In 1961, Jane Jacobs defined the term “walkability” to describe features and characteristics of an area that increase the likelihood of those who live there to walk. Jacobs, a famous Urban Planner who penned the book The Death and Life of Great American Cities, believed that ideal neighborhoods facilitate walkability through features that allow individuals to choose between walking and driving.
Experts recommend that walkable neighborhoods include the ability for one to take comfortable, safe, practical, and exciting walks. City planner Jeff Speck explained these concepts in the “General Theory of Walkability.” Other factors like residential versus business density, public transit, street design, traffic, and population numbers also affect a neighborhood's walkability.
Research has shown that individuals living in walkable neighborhoods partake in more physical activity and have less body fat than those in less walkable areas. As we uncover more and more links between obesity and diseases, including diabetes, heart disease, and cancer, essential questions present themselves. Researchers addressed one such question in a recent article in the journal Environmental Health Perspectives: Does walkability reduce the risk or mortality of cancer?
The study evaluated how the walkability of a neighborhood associated with obesity-related cancers in women. The researchers used data from the New York University Women’s Health Study (NYUWHS), a cohort that enrolled over 14,000 women between 1985 and 1991 (aged 34 to 65 at the time of enrollment). Notably, NYUWHS followed the participants for nearly three decades, providing a plethora of data for prospective analysis.
The researchers obtained each participant’s address throughout her time in the study. Using geocoding, the researchers calculated an average annual measure of neighborhood walkability across the follow-up time. To calculate this measure, researchers considered factors, including population density and accessibility to destinations. To determine the incidence of obesity-related cancers, the researchers used ICD-9 codes, which consistently classify diagnoses.
Before 2017, over 2,000 (18.2%) participants had developed an obesity-related cancer. The most common obesity-related cancers diagnosed in women in the study included postmenopausal breast (53%), colorectal (14%), and endometrial (12%) cancers.
The data revealed the women residing in the most walkable neighborhoods had a 26% lower risk of obesity-related cancers than women living in the least walkable areas. This trend remained true for both the overall risk of obesity-related and site-specific obesity-related cancers. The researchers considered a 1-standard deviation increase in average annual neighborhood walkability to evaluate the association between walkability and specific obesity-related cancers. With each one increment increase, the risk of site-specific obesity-related cancers decreased notably (postmenopausal breast- 12% decrease; endometrial- 13% decrease; ovarian- 18% decrease; multiple myeloma- 32% decrease).
The authors conclude that women living in more walkable communities have some protection against obesity-related cancers. With the growing incidence of obesity in the United States and, subsequently, the incidence of these types of cancer diagnoses, this information could help doctors identify high-risk women to implement appropriate preventative and early screening measures.
Sources: Cities, BMC Public Health, Env Health Persp (Roscoe), Lancet Planet Health, Env Health Persp (India-Aldana)
