Date Published: October 23, 2007
Publisher: Public Library of Science
Author(s): Gary G Bennett, Lorna H McNeill, Kathleen Y Wolin, Dustin T Duncan, Elaine Puleo, Karen M Emmons, Olivier Duperrex
Abstract: BackgroundDespite its health benefits, physical inactivity is pervasive, particularly among those living in lower-income urban communities. In such settings, neighborhood safety may impact willingness to be regularly physically active. We examined the association of perceived neighborhood safety with pedometer-determined physical activity and physical activity self-efficacy.Methods and FindingsParticipants were 1,180 predominantly racial/ethnic minority adults recruited from 12 urban low-income housing complexes in metropolitan Boston. Participants completed a 5-d pedometer data-collection protocol and self-reported their perceptions of neighborhood safety and self-efficacy (i.e., confidence in the ability to be physically active). Gender-stratified bivariate and multivariable random effects models were estimated to account for within-site clustering. Most participants reported feeling safe during the day, while just over one-third (36%) felt safe at night. We found no association between daytime safety reports and physical activity among both men and women. There was also no association between night-time safety reports and physical activity among men (p = 0.23) but women who reported feeling unsafe (versus safe) at night showed significantly fewer steps per day (4,302 versus 5,178, p = 0.01). Perceiving one’s neighborhood as unsafe during the day was associated with significantly lower odds of having high physical activity self-efficacy among both men (OR 0.40, p = 0.01) and women (OR 0.68, p = 0.02).ConclusionsResiding in a neighborhood that is perceived to be unsafe at night is a barrier to regular physical activity among individuals, especially women, living in urban low-income housing. Feeling unsafe may also diminish confidence in the ability to be more physically active. Both of these factors may limit the effectiveness of physical activity promotion strategies delivered in similar settings.
Partial Text: The benefits of regular physical activity have been frequently documented [1–3]. Physical activity is associated with reduced risk of numerous chronic conditions and premature mortality . Indeed, up to 20% of chronic disease mortality may be attributed to physical inactivity . Although some data suggest that the prevalence of physical inactivity is declining [5–7], sedentary behavior remains pervasive. The highest levels of physical inactivity are found among racial/ethnic minorities and those of lower socioeconomic position (SEP) [5,7–15], despite widespread recognition of the health benefits of regular physical activity in these groups .
This study used a randomized cluster design with 12 urban public housing communities in metropolitan Boston as the primary sampling units. The housing sites involved range in size and layout from high-rise apartment buildings to more dispersed townhouse-style complexes. Secondary sampling units were individuals within the sites. Unequal probability sampling across housing sites was employed due to the varying sizes of the sites. In half of the sites (with populations less than 300 persons), the full population was sampled, and in the remaining sites (with populations greater than 300 persons), sampling was conducted to obtain an approximate 35% sample with a minimum of 250 individuals per site.
As shown in Table 1, the study sample was predominately female (73.2% weighted) and was largely composed of racial/ethnic minorities; most participants identified themselves as Hispanic (42.1% weighted) or black (43.6% weighted). Most of the residents were either not currently working or were disabled (59.6% weighted). Average age was approximately 49 y and mean BMI was 30.0 kg/m2. Participants accumulated an average of 5,649 steps per day (steps/d) (range 500-2000). There was a striking difference between perceptions of neighborhood safety by time of day. More than 80% (weighted) of the respondents reported feeling safe during the daytime, whereas only 37% (weighted) reported feeling safe at night-time. As expected, males tended to report feeling safer than females at both times of day.
Boston, like other major cities in the United States and European Union (an intergovernmental union of 27 European nations) has experienced an increase in violent crime after historic lows since the mid-1990s; however, few studies have explored how perceptions of perceived safety might impact physical activity practices in the communities most affected by this pressing social exposure. In contrast to previous studies, our work highlights the importance of considering neighborhood safety at night-time as a possible barrier to physical activity among women. We found that women reporting their neighborhoods as unsafe during night-time hours had nearly 1,100 fewer steps/d than those who viewed their surroundings as safe. We consider this effect sizeable relative to the studied demographic predictors and considering the average steps/d (5,206) among female participants. This average itself is clearly short of the 10,000 steps/d threshold that is roughly comparable to the number of steps/d necessary to meet the consensus US Centers for Disease Control/American College of Sports Medicine national physical activity guidelines [70–72]. Thus the effect on steps/d of rating one’s neighborhood as unsafe accounts for approximately one-fifth of steps/d in our study and one-tenth of the nationally recommended steps/d for women in the sample.