Table 3

Associations between the local environment and total step count (steps per day)

n (%)Geometric mean (SD) stepsMinimally adjustedConfounder adjustedMutually adjusted
Relative diff.95% CIP value
(trend)
Relative diff.95% CIP value
(trend)
Relative diff.95% CIP value
(trend)
Area-level exposures of interest
Road quality score*0.660.650.45
 0 (worst quality walking environment)415 (29.0)4026.92 (1.82)1.00(ref)1.00(ref)1.00(ref)
 1530 (37.0)3831.96 (1.90)0.950.87 to 1.020.970.90 to 1.030.970.90 to 1.04
 2 (best quality walking environment)488 (34.1)4107.40 (1.79)0.980.90 to 1.071.020.95 to 1.091.030.95 to 1.11
Transport0.570.800.90
 0 (fewest bus stops)454 (31.7)3944.57 (1.87)1.00(ref)1.00(ref)1.00(ref)
 1539 (37.6)4071.27 (1.82)1.030.95 to 1.111.030.97 to 1.101.020.95 to 1.11
 2 (most bus stops)440 (30.7)3908.18 (1.84)0.980.90 to 1.060.990.92 to 1.061.000.91 to 1.09
Aesthetics†0.980.650.98
 0 (worst aesthetics)564 (39.4)4011.37 (1.81)1.00(ref)1.00(ref)1.00(ref)
 1484 (33.8)3961.59 (1.90)1.010.94 to 1.090.990.93 to 1.060.980.90 to 1.06
 2 (best aesthetics)385 (26.9)3959.01 (1.81)1.000.92 to 1.080.980.92 to 1.061.000.90 to 1.11
Shops and services0.910.530.20
 0 (fewest shops and services)515 (35.9)4000.38 (1.85)1.00(ref)1.00(ref)1.00(ref)
 1552 (38.5)3949.88 (1.85)0.990.92 to 1.060.990.93 to 1.061.010.94 to 1.08
 2 (most shops and services)366 (25.5)3998.67 (1.81)1.000.92 to 1.081.030.96 to 1.101.060.97 to 1.15
Green areas0.940.690.88
 0 (fewest green areas)518 (36.2)3952.02 (1.83)1.00(ref)1.00(ref)1.00(ref)
 1462 (32.2)3983.97 (1.87)0.990.91 to 1.071.030.96 to 1.101.020.95 to 1.09
 2 (most green areas)453 (31.6)4009.48 (1.82)1.000.91 to 1.091.010.94 to 1.091.010.93 to 1.08
Income‡0.0030.020.03
 0 (least deprived)745 (52.0)4164.28 (1.83)1.00(ref)1.00(ref)1.00(ref)
 1395 (27.6)3999.60 (1.77)0.970.90 to 1.050.980.92 to 1.050.970.91 to 1.05
 2 (most deprived)293 (20.5)3525.71 (1.93)0.870.80 to 0.950.910.84 to 0.980.900.82 to 0.98
Crime‡0.460.340.89
 0 (lowest crime)667 (46.6)4126.41 (1.87)1.00(ref)1.00(ref)1.00(ref)
 1434 (30.3)3918.58 (1.78)0.970.90 to 1.040.980.92 to 1.051.000.93 to 1.07
 2 (highest crime)332 (23.2)3779.09 (1.85)0.970.89 to 1.060.970.90 to 1.040.990.91 to 1.09
Walkability§0.400.590.87
 0 (lowest walkability)393 (27.4)4088.54 (1.83)1.00(ref)1.00(ref)1.00(ref)
 1552 (38.5)3916.07 (1.79)0.970.89 to 1.050.990.93 to 1.060.980.90 to 1.07
 2 (highest walkability)488 (34.1)3967.90 (1.91)0.960.89 to 1.050.980.91 to 1.051.000.90 to 1.13
Population density¶0.110.250.49
 0 (lowest population density)460 (32.1)4026.53 (1.83)1.00(ref)1.00(ref)1.00(ref)
 1523 (36.5)4105.02 (1.84)1.010.94 to 1.091.020.96 to 1.101.030.94 to 1.14
 2 (highest population density)450 (31.4)3795.39 (1.85)0.940.86 to 1.010.960.89 to 1.030.970.86 to 1.10
Confounders
Sex (study)0.12
 Female (BWHHS)638 (44.5)3976.83 (1.78)1.00(ref)
 Male (BRHS)795 (55.5)3983.29 (1.89)0.950.89 to 1.01
Age (years)<0.001
 <75470 (32.8)5139.05 (1.67)1.00(ref)
 75–79492 (34.3)4322.75 (1.70)0.850.80 to 0.91
 80–84334 (23.3)3101.12 (1.78)0.620.58 to 0.67
 85+137 (9.6)2264.11 (1.96)0.470.42 to 0.52
Adult social class0.12
 I (professional)/II(intermediate)631 (44.0)4171.57 (1.80)1.00(ref)
 IIInm (skilled non-manual)248 (17.3)3720.68 (1.79)0.930.85 to 1.01
 IIIm (skilled manual)389 (27.2)4038.95 (1.91)1.000.93 to 1.07
 IV (partially skilled manual)/V (unskilled manual)165 (11.5)3557.33 (1.88)0.920.84 to 1.02
Long-standing illness, disability or infirmity<0.001
 No920 (64.2)4507.46 (1.74)1.00(ref)
 Yes513 (35.8)3184.78 (1.90)0.730.69 to 0.77
Country0.01
 England1305 (91.1)3915.01 (1.85)1.00(ref)
 Scotland128 (8.9)4712.91 (1.74)1.211.05 to 1.39
  • Multilevel linear regression models with random intercepts at the town and LSOA/data zone levels. Restricted to study members non-missing for all variables in the table (n=1433 study members (638 women, 795 men) across 618 LSOAs/data zones with median 2 (range 1–16) study members per LSOA/data zone and with median 78 (range 17–120) study members per town).

  • All models adjusted for actigraph wear time and season of physical activity data collection (season defined as spring (March to May), summer (June to August), autumn (September to November) and winter (December to February).

  • *Road quality score calculated from latent class analysis including 10 variables: ‘quality of pavement’; ‘lowered curbs’; ‘barriers on pavement’; ‘pavement width’; ‘pedestrian traffic’; ‘road use’; ‘road connectivity’; ‘traffic calming measures’; ‘lamp posts’ and ‘road crossings’ (full details in online supplementary material).

  • †Variables included in aesthetic score = ‘neighbourhood watch signs’; ‘security measures’; greenery factors’; ‘graffiti’ and ‘litter/dog foul’.

  • ‡Income deprivation score and crime score generated from the 2010 Index of Multiple Deprivation LSOA rank (IMD: www.gov.co.uk/government/statistics/english-indices-of-deprivation-2010) or the 2009 Scottish Index of Multiple Deprivation datazone rank (SIMD: http://www.gov.scot/Topics/Statistics/SIMD) to define relative deprivation of an area for England and Scotland respectively.

  • §Area walkability generated from street connectivity defined as the number of road nodes/interconnections per km2 within an LSOA/datazone obtained from 2015 Ordinance Survey (Digimap Meridian 2 National).

  • ¶Population density obtained from mid-year population estimates from 2010 from the Office of National Statistics (www.ons.gov.uk) and the Scottish Neighbourhood Statistics (www.sns.gov.uk). Estimates used to generate population density per km2 at the area level smoothed using a 5 km radius buffer.

  • BRHS, British Regional Heart Study; BWHHS, British Womens’ Heart and Health Study; LSOA, Lower Layer Super Output Areas.