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Joint Associations of Walking and Car Use with Chronic-Disease Risk Markers: Linking Data from Population Health and Travel Surveys
Abstract   Peer reviewed

Joint Associations of Walking and Car Use with Chronic-Disease Risk Markers: Linking Data from Population Health and Travel Surveys

Takemi Sugiyama, Rachel Cole, Mary Kynn and Neville Owen
Journal of Transport & Health, Vol.14(Supplement), p.S12
International Conference on Transport and Health (ICTH), 5th (Melbourne, Australia, 04-Nov-2019–08-Nov-2019)
2019
DOI: https://doi.org/10.1016/j.jth.2019.100714
url
https://doi.org/10.1016/j.jth.2019.100714View
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Abstract

Public Health and Health Services Urban and Regional Planning Transportation and Freight Services
Background: Walking is known to be protective against obesity and hypertension, which are risk factors for chronic diseases, particularly type 2 diabetes and heart disease. However, less is known whether walking is protective against the risk in the presence of prolonged car use, which can be associated with higher risk. We examined associations of the area-level rates of high waist circumference and high blood pressure with residents' walking, prolonged car use and their combined presence, by linking population health and travel surveys. Methods: The outcomes of the study were the age-standardised rates (ASR) of high waist circumference (≥94 cm for men, ≥80 cm for women) and high blood pressure (systolic/diastolic blood pressure over 140/90 mmHg). These were calculated at the level of Population Health Area (PHA) based on the 2014-15 National Health Survey. For walking and car use, we used the 2009 South-East Queensland Travel Survey (n=16,464). For each PHA, we calculated the proportion of adult participants who walked (≥10 min/day) but did not use cars over 1 hr/day (walkers); who walked and used cars over 1 hr/day (walker/car users); and who did not walk but used cars over 1 hr/day (car users). Linear regression analyses examined associations of the ASR of high waist circumference and high blood pressure with the proportion of three travel behaviour categories. Results: For 131 PHAs in the study area (median size: 14 km2), the mean ASR of high waist circumference was 64% and that of high blood pressure was 23%. The mean proportion of walkers, walker/car users, and car users was 16%, 4%, and 40%, respectively. For high waist circumference, significant associations were found for the proportion of walkers (0.57% lower rates for each 1% increment in the proportion [95%CI: -0.68, -0.44]), walkers/car users (0.17% lower rates [-0.33, 0.00]), and car users (0.43% higher rates [0.28, 0.56]). For high blood pressure, associations were significant for the proportion of walkers (0.27% higher rates [0.10, 0.42]), but not for walker/car users (0.03% higher rates [-0.14, 0.20]) and car users (0.14% lower rates ([-0.30, 0.03]). Conclusions: We found that PHAs with a high proportion of walker/car users had a lower rate of obesity, suggesting that walking may be protective against obesity even in the presence of prolonged car use. However, unexpectedly, we found that PHAs with a high proportion of walkers had a higher rate of hypertension. Further research on walking and hypertension is warranted.

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