aim was to undertake a scoping review to synthesize evidence from quantitative studies that have investigated the relationship between built environment and chronic health conditions, self-reported health and quality of life, and injuries in the Canadian adult population. Methods: From January to March 2017, we searched 13 databases to identify peer-reviewed quantitative studies from all years that estimated associations between the objectivelymeasured built environment and health conditions in Canadian adults. Studies undertaken within urban settings only were included. Relevant studies were catalogued and synthesized in relation to their reported study and sample design, and health outcome and built environment features. Results: Fifty-five articles met the inclusion criteria, 52 of which were published after 2008. Most single province studies were undertaken in Ontario (n = 22), Quebec (n = 12), and Alberta (n = 7). Associations between the built environment features and 11 broad health outcomes emerged from the review, including injury (n = 19), weight status (n = 19), cardiovascular disease (n = 5), depression/anxiety (n = 5), diabetes (n = 5), mortality (n = 4), self-rated health (n = 2), chronic conditions (n = 2), metabolic conditions (n = 2), quality of life (n = 1), and cancer (n = 1). Consistent evidence for associations between aggregate built environment indicators (e.g., walkability) and diabetes and weight and between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern, intersections, route characteristics) and injury were found. Evidence for greenspace, parks and recreation features impacting multiple health outcomes was also found. Conclusion: Within the Canadian context, the built environment is associated with a range of chronic health conditions and injury in adults, but the evidence to date has limitations. More research on the built environment and health incorporating rigorous study designs are needed to provide stronger causal evidence to inform policy and practice. [ABSTRACT FROM AUTHOR]

Abstract Despite associations found between physical activity and depression, and the built environment and physical activity, there appears to be inconclusive evidence regarding the role of built environment attributes with preventing depression among the elderly. This is mainly because few studies exist on this topic. In addition, the majority of existing studies have been conducted in Western countries; and there is a dearth of studies in other regions, where the built, social, and cultural environment is different than Western countries. Using data from Japanese older adults, this study examined the associations between objectively-assessed built environment attributes and depressive symptoms. We examined these associations stratified by gender, since research has well-documented gender differences in depression. Data were from 328 older adults living in Japan. Built environment attributes were objectively calculated and Walk Score ® ratings were obtained from the website. Depressive symptoms were assessed using the GDS-15. Gender-stratified regression models were used to estimate the associations. We found that a walkable environment characterized by a high population density and proximate local destinations to be supportive for a better mental health among older adults, in particular for women. These findings suggest that walkable built environment attributes may influence depression among older women in an Asian urban context. This study contributed to the literature by examining how walkable urban design may influence elderly's depression in a setting with extreme level of environmental attributes. Investing in urban design to promote walkability may help in reducing the observed gender gap in depression in the Japanese population. Highlights • Urban design attributes were associated with older adults' depression among women. • High population density and proximate destinations supported better mental health. • Walkable environment may influence depression among women in an Asian context. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to estimate the associations between neighbourhood built environment characteristics and transportation walking (TW), recreational walking (RW), and moderate-intensity (MPA) and vigorous-intensity physical activity (VPA) in adults independent of sociodemographic characteristics and residential self-selection (i.e. the reasons related to physical activity associated with a person's choice of neighbourhood). Methods: In 2007 and 2008, 4423 Calgary adults completed land-based telephone interviews capturing physical activity, sociodemographic characteristics and reasons for residential self-selection. Using spatial data, we estimated population density, proportion of green space, path/cycleway length, business density, bus stop density, city-managed tree density, sidewalk length, park type mix and recreational destination mix within a 1.6 km street network distance from the participants' geolocated residential postal code. Generalized linear models estimated the associations between neighbourhood built environment characteristics and weekly neighbourhood-based physical activity participation (= 10 minutes/week; odds ratios [ORs]) and, among those who reported participation, duration of activity (unstandardized beta coefficients [B]). Results: The sample included more women (59.7%) than men (40.3%) and the mean (standard deviation) age was 47.1 (15.6) years. TW participation was associated with intersection (OR = 1.11; 95% CI: 1.03 to 1.20) and business (OR = 1.52; 1.29 to 1.78) density, and sidewalk length (OR = 1.19; 1.09 to 1.29), while TW minutes was associated with business (B = 19.24 minutes/week; 11.28 to 27.20) and tree (B = 6.51; 2.29 to 10.72 minutes/week) density, and recreational destination mix (B = -8.88 minutes/week; -12.49 to -5.28). RW participation was associated with path/cycleway length (OR = 1.17; 1.05 to 1.31). MPA participation was associated with recreational destination mix (OR = 1.09; 1.01 to 1.17) and sidewalk length (OR = 1.10; 1.02 to 1.19); however, MPA minutes was negatively associated with population density (B = -8.65 minutes/week; -15.32 to -1.98). VPA participation was associated with sidewalk length (OR = 1.11; 1.02 to 1.20), path/cycleway length (OR = 1.12; 1.02 to 1.24) and proportion of neighbourhood green space (OR = 0.89; 0.82 to 0.98). VPA minutes was associated with tree density (B = 7.28 minutes/week; 0.39 to 14.17). Conclusion: Some neighbourhood built environment characteristics appear important for supporting physical activity participation while others may be more supportive of increasing physical activity duration. Modifications that increase the density of utilitarian destinations and the quantity of available sidewalks in established neighbourhoods could increase overall levels of neighbourhood-based physical activity. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence demonstrating the importance of the neighbourhood built environment in supporting physical activity. Physical activity provides numerous health benefits including improvements in health-related fitness (i.e., muscular, cardiorespiratory, motor, and morphological fitness). Emerging evidence also suggests that the neighbourhood built environment is associated with health-related fitness. Our aim was to summarize evidence on the associations between the neighbourhood built environment and components of health-related fitness in adults. Methods: We undertook a systematic review following PRISMA guidelines. Our data sources included electronic searches in MEDLINE, Embase, CINAHL, Web of Science, SPORTDiscus, Environment Complete, ProQuest Dissertations and Theses, and Transport Research International Documentation from inception to March 2021. Our eligibility criteria consisted of observational and experimental studies estimating associations between the neighbourhood built environment and health-related fitness among healthy adults (age ≥ 18 years). Eligible studies included objective or self-reported measures of the neighbourhood built environment and included either objective or self-reported measures of health-related fitness. Data extraction included study design, sample characteristics, measured neighbourhood built environment characteristics, and measured components of health-related fitness. We used individual Joanna Briggs Institute study checklists based on identified study designs. Our primary outcome measure was components of health-related fitness (muscular; cardiorespiratory; motor, and morphological fitness). Results: Twenty-seven studies (sample sizes = 28 to 419,562; 2002 to 2020) met the eligibility criteria. Neighbourhood destinations were the most consistent built environment correlate across all components of health-related fitness. The greatest number of significant associations was found between the neighbourhood built environment and morphological fitness while the lowest number of associations was found for motor fitness. The neighbourhood built environment was consistently associated with health-related fitness in studies that adjusted for physical activity. Conclusion: The neighbourhood built environment is associated with health-related fitness in adults and these associations may be independent of physical activity. Longitudinal studies that adjust for physical activity (including resistance training) and sedentary behaviour, and residential self-selection are needed to obtain rigorous causal evidence for the link between the neighbourhood built environment and health-related fitness. Trial registration: Protocol registration: PROSPERO number CRD42020179807. [ABSTRACT FROM AUTHOR]

