J Epidemiol Community Health 61:978-983 doi:10.1136/jech.2006.054775
  • Evidence-based public health policy and practice

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

  1. Cheryl M Kelly1,
  2. Mario Schootman3,
  3. Elizabeth A Baker2,
  4. Ellen K Barnidge2,
  5. Amanda Lemes2
  1. 1
    Transtria, 3525 Watson Road, St Louis, MO 63139, USA
  2. 2
    Saint Louis University, School of Public Health, St Louis, MO 63104, USA
  3. 3
    Department of Medicine and Pediatrics, Washington University School of Medicine, St Louis, MO, USA
  1. Cheryl M Kelly, Transtria, 3525 Watson Road, St Louis, MO 63139, USA; kellycm{at}
  • Accepted 3 January 2007


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.


  • Funding: This research was supported in part by grants from the American Cancer Society (TURPG-00-129-01-PBP), the Centers for Disease Control and Prevention (R06/CCR721356) and the National Cancer Institute (P30 CA91842).

  • Competing interests: None declared.

  • Abbreviations:
    deviance information criterion
    Garden of Eden
    intraclass correlation
    interval odds ratio
    median odds ratio