Neighborhood built environment and socioeconomic status in relation to physical activity, sedentary behavior, and weight status of adolescents

Introduction: The study examined the association of neighborhood walkability to multiple activity-related outcomes and BMI among adolescents and evaluated socioeconomic status as an effect modifier. Method: Cross-sectional study, with adolescents recruited from neighborhoods that met criteria for a 2x2 matrix defined by high/low GIS-defined walkability and high/low median income. Adolescents aged 12-16 years (n= 928) were recruited from selected neighborhoods in Maryland and King County, Washington regions in 2009-2011. There were 50.4% girls, and 66.3% were non-Hispanic white, with no medical restrictions on physical activity (PA) or diets. Total PA and sedentary time was assessed by 7 days of accelerometer monitoring. Adolescents self-reported active transport, time spent on 6 sedentary behaviors, and height and weight, used to compute BMI percentiles. Mixed model linear and logistic regressions examined outcomes for association with walkability and income, adjusting for demographic covariates and clustering within block groups. Results: Walkability was positively and significantly related to objectively-measured PA (p <.001) and more frequent walking for transportation (p <.001). Total self-reported sedentary time (p=. 048) and TV time (p <.007) were negatively related to walkability. Time in vehicles was negatively related to walkability only among higher-income adolescents. Conclusions: Neighborhood walkability was strongly and consistently associated with adolescents' objectivelyassessed total physical activity and reported active transportation. A novel finding was that adolescents living in walkable neighborhoods reported less television time and less time in vehicles. Most results were similar across income categories. Results strengthen the rationale for recommendations to improve walkability.