Linking objectively measured physical activity with objectively measured urban form

Background To date, nearly all research on physical activity and the built environment is based on self-reported physical activity and perceived assessment of the built environment. Objective To assess how objectively measured levels of physical activity are related with objectively measured aspects of the physical environment around each participant’s home while controlling for sociodemographic covariates. Methods Objective measures of the built environment unique to each household’s physical location were developed within a geographic information system to assess land-use mix, residential density, and street connectivity. These measures were then combined into a walkability index. Accelerometers were deployed over a 2-day period to capture objective levels of physical activity in 357 adults. Results Measures of land-use mix, residential density, and intersection density were positively related with number of minutes of moderate physical activity per day. A combined walkability index of these urban form factors was significant (p =0.002) and explained additional variation in the number of minutes of moderate activity per day over sociodemographic covariates. Thirty-seven percent of individuals in the highest walkability index quartile met the ≥30 minutes of physical activity recommended, compared to only 18% of individuals in the lowest walkability quartile. Individuals in the highest walkability quartile were 2.4 times more likely (confidence interval=1.18–4.88) than individuals in the lowest walkability quartile to meet the recommended ≥30 minutes of moderate physical activity per day. Conclusions This research supports the hypothesis that community design is significantly associated with moderate levels of physical activity. These results support the rationale for the development of policy that promotes increased levels of land-use mix, street connectivity, and residential density as interventions that can have lasting public health benefits.