Association between Physical Activity and Neighborhood Environment among Middle-Aged Adults in Shanghai

Objective. To determine the perceived neighborhood environment (NE) variables that are associated with physical activity (PA) in urban areas in China. Methods. Parents of students at two junior high schools in Shanghai, one downtown and the other in the suburbs, were recruited to participate in the study. They completed an International Physical Activity Questionnaire (IPAQ) and Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) survey. Participant physical activity was also objectively measured using accelerometers. Results. Participants from downtown areas were more positively associated with transportation PA and leisure-time PA than respondents living in the suburbs. Residential density was found to be a significant positive predictor of recreational or leisure-based PA. Street connectivity was negatively associated with leisure time PA for respondents. Moderate-vigorous PA was found to be negatively associated with traffic safety. There were no significant associations between environmental factors and transportation PA. Women had higher levels of moderate-vigorous PA than men. Conclusions. The results of this study demonstrate that residential density, street connectivity, and traffic safety have a significant impact on Chinese middle-aged adults' PA, suggesting urban planning strategies for promoting positive public health outcomes. 1. Introduction Much research has identified and quantified the health benefits of physical activity (PA) [1]. For example, increased PA has been found to reduce the risk of cardiovascular diseases, diabetes, cancers, osteoporosis, and depression [2]. One interesting trend found in countries with emergent economies is a consistent decline of PA associated with economic development [3]. China is experiencing a process of transition from a developing country to a developed one, with increases in urbanization/urban living and associated increases of physical inactivity [4, 5]. For example, average weekly physical activity among adults in China fell by 32% between 1991 and 2006 [5] and car ownership increased from 0.5% to 13.1% between 2000 and 2010 [6]. Some variation with age has been identified: participation in exercise by all Chinese residents was 14.1% but was the lowest amongst the 18–44 age group at 5.9%. The U-shape trend of PA with age is also reflected locally and data from 2005 [7] showed that participation in exercise by Shanghai residents was the least at around 40 years of age. These data and trends indicate an urgent need to consider factors influencing middle-age adults’ PA in China. Many