|Cerin, Ester -|
|Leslie, Eva -|
|Owen, Neville -|
Submitted to: Social Science and Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: June 1, 2009
Publication Date: June 30, 2009
Citation: Cerin, E., Leslie, E., Owen, N. 2009. Explaining socio-economic status differences in walking for transport: An ecological analysis of individual, social and environmental factors. Social Science & Medicine. 68:1013-1020. Interpretive Summary: Lower socio-economic status has been associated with increased prevalence of overweight and obesity, and related diseases. To devise interventions aimed at reducing health inequalities, it is necessary to understand the mechanisms underlying differences in health behaviors. As walking for transport can contribute to the accumulation of health-enhancing doses of physical activity, this study examined potential individual, social and environmental determinants of differences in walking for transport across socio-economic groups. This study suggests that environmental interventions aimed at increasing residential density, reducing barriers to walking, and traffic load, developing social-support networks, and creating greener and more aesthetically pleasing environments in more-disadvantaged areas may help reduce socio-economic inequalities in participation in physical activity by facilitating walking for transport.
Technical Abstract: The identification of potential mechanisms of influence (mediators) of socio-economic status (SES) on walking for transport is important, because the likely opposing forces of influence may obscure pathways for intervention across different SES groups. This study examined individual, and perceived social and physical environmental mediators of the relations of individual and area-level SES with walking for transport. Two mailed surveys, six months apart, collected data on transport-related walking and its hypothesized individual, social, and environmental correlates. The sample consisted of 2194 English-speaking adults (aged 20-65) living in 154 Census Collection Districts (CCDs) of Adelaide, Australia. Individual-level SES was assessed using data on self-reported educational attainment, household income, and household size. Area-level SES was assessed using census data on median household income and household size for each selected CCD. Bootstrap generalized linear models examined associations between SES, potential mediators, and total weekly minutes and frequency of walking for transport. The product-of-coefficient test was used to assess mediating effects. Individual, social-environmental, and physical environmental factors significantly contributed to the explanation of the relations between SES and transport-related walking frequency. Educational attainment and area- and individual-level income played independent roles in explaining frequency of walking for transport, through opposing common and distinct pathways. While engagement in leisure-time physical activity was the most influential mediator of the association between educational attainment and frequency of walking for transport, the number of motorized vehicles and perceived levels of environmental aesthetics and greenery were the strongest mediators of the relations of frequency of transport-related walking with individual- and area-level income, respectively. Environmental interventions aimed at increasing residential density, reducing physical barriers to walking and traffic load, developing social-support networks, and creating greener and more aesthetically pleasing environments in more-disadvantaged areas may help to reduce SES inequalities in participation in physical activity, by facilitating walking for transport.