Walk Score® and Its Associations with Older Adults’ Health Behaviors and Outcomes

Abstract

This study aimed to investigate the associations between Walk Score® and lifestyle behaviors and health outcomes in older Taiwanese adults. A nationwide survey was conducted through telephone-based interviews with older adults (65 years and older) in Taiwan. Data on Walk Score®, lifestyle behaviors (physical activity, sedentary behavior, healthy eating behavior, alcohol use, and smoking status), health outcomes (overweight/obesity, hypertension, type 2 diabetes, and cardiovascular disease), and personal characteristics were obtained from 1052 respondents. A binary logistic regression adjusting for potential confounders was employed. None of the Walk Score® categories were related to the recommended levels of total physical activity. The categories “very walkable” and “walker’s paradise” were positively related to total sedentary time and TV viewing among older adults. No significant associations were found between Walk Score® and other lifestyle health behaviors or health outcomes. While Walk Score® was not associated with recommended levels of physical activity, it was positively related to prolonged sedentary time in the context of a non-Western country. The different associations between the walk score and health lifestyle behaviors and health outcomes in different contexts should be noted.

Which Neighborhood Destinations Matter in the Asian Context? The Role of Destinations in Older Adults’ Physical Activity and Sedentary Behaviors

“…Contrary to our hypothesis, we also found that neighborhoods with more utilitarian destinations were associated with excessive sedentary time among older women. This is consistent with previous findings in the Asian context asserting that walkable neighborhood attributes were positively associated with sedentary behaviors [ 23 , 24 ]. Here, it is possible that neighborhoods with higher numbers of utilitarian destinations reduce the time it takes older women to complete daily errands.…”

“…First, neighborhood temples should be considered prominent local destinations for promoting daily physical activity levels for older men. Second, although previous studies have found that utilitarian destinations were related to increased walking time [ 9 , 22 ] (in the Asian context, see [ 23 , 24 ], walking-supportive environmental attributes may increase sedentary behavior for older adults in Asian countries.…”

“…Further studies should thus attempt to objectively measure these factors among older adults. Finally, older adults in Taiwan may be reluctant to report their exact residential addresses [ 23 ]. The neighborhood destinations used in this study were thus obtained according to participant residential neighborhood rather than exact residential addresses.…”

The associations between neighborhood walkability attributes and objectively measured physical activity in older adults

“…Third, the exposure variables (neighborhood walkability attributes) were calculated by using participants’ self-reported living neighborhood and not exact residential address. This is because reporting personal residential address in detail is a vulnerable matter for the senior of Taiwan [43]. However, residential neighborhood has been used widely as the validated geographic unit for measuring walkability attributes in neighborhoods [44].…”

Neighborhood Walkability and Active Transportation: A Correlation Study in Leisure and Shopping Purposes

“…Consequently, several indices such as the Walk Score, Walkability Index, and Pedestrian Index of the Environment were developed combining various built environmental variables that influence walking behavior [7,[19][20][21][22][23][24][25][26][27][28][29][30][31][32]. The Walk Score is one of the popular indices that objectively measures neighborhood walkability, taking into account the accessibility of amenities in the vicinity (e.g., grocery stores, restaurants, shopping centers, coffee shops, parks, schools) and pedestrian friendliness (e.g., intersection density and average block length) [25], and is currently used in various fields, including public health, real estate, and urban planning [33][34][35][36][37]. Studies have verified whether the Walk Score is appropriate to describe the level of walkability, and correspondingly, several works of the literature showed that a higher level of Walk Score is positively correlated with walking behavior [7,26,29,30,[38][39][40][41][42].…”