Background: Walkability is a popular term used to describe aspects of the built and social environment that have important population-level impacts on physical activity, energy balance, and health. Although the term is widely used by researchers, practitioners, and the general public, and multiple operational definitions and walkability measurement tools exist, there are is no agreed-upon conceptual definition of walkability.Method: To address this gap, researchers from Memorial University of Newfoundland hosted "The Future of Walkability Measures Workshop" in association with researchers from the Canadian Urban Environmental Health Research Consortium (CANUE) in November 2017. During the workshop, trainees, researchers, and practitioners worked together in small groups to iteratively develop and reach consensus about a conceptual definition and name for walkability. The objective of this paper was to discuss and propose a conceptual definition of walkability and related concepts.Results: In discussions during the workshop, it became clear that the term walkability leads to a narrow conception of the environmental features associated with health as it inherently focuses on walking. As a result, we suggest that the term Active Living Environments, as has been previously proposed in the literature, are more appropriate. We define Active Living Environments (ALEs) as the emergent natural, built, and social properties of neighbourhoods that promote physical activity and health and allow for equitable access to health-enhancing resources.Conclusions: We believe that this broader conceptualization allows for a more comprehensive understanding of how built, natural, and social environments can contribute to improved health for all members of the population. [ABSTRACT FROM AUTHOR]

Introduction: Evidence to date suggests that the built environment has the potential to facilitate and even discourage physical activity. A limitation of previous reviews is that they have typically not been country-specific. We conducted a systematized literature review of quantitative studies that estimated associations between the built environment--which were objectively measured--and walking among Canadian adults. Methods: Five scientific databases were searched for peer-reviewed studies published in all years up to December 31, 2016, that estimated the association between the built environment (i.e. objectively measured using audits and Geographic Information Systems [GIS]) and physical activity among a sample of Canadian adults. The database searches, title and abstract screen, full-text review and data extraction were undertaken by two reviewers. Results: Of 4140 articles identified, 25 met the inclusion criteria. Most studies included data from a single Canadian province. All but two studies were cross-sectional. Most studies captured self-reported walking for transportation and walking for any purpose. Overall walkability and land use were consistently associated with walking for transportation, while proximity to destinations was associated with walking for any purpose. Conclusions: Our review findings suggest that the built environment is potentially important for supporting adult walking. Overall walkability, land use and proximity to destinations appear to be important given their association with transportation walking and walking for any purpose. [ABSTRACT FROM AUTHOR]

