Relationship Between Built Environment, Physical Activity, Adiposity, and Health in Adults Aged 46-80 in Shanghai, China

Background: Seldom studies are about the relationship between built environment and physical activity, weight, and health outcome in meso- and microscales. Methods: 1100 residents aged 46 to 80 were recruited from 80 neighborhoods of 13 selected communities of Shanghai, China. An analysis of the relationship between dependent variables (physical activity; Body Mass Index [BMI], overweight/obesity, weight, and health outcomes) and independent variables (involved a geographic-information-system-derived measure of built environment) was conducted with hierarchical linear models. Results: Street connectivity was positively associated with physical activity (P < .01). River proximity was inversely related with overweight/obesity (P = .0220). Parkland and square proximity have a significant relationship with physical activity (P = .0270, .0010), BMI (P = .0260, .0130), and overweight/obesity (P = .0020, .0470). Land-use mix was positively associated with physical activity (P < .01) and inversely associated with BMI (P = .0240) and overweight/obesity (P = .0440). Green and open spaces were positively related with BMI (P < .01) and health status (P < .01). For residential style, residents living in a village were more likely to have a lower BMI and overweight/obesity than those living in an urban old or newer residential building. The direct effect of square proximity is much stronger than the indirect effect on BMI through physical activity. Conclusions: The findings can help planners build more pedestrian-friendly communities. They are also useful for creating interventions that are sensitive to possible environmental barriers to physical activity in older adults.