Countrywide natural experiment reveals impact of built environment on physical activity
CoRR(2024)
Abstract
While physical activity is critical to human health, most people do not meet
recommended guidelines. More walkable built environments have the potential to
increase activity across the population. However, previous studies on the built
environment and physical activity have led to mixed findings, possibly due to
methodological limitations such as small cohorts, few or single locations,
over-reliance on self-reported measures, and cross-sectional designs. Here, we
address these limitations by leveraging a large U.S. cohort of smartphone users
(N=2,112,288) to evaluate within-person longitudinal behavior changes that
occurred over 248,266 days of objectively-measured physical activity across
7,447 relocations among 1,609 U.S. cities. By analyzing the results of this
natural experiment, which exposed individuals to differing built environments,
we find that increases in walkability are associated with significant increases
in physical activity after relocation (and vice versa). These changes hold
across subpopulations of different genders, age, and body-mass index (BMI), and
are sustained over three months after moving.The added activity observed after
moving to a more walkable location is predominantly composed of
moderate-to-vigorous physical activity (MVPA), which is linked to an array of
associated health benefits across the life course. A simulation experiment
demonstrates that substantial walkability improvements (i.e., bringing all US
locations to the walkability level of Chicago or Philadelphia) may lead to
10.3
guidelines. Evidence against residential self-selection confounding is
reported. Our findings provide robust evidence supporting the importance of the
built environment in directly improving health-enhancing physical activity, in
addition to offering potential guidance for public policy activities in this
area.
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