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International variation in neighborhood walkability, transit, and recreation environments using geographic information systems : the IPEN adult study

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Abstract
Background: The World Health Organization recommends strategies to improve urban design, public transportation, and recreation facilities to facilitate physical activity for non-communicable disease prevention for an increasingly urbanized global population. Most evidence supporting environmental associations with physical activity comes from single countries or regions with limited variation in urban form. This paper documents variation in comparable built environment features across countries from diverse regions. Methods: The International Physical Activity and the Environment Network (IPEN) study of adults aimed to measure the full range of variation in the built environment using geographic information systems (GIS) across 12 countries on 5 continents. Investigators in Australia, Belgium, Brazil, Colombia, the Czech Republic, Denmark, China, Mexico, New Zealand, Spain, the United Kingdom, and the United States followed a common research protocol to develop internationally comparable measures. Using detailed instructions, GIS-based measures included features such as walkability (i.e., residential density, street connectivity, mix of land uses), and access to public transit, parks, and private recreation facilities around each participant's residential address using 1-km and 500-m street network buffers. Results: Eleven of 12 countries and 15 cities had objective GIS data on built environment features. We observed a 38-fold difference in median residential densities, a 5-fold difference in median intersection densities and an 18-fold difference in median park densities. Hong Kong had the highest and North Shore, New Zealand had the lowest median walkability index values, representing a difference of 9 standard deviations in GIS-measured walkability. Conclusions: Results show that comparable measures can be created across a range of cultural settings revealing profound global differences in urban form relevant to physical activity. These measures allow cities to be ranked more precisely than previously possible. The highly variable measures of urban form will be used to explain individuals' physical activity, sedentary behaviors, body mass index, and other health outcomes on an international basis. Present measures provide the ability to estimate dose-response relationships from projected changes to the built environment that would otherwise be impossible.
Keywords
TRANSPORTATION, OBESITY, DETERMINANTS, URBAN SPRAWL, BUFFER SIZE, ASSOCIATIONS, WALK SCORE(R), BUILT ENVIRONMENT, 11 COUNTRIES, PHYSICAL-ACTIVITY, International health, Walkability, Physical activity, Parks, Transportation, Urban planning, Exercise, Built environment

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MLA
Adams, Marc A., et al. “International Variation in Neighborhood Walkability, Transit, and Recreation Environments Using Geographic Information Systems : The IPEN Adult Study.” INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS, vol. 13, 2014, doi:10.1186/1476-072X-13-43.
APA
Adams, M. A., Frank, L. D., Schipperijn, J., Smith, G., Chapman, J., Christiansen, L. B., … Sallis, J. F. (2014). International variation in neighborhood walkability, transit, and recreation environments using geographic information systems : the IPEN adult study. INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS, 13. https://doi.org/10.1186/1476-072X-13-43
Chicago author-date
Adams, Marc A, Lawrence D Frank, Jasper Schipperijn, Graham Smith, James Chapman, Lars B Christiansen, Neil Coffee, et al. 2014. “International Variation in Neighborhood Walkability, Transit, and Recreation Environments Using Geographic Information Systems : The IPEN Adult Study.” INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS 13. https://doi.org/10.1186/1476-072X-13-43.
Chicago author-date (all authors)
Adams, Marc A, Lawrence D Frank, Jasper Schipperijn, Graham Smith, James Chapman, Lars B Christiansen, Neil Coffee, Deborah Salvo, Lorinne du Toit, Jan Dygrýn, Adriano Akira Ferreira Hino, Poh-chin Lai, Suzanne Mavoa, José David Pinzón, Nico Van de Weghe, Ester Cerin, Rachel Davey, Duncan Macfarlane, Neville Owen, and James F Sallis. 2014. “International Variation in Neighborhood Walkability, Transit, and Recreation Environments Using Geographic Information Systems : The IPEN Adult Study.” INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS 13. doi:10.1186/1476-072X-13-43.
Vancouver
1.
Adams MA, Frank LD, Schipperijn J, Smith G, Chapman J, Christiansen LB, et al. International variation in neighborhood walkability, transit, and recreation environments using geographic information systems : the IPEN adult study. INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS. 2014;13.
IEEE
[1]
M. A. Adams et al., “International variation in neighborhood walkability, transit, and recreation environments using geographic information systems : the IPEN adult study,” INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS, vol. 13, 2014.
@article{5909065,
  abstract     = {{Background: The World Health Organization recommends strategies to improve urban design, public transportation, and recreation facilities to facilitate physical activity for non-communicable disease prevention for an increasingly urbanized global population. Most evidence supporting environmental associations with physical activity comes from single countries or regions with limited variation in urban form. This paper documents variation in comparable built environment features across countries from diverse regions. 
Methods: The International Physical Activity and the Environment Network (IPEN) study of adults aimed to measure the full range of variation in the built environment using geographic information systems (GIS) across 12 countries on 5 continents. Investigators in Australia, Belgium, Brazil, Colombia, the Czech Republic, Denmark, China, Mexico, New Zealand, Spain, the United Kingdom, and the United States followed a common research protocol to develop internationally comparable measures. Using detailed instructions, GIS-based measures included features such as walkability (i.e., residential density, street connectivity, mix of land uses), and access to public transit, parks, and private recreation facilities around each participant's residential address using 1-km and 500-m street network buffers. 
Results: Eleven of 12 countries and 15 cities had objective GIS data on built environment features. We observed a 38-fold difference in median residential densities, a 5-fold difference in median intersection densities and an 18-fold difference in median park densities. Hong Kong had the highest and North Shore, New Zealand had the lowest median walkability index values, representing a difference of 9 standard deviations in GIS-measured walkability. 
Conclusions: Results show that comparable measures can be created across a range of cultural settings revealing profound global differences in urban form relevant to physical activity. These measures allow cities to be ranked more precisely than previously possible. The highly variable measures of urban form will be used to explain individuals' physical activity, sedentary behaviors, body mass index, and other health outcomes on an international basis. Present measures provide the ability to estimate dose-response relationships from projected changes to the built environment that would otherwise be impossible.}},
  articleno    = {{43}},
  author       = {{Adams, Marc A and Frank, Lawrence D and Schipperijn, Jasper and Smith, Graham and Chapman, James and Christiansen, Lars B and Coffee, Neil and Salvo, Deborah and du Toit, Lorinne and Dygrýn, Jan and Ferreira Hino, Adriano Akira and Lai, Poh-chin and Mavoa, Suzanne and David Pinzón, José and Van de Weghe, Nico and Cerin, Ester and Davey, Rachel and Macfarlane, Duncan and Owen, Neville and Sallis, James F}},
  issn         = {{1476-072X}},
  journal      = {{INTERNATIONAL JOURNAL OF HEALTH GEOGRAPHICS}},
  keywords     = {{TRANSPORTATION,OBESITY,DETERMINANTS,URBAN SPRAWL,BUFFER SIZE,ASSOCIATIONS,WALK SCORE(R),BUILT ENVIRONMENT,11 COUNTRIES,PHYSICAL-ACTIVITY,International health,Walkability,Physical activity,Parks,Transportation,Urban planning,Exercise,Built environment}},
  language     = {{eng}},
  pages        = {{17}},
  title        = {{International variation in neighborhood walkability, transit, and recreation environments using geographic information systems : the IPEN adult study}},
  url          = {{http://doi.org/10.1186/1476-072X-13-43}},
  volume       = {{13}},
  year         = {{2014}},
}

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