Journal of General Internal Medicine

, Volume 22, Issue 12, pp 1674–1680

Walking for Transportation or Leisure: What Difference Does the Neighborhood Make?

  • Ming Wen
  • Namratha R. Kandula
  • Diane S. Lauderdale
Original Article

DOI: 10.1007/s11606-007-0400-4

Cite this article as:
Wen, M., Kandula, N.R. & Lauderdale, D.S. J GEN INTERN MED (2007) 22: 1674. doi:10.1007/s11606-007-0400-4



Patients are often advised to initiate a physical activity program by walking for transportation or leisure. This study explored whether neighborhood factors beyond the individual might affect compliance.


We examined the associations between total walking and neighborhood factors in a multi-ethnic population-based sample in California and the roles race/ethnicity plays in these associations.


Cross-sectional study


Individual-level data were obtained from the 2003 California Health Interview Survey. Participants’ census tracts were linked to Census 2000 data to capture neighborhood SES.

Measurements and Main Results

The dependent variable was self-reported walking at recommended levels. Neighborhood SES was measured by a scale of 4 Census-based variables (alpha = 0.83). Social cohesion was measured by a scale tapping the extent of perceived social connectedness, trust, and solidarity among neighbors (alpha = 0.70). Neighborhood access to a park, playground, or open space was measured by a single item. Safety was measured by a scale of three items (alpha = 0.66). We performed a series of multiple logit models with robust variance estimates while taking complex survey design into account. Neighborhood social cohesion (odds ratio [OR] = 1.09, 95% CI = 1.04, 1.14) and access to a park, playground, or open space (OR = 1.26, 95% CI = 1.16, 1.36) were significant environmental correlates of walking at recommended levels, independent of individual socio-demographics. Subgroup analysis showed that neighborhood effects were different by race/ethnicity.


Neighborhood physical and social environmental factors are significantly associated with walking at recommended levels. Being aware of the ways that the environment could affect a patient’s compliance with PA recommendations may help physicians tailor recommendations to circumstances.


physical activitywalkingneighborhood social cohesiontrustneighborhood safetyneighborhood SES

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Ming Wen
    • 1
  • Namratha R. Kandula
    • 2
  • Diane S. Lauderdale
    • 3
  1. 1.Department of SociologyUniversity of UtahSalt LakeUSA
  2. 2.Division of General Internal MedicineNorthwestern UniversityChicagoUSA
  3. 3.Department of Health StudiesUniversity of ChicagoChicagoUSA