EVIDENCE-BASED PUBLIC HEALTH POLICY AND PRACTICE

The association of sidewalk walkability and physical disorder with area-level race and poverty

Cheryl M Kelly¹, Mario Schootman³, Elizabeth A Baker², Ellen K Barnidge², Amanda Lemes²

¹ Transtria, 3525 Watson Road, St Louis, MO 63139, USA
² Saint Louis University, School of Public Health, St Louis, MO 63104, USA
³ Department of Medicine and Pediatrics, Washington University School of Medicine, St Louis, MO, USA

Correspondence to:
Cheryl M Kelly, Transtria, 3525 Watson Road, St Louis, MO 63139, USA; kellycm{at}gmail.com

Introduction: There are significant differences in physical inactivity in various geographical areas and among demographic groups. Previous research suggests that walking is the most common form of physical activity; however, not all built environments support walking for recreational or transportation purposes.

Objective: The purpose of this study was to assess the extent to which area-level factors, poverty rate and racial distribution, are associated with aspects of the street-scale environment (i.e. sidewalk walkability and physical disorder) using community audits.

Methods: Street segments were randomly selected from 210 block groups. Pairs of trained auditors walked each street segment using an audit tool designed to capture aspects of the street environment. Multilevel logistic regression was used to assess the degree of neighborhood (i.e. block group) variation in sidewalk unevenness, sidewalk obstruction and the presence of physical disorder and the association with area-level characteristics.

Results: 1780 street segments were audited. Block groups that were predominantly African–American were 38 times more likely to have a lot of unevenness, 15 times more likely to have many obstructions, and 12 times more likely to have physical disorder. Poverty rate was not independently associated with sidewalk walkability; however, block groups with the highest poverty rates were 21 times more likely to have physical disorder.

Conclusion: The results indicate that aspects of the built environment vary by characteristics of the neighborhood. This suggests that there is a differential investment in community infrastructures and resources in neighborhoods that are mostly African–American. This differential investment is likely to influence disparities in rates of physical activity.

Abbreviations: DIC, deviance information criterion; GOE, Garden of Eden; ICC, intraclass correlation; IOR, interval odds ratio; MOR, median odds ratio

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