Article2022

Pathways from Built Environment to Health Care Costs: Linking Objectively Measured Built Environment with Physical Activity and Health Care Expenditures

Behram Wali · Lawrence Douglas Frank · Deborah Rohm Young · Brian E. Saelens · Richard T. Meenan · John F. Dickerson +3 more

25 citations0/0 files storedEnvironment and Behavior

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Urban Transport and Accessibility Physical Activity and Health Urban Green Space and Health

Abstract

Evidence connecting health care expenditures with physical activity and built environment is rare. We examined how detailed urban form relates to mode specific moderate-to-vigorous physical activity (MVPA) and health care costs—controlling for transit access, residential choices/preferences, sociodemographic factors. We harness high resolution data for 476 participants in the Rails and Health study on health care costs, mode specific MVPA, parcel-level built environment, and neighborhood perception surveys. To account for dependencies among outcomes, structural equation modeling framework is used. A 1% increase in bike, walk, and transit-related MVPA was associated with lower health care costs by −0.28%, −0.09%, and −0.27% respectively. A one-unit increase in neighborhood walkability index correlates with a 6.48% reduction in health care costs. Indirect associations between residential choices, attitudes, and health outcomes through MVPA were also observed. The results suggest the potential to alter behaviors and lower health care costs through retrofitting neighborhoods.

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References

2003Neighborhood-Based Differences in Physical Activity: An Environment Scale Evaluation 2002How the built environment affects physical activity 2008Built Environment Correlates of Walking 2004Obesity relationships with community design, physical activity, and time spent in cars 2005Linking objectively measured physical activity with objectively measured urban form 2006Many Pathways from Land Use to Health: Associations between Neighborhood Walkability and Active Transportation, Body Mass Index, and Air Quality 2009The development of a walkability index: application to the Neighborhood Quality of Life Study 2005Correlation or causality between the built environment and travel behavior? Evidence from Northern California

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