The Relationship Between Mental and Physical Health and Walking During the COVID-19 Pandemic

Introduction: COVID-19 policies such as quarantining, social isolation, and lockdowns are an essential public health measure to reduce the spread of disease but may lead to reduced physical activity. Little is known if these changes are associated with changes in physical or mental health.Methods: Between September 2017 and December 2018 (baseline) and March 2020 and February 2021 (follow-up), we obtained self-reported demographic, health, and walking (only at follow-up) data on 2042 adults in primary care with multiple chronic health conditions. We examined whether the perceived amount of time engaged in walking was different compared with prepandemic levels and if this was associated with changes in Patient-Reported Outcomes Measurement Information System-29 mental and physical health summary scores. Multivariable linear regression controlling for demo-graphic, health, and neighborhood information were used to assess this association.Results: Of the 2042 participants, 9% reported more walking, 28% reported less, and 52% reported the same amount compared with prepandemic levels. Nearly 1/3 of participants reported less walking dur-ing the pandemic. Multivariable models revealed that walking less or not at all was associated with nega-tive changes in mental (ss = -1.0; 95% CI [-1.6, -0.5]; ss = -2.2; 95% CI [-2.9, -1.4]) and physical (ss = -0.9; 95% CI [-1.5, -0.3]; ss = -3.1; 95% CI [-4.0, -2.3]) health, respectively. Increasing walk-ing was significantly associated with a positive change in physical health (ss = 1.3; 95% CI [0.3, 2.2]). Conclusions: These findings demonstrate the importance of walking during the COVID-19 pandemic. Promotion of physical activity should be taken into consideration when mandating restrictions to slow the spread of disease. Primary care providers can assess patient's walking patterns and implement brief interventions to help patients improve their physical and mental health through walking.