Background: The neighbourhood environment may play an important role in diet quality. Most previous research has examined the associations between neighbourhood food environment and diet quality, and neighbourhood socioeconomic status and diet quality separately. This study investigated the independent and joint effects of neighbourhood food environment and neighbourhood socioeconomic status in relation to diet quality in Canadian adults.Methods: We undertook a cross-sectional study with n = 446 adults in Calgary, Alberta (Canada). Individual-level data on diet and socio-demographic and health-related characteristics were captured from two self-report internet-based questionnaires, the Canadian Diet History Questionnaire II (C-DHQ II) and the Past Year Physical Activity Questionnaire (PAQ). Neighbourhood environment data were derived from dissemination area level Canadian Census data, and Geographical Information Systems (GIS) databases. Neighbourhood was defined as a 400 m network-based 'walkshed' around each participant's household. Using GIS we objectively-assessed the density, diversity, and presence of specific food destination types within the participant's walkshed. A seven variable socioeconomic deprivation index was derived from Canadian Census variables and estimated for each walkshed. The Canadian adapted Healthy Eating Index (C-HEI), used to assess diet quality was estimated from food intakes reported on C-DHQ II. Multivariable linear regression was used to test for associations between walkshed food environment variables, walkshed socioeconomic status, and diet quality (C-HEI), adjusting for individual level socio-demographic and health-related covariates. Interaction effects between walkshed socioeconomic status and walkshed food environment variables on diet quality (C-HEI) were also tested.Results: After adjustment for covariates, food destination density was positively associated with the C-HEI (β 0.06, 95 % CI 0.01-0.12, p = 0.04) though the magnitude of the association was small. Walkshed socioeconomic status was not significantly associated with the C-HEI. We found no statistically significant interactions between walkshed food environment variables and socioeconomic status in relation to the C-HEI. Self-reported physical and mental health, time spent in neighbourhood, and dog ownership were also significantly (p < .05) associated with diet quality.Conclusions: Our findings suggest that larger density of local food destinations may is associated with better diet quality in adults. [ABSTRACT FROM AUTHOR]

Evidence of associations between neighbourhood built characteristics and sedentary behaviours is mixed. The study aim was to investigate the associations between objectively-derived neighbourhood built characteristics and self-reported sedentary behaviours among Canadian men and women. This study sourced survey data from Alberta's Tomorrow Project (2008; n = 14,785), in which sitting and motor vehicle travel times during the last 7 days was measured. Geographic Information System was used to calculate neighbourhood built characteristics within a 400 m buffer of participant's home and a walkability score was estimated. To estimate the associations between neighbourhood characteristics and sedentary behaviours, covariate-adjusted generalized linear regression models were used. Walkability , 3-way intersections, and population count were positively associated with sitting time. Business destinations and greenness were negatively associated with sitting time. Walkability, 3-way , and 4-way intersections were negatively associated with motor vehicle travel time. Sex-specific associations between neighbourhood characteristics and sedentary behaviour were found. Among men, business destinations were negatively associated with sitting time, and 3-way intersections , population count, and walkability were negatively associated with motor vehicle travel time. Among women, Normalized Difference Vegetation Index was negatively associated with sitting time. Interventions to reduce sedentary behaviours may need to target neighbourhoods that have built characteristics which might support these behaviours. More research is needed to disentangle the complex relationships between different neighbourhood built characteristics and specific types of sedentary behaviour. • Less sitting time was associated with more business destinations and greenness. • More sitting time was associated with more 3-way intersections and population count. • Less motor vehicle time was associated with more 3-way and 4-way intersections. • A unit increase in walkability was associated with a 13-min/week increase in sitting. • Some built environment-sedentary behaviour associations were sex-specific. [ABSTRACT FROM AUTHOR]

