Racial Disparities Apparent in Benefits to Walkability, Neighborhood SDOH

Neighborhood walkability has the potential to boost physical activity and improve BMI, two key factors for addressing obesity. But neighborhood conditions like safety, another key element of neighborhood SDOH, can dampen those impacts and disproportionately impact populations of color, according to new data from the Boston University School of Public Health.

The study, published in the journal Obesity, found that despite living in neighborhoods with higher walkability scores, Black, Hispanic, and Asian people were less likely to engage in physical activity near their homes.

The researchers said this trend was tied to differences in other built environmental factors, like perceived safety and neighborhood quality, that could discourage individuals from going outside near their homes.

Said otherwise, centuries of institutional racism and redlining have made neighborhood walkability a moot point for populations of color.

“In cities and counties across the US, the legacy of racial residential segregation and policies like redlining resulted in poorer built physical activity environments, characterized by decreased walkability, street connectivity, and green space, and increased pollution that disproportionately impact communities of color,” study lead author Monica Wang, ScD, associate professor of community health sciences at BUSPH, said in a public statement.

“We’re continuing to see the effects of structural racism on physical activity and obesity risk in the data today.”

Using data about around 31,000 adults from the 2020 National Health Interview Survey, the researchers found that those who lived in walkable neighborhoods—defined as “the extent to which the built environment is conducive to walking”—were 1.5 times more likely to engage in adequate levels of physical activity than those who did not.

The Centers for Disease Control and Prevention defines adequate physical activity as 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity each week.

That penchant for more physical activity translated into health outcomes, the researchers reported. Those who lived in walkable neighborhoods were 0.76 times less likely to have obesity, a common chronic illness in the US.

“Living in a neighborhood that is more conducive to walking based on a variety of factors may facilitate and encourage residents in that neighborhood to spend more active time outdoors, resulting in overall higher activity levels and subsequently reduced BMI and obesity risk,” the researchers wrote in the study’s discussion section.

But those figures didn’t hold when breaking down the data by race. In fact, when looking at Black, Hispanic, and Asian people, the researchers found an inverse trend for neighborhood walkability and obesity. Racial minorities who lived in more walkable neighborhoods had an increased chance of obesity and lower physical activity levels.

This finding is particularly salient because Black, Hispanic, and Asian people are among the most likely to live in neighborhoods with the highest perceived walkability scores, the researchers said.

“While individuals may perceive their neighborhoods to be walkable, it may not be safe, desirable, or normative to walk in these communities,” Wang explained.

“This is particularly relevant for communities who have been displaced, whether historically by force or through gentrification,” she added. “This suggests that a combination of approaches—such as improving pedestrian and public transit infrastructure, implementing policies that slow traffic, enhancing park quality, and community programming—are needed to promote walkability and well-being.”

This study adds to the literature about neighborhood environment as a social determinant of health and how it can fuel racial health disparities. In January 2023, researchers from BU’s Center for Antiracist Research wrote that Black people are more likely to live in neighborhoods with worse built environment than White people.

The researchers said this was likely a lingering consequence of redlining.

“Associations between neighborhood racial and ethnic composition and health are not due to biological differences between racial and ethnic groups,” they wrote in JAMA Network Open. “Rather, these disparities are due to policies and systems that uphold structural racism, leading to differential access to resources that promote health and well-being.”