The association between health enhancing physical activity and neighbourhood environment among Swedish adults - a population-based cross-sectional study

Background: This study examines the relationship of neighbourhood environment factors with walking and total health enhancing physical activity. Methods: A population-based cross-sectional study. The short self-administered version of the validated International Physical Activity Questionnaire (IPAQ) was used to assess health enhancing physical activity including walking. The neighbourhood environment was assessed using a 17-item environmental module. A principal component analysis among the environmental variables was conducted. The factor scores were divided into tertiles and independent associations between factor tertiles and physical activity categories and walking were studied by multinomial logistic regression with adjustment for confounders. Results: In adjusted models, a lower odds ratio ( OR) for reaching the middle, OR: 0.66 (95% Confidence Interval (CI): 0.47-0.98), and upper, OR: 0.65 (0.45-0.95), tertile of walking was observed among those in the lowest tertile of the degree of urbanisation. A higher OR for reaching the middle, OR: 1.84 (1.28-1.64), and upper tertile, OR: 1.64 (1.14-2.36), of walking was observed among those in the lowest tertile of fear of crime. A higher OR for reaching the high category of total health enhancing physical activity was observed among those in the lowest, OR: 2.01 (1.32-3.05), and middle tertile, OR: 1.52 (1.02-2.25), of the factor degree of urbanisation. Conclusion: The findings suggest that the environment is differentially related to walking and total health enhancing physical activity. This should be explored in future research to disentangle the complex relationship between different levels and aspects of physical activity and their relationship with the environment.