Neighborhood walkability and cardiometabolic disease in Texas
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Abstract
Cardiometabolic diseases (CMDs) are prevalent but often preventable, affecting significant numbers of adults in the United States, with 11% diagnosed with diabetes and 10% with cardiovascular diseases (CVDs). Regular physical activities, like walking, play a crucial role in reducing health risks, particularly obesity and diabetes. We collected 1,994 observations for the year 2019, merging data from the Texas Behavioral Risk Factor Surveillance System and the Environmental Protection Agency. We employed multivariable regression to assess the association between neighborhood walkability and CMD measures in Texas, while controlling for age, sex, racial/ethnic background, and family history of diabetes. Our findings revealed that higher neighborhood walkability is significantly associated with a lower body mass index (BMI) (β = -0.2781, p = 0.001), a reduced risk of high blood pressure (β = -0.0343, p = 0.098), diabetes (β = -0.0555, p = 0.046), heart disease (β = -0.0717, p = 0.062), and CVDs (β = -0.0603, p = 0.063), and a higher likelihood of engaging in aerobic physical activity (β = 0.0392, p = 0.062). The effects of the control variables align with prior studies, showing that being male or older increases the risk of high blood pressure, diabetes, and heart disease, while a family history of diabetes increases the risk of diabetes. We also found that African Americans live in communities with lower walkability scores compared to other racial/ethnic groups. Our findings highlight the importance of urban planning policies that promote walkable neighborhoods, as increased walkability can significantly reduce the incidence of CMDs and improve public health. These results also suggest incorporating community-based approaches in health promotion strategies, focusing on creating more walkable environments to mitigate the risk of these preventable diseases.