Evidence of associations between neighbourhood built characteristics and sedentary behaviours is mixed. The study aim was to investigate the associations between objectively-derived neighbourhood built characteristics and self-reported sedentary behaviours among Canadian men and women. This study sourced survey data from Alberta's Tomorrow Project (2008; n = 14,785), in which sitting and motor vehicle travel times during the last 7 days was measured. Geographic Information System was used to calculate neighbourhood built characteristics within a 400 m buffer of participant's home and a walkability score was estimated. To estimate the associations between neighbourhood characteristics and sedentary behaviours, covariate-adjusted generalized linear regression models were used. Walkability, 3-way intersections, and population count were positively associated with sitting time. Business destinations and greenness were negatively associated with sitting time. Walkability, 3-way, and 4-way intersections were negatively associated with motor vehicle travel time. Sex-specific associations between neighbourhood characteristics and sedentary behaviour were found. Among men, business destinations were negatively associated with sitting time, and 3-way intersections, population count, and walkability were negatively associated with motor vehicle travel time. Among women, Normalized Difference Vegetation Index was negatively associated with sitting time. Interventions to reduce sedentary behaviours may need to target neighbourhoods that have built characteristics which might support these behaviours. More research is needed to disentangle the complex relationships between different neighbourhood built characteristics and specific types of sedentary behaviour. [ABSTRACT FROM AUTHOR]

Few studies examine associations between objectively-calculated neighbourhood built environment attributes and objectively-assessed sedentary behaviour in different geographical locations, especially in highly-populated environments. Additionally, no study, to our knowledge, has investigated associations between objective measures of neighbourhood built environment attributes and objectively-assessed sedentary behaviours in middle-aged adults, despite the fact that this is a critical stage of life when age-related functional decline begins. We examined the associations between neighbourhood built environment attributes with the total, and patterns of, objectively-assessed sedentary behaviours in a densely-populated area in Asia. Data from 866 adults (ages 40 to 64) living in Japan were included. Four classifications of sedentary behaviours, including daily total sedentary time, duration and number of long (≥30 min) sedentary bouts and breaks per sedentary hour, were estimated using hip-worn accelerometers. Individual (population density, availability of destinations, number of intersections, and distance to the nearest park) and composite (walkability and Walk Score®) neighbourhood built environment indices were calculated using geographic information systems. Covariate-adjusted multilevel linear mixed effects models were used to estimate the associations between the neighbourhood built environment attributes and sedentary behaviours. Population density and availability of destinations were positively associated with sedentary behaviours; however, the number of intersections was negatively associated with sedentary behaviours. No associations were observed between the distance to the nearest park and sedentary behaviours. There were positive associations between walkability and total sedentary time, and duration and the number of long sedentary bouts. Walk Score® was positively associated with total sedentary time and the number of long sedentary bouts. These findings suggest that urban design attributes supportive of walking (except for the number of intersections) may encourage sedentary behaviour among middle-aged adults living in densely-populated environments. [ABSTRACT FROM AUTHOR]

This study estimated the associations between neighbourhood characteristics and self-reported body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) risk categories among Canadian men and women. Using data from the Alberta's Tomorrow Project (n = 14,550), we estimated 3- and 4-way intersections, business destinations, population count, and normalized difference vegetation index (NDVI) within a 400 m radius of participant's home. Intersections, business destinations, and population count (z-scores) were summed to create a walkability score. Four-way intersections and walkability were negatively associated with overweight and obesity. Walkability was negatively associated with obesity. NDVI was negatively associated with high-risk WHR and population count and walkability positively associated with high-risk WHR. Among men, population count and walkability were negatively associated with obesity, and business destinations and walkability were negatively associated with overweight and obesity. Among women, NDVI was negatively associated with overweight (including obesity), obesity, and high-risk WC. Interventions promoting healthy weight could incorporate strategies that take into consideration local built environment characteristics. [ABSTRACT FROM AUTHOR]

Few Canadian studies have examined whether or not associations between neighbourhood walkability and physical activity differ by sex. We estimated associations between perceived neighbourhood walkability and physical activity among Canadian men and women. This study included cross-sectional survey data from participants in 'Alberta's Tomorrow Project' (Canada; n = 14,078), a longitudinal cohort study. The survey included socio-demographic items as well as the International Physical Activity Questionnaire (IPAQ) and the abbreviated Neighbourhood Environment Walkability Scale (NEWS-A), which captured perceived neighbourhood built characteristics. We computed subscale and overall walkability scores from NEWS-A responses. Covariate-adjusted generalized linear models estimated the associations of participation (≥10 min/week) and minutes of different types of physical activity, including transportation walking (TW), leisure walking (LW), moderate-intensity physical activity (MPA), and vigorous-intensity physical activity (VPA) with walkability scores. Walkability was positively associated with participation in TW, LW, MPA and VPA and minutes of TW, LW, and VPA. Among men, a negative association was found between street connectivity and VPA participation. Additionally, crime safety was negatively associated with VPA minutes among men. Among women, pedestrian infrastructure was positively associated with LW participation and overall walkability was positively associated with VPA minutes. Notably, overall walkability was positively associated with LW participation among men and women. Different perceived neighbourhood walkability characteristics might be associated with participation and time spent in different types of physical activity among men and women living in Alberta. Interventions designed to modify perceptions of neighbourhood walkability might influence initiation or maintenance of different types of physical activity. [ABSTRACT FROM AUTHOR]