Prevalence of active transportation among adults in Latin America and the Caribbean: a systematic review of population-based studies

Perceived neighborhood built environment and physical activity in urban population in Chile

BACKGROUND

Various indicators of neighborhood environmental perceptions are differently associated with physical activity (PA) domains, with notable variations by sex. However, few studies in Latin America have examined these associations across distinct PA domains. In this study, we analyzed the relationship between neighborhood environmental perceptions and PA in the domains of transportation and leisure among Chilean adults.

METHODS

This cross-sectional analytical study included 770 participants from the 2014-2016 Latin American Nutrition and Health Survey (ELANS). Perceptions of land use diversity, access to land use, street connectivity, walking and cycling infrastructure, aesthetics, safety from crime, and neighborhood traffic were assessed using the Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) questionnaire. PA was measured with the International Physical Activity Questionnaire-Long Form (IPAQ-LF), focusing on the transportation and leisure-time domains. Logistic regression and multiple linear regression models were used for the analysis.

RESULTS

Logistic regression analysis in men showed no association between neighborhood characteristics and PA in the transportation or leisure-time domains. However, for women, greater perception of facilities for walking or cycling was inversely associated with transportation PA (OR: 0.62; 95%CI: 0.42;0.92). In the multiple linear regression analysis, higher perceived traffic safety was associated with greater PA (min/week) for both transportation (β: 0.098; 95%CI: 0.005;0.192) and leisure time (β: 0.160, 95%CI: 0.012;0.309). For men, higher scores for perceived access to land use were inversely associated with leisure-time PA (β: -0.150, 95%CI: -0.266;-0.034).

CONCLUSIONS

Different perceived neighborhood characteristics are associated with PA across various domains, with notable gender differences. A better perceived condition of traffic safety would promote urban population to engage in more transportation and leisure-time PA.

CLINICAL TRIAL NUMBER

ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

TRIAL REGISTRATION

ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

A cohort study examining individual factors influencing cycling as a transportation mode in São Paulo, Brazil

The aim of this study is to explore the relationship between individual-level factors and cycling for transportation in a cohort of participants living in São Paulo city, Brazil. The same participants (n = 1,431 adults) were interviewed in 2014/2015 (Wave 1) and 2020/2021 (Wave 2) as part of the 'São Paulo Health Survey-ISA: Physical Activity and Environment'. For the longitudinal transport cycling binary outcome, participants who reported cycling at both time-points and those who were cycling at Wave 2 only were coded as a positive longitudinal pattern for cycling. Those who were not cycling at either Waves, and those who were cycling at Wave 1 only, were grouped into a negative pattern for cycling. The relationship between the longitudinal patterns for transport cycling and sociodemographics, health characteristics, and behaviors at Wave 1 were tested using bivariate analysis, and the significant individual-level factors were then examined in a multivariable binary logistic regression model. The odds of being classified in the positive cycling pattern were lower for women [OR = 0.09; 95 % CI = 0.04---0.19], and higher for persons aged 30 - 39 [OR = 3.25; 95 % CI = 1.38---7.66], those who owned a bicycle [OR = 2.00; 95 % CI = 1.13---3.54], and those who engaged in ≥ 120 min/week of transport walking [OR = 2.07; 95 % CI = 1.24---3.47] or leisure-time physical activity [OR = 1.77; 95 % CI = 1.02---3.06]. Cycling interventions and promotion should target women, the mid-aged and involve facilitating bicycle access. Advocacy for physical activity interventions is needed to influence transport cycling.

Bicycle use in Latin American cities: changes over time by socio-economic position

Introduction

We aimed to examine utilitarian bicycle use among adults from 18 large Latin American cities and its association with socio-economic position (education and income) between 2008 and 2018.

Methods

Data came from yearly cross-sectional surveys collected by the Development Bank of Latin America (CAF). A total of 77,765 survey respondents with complete data were used to estimate multilevel logistic regression models with city as random intercept and year as random slope.

Results

Individuals with high education and high-income levels had lower odds of using a bicycle compared with participants with lower education and income levels. These associations, however, changed over time with the odds of bicycle use increasing for all groups, especially among individuals with the highest education and income levels.

Discussion

Our results confirm the broadening appeal of bicycling across socioeconomic positions in several Latin American cities and reinforce the importance of considering policies aimed at supporting and enhancing bicycle travel for all users.

Is city-level travel time by car associated with individual obesity or diabetes in Latin American cities? Evidence from 178 cities in the SALURBAL project

There is growing evidence that longer travel time by private car poses physical and mental risks. Individual-level obesity and diabetes, two of the main public health challenges in low- and middle-income contexts, could be associated to city-level travel times by car. We used individual obesity and diabetes data from national health surveys from individuals in 178 Latin American cities, compiled and harmonized by the SALURBAL project. We calculated city-level travel times by car using the Google Maps Distance Matrix API. We estimated associations between peak hour city-level travel time by car and obesity and diabetes using multilevel logistic regression models, while adjusting for individual characteristics and other city-level covariates. In our study we did not observe a relationship between city-level peak-hour travel time by car and individual obesity and diabetes, as reported in previous research for individual time spent in vehicles in high-income settings. Our results suggest that this relationship may be more complex in Latin America compared to other settings, especially considering that cities in the region are characterized by high degrees of population density and compactness and by a higher prevalence of walking and public transportation use.

Walking for transportation in large Latin American cities: walking-only trips and total walking events and their sociodemographic correlates

Walking for transportation is a common and accessible means of achieving recommended physical activity levels, while providing important social and environmental co-benefits. Even though walking in rapidly growing urban areas has become especially challenging given the increasing dependence on motorised transportation, walking remains a major mode of transportation in Latin American cities. In this paper we aimed to quantify self-reported walking for transportation in Mexico City, Bogota, Santiago de Chile, Sao Paulo, and Buenos Aires, by identifying both walking trips that are conducted entirely on foot and walking events involved in trips mainly conducted on other means of transportation (e.g. private vehicle, public transit) among individuals ≥5-years old. We show how walking-only trips account for approximately 30% trips in the analysed cities, and we evidence how the pedestrian dimension of mobility is largely underestimated if walking that is incidental to other transportation modes is not accounted for: when considering all walking events, we observed an increase between 73% and 217% in daily walking time. As a result, we estimated that between 19% and 25% of residents in these cities meet the WHO physical activity guidelines solely from walking for transportation. The results of the study also suggest that the promotion of public transportation in large Latin American cities can especially help certain population groups achieve the daily recommended levels of physical activity, while among low-income groups accessibility and safety seem to be the key challenges to be addressed.

Workplace neighbourhood built environment and workers' physically-active and sedentary behaviour: a systematic review of observational studies

Background

Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers’ physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies.

Methods

Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers’ physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019.

Results

A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving).

Conclusions

The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships.

Protocol registration

The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-020-01055-x.

Socio-demographic patterning of objectively measured physical activity and sedentary behaviours in eight Latin American countries: Findings from the ELANS study

Physical activity (PA) and sedentary behaviours (SB) are two independent risk factors for non-communicable diseases. However, there is a lack of objectively measured information on PA and SB in low- and middle-income countries. The aim of this study was to use objective data to characterise socio-demographic patterns of PA and SB in eight Latin American countries. 2732 participants (aged 15-65 years) from the Latin American Study of Nutrition and Health (ELANS) were included. PA and SB data were collected using accelerometers. Overall and country-specific average levels of time spent in PA and SB were compared by sex, age, socioeconomic and education level. Overall, the mean time spent in SB was 571.6 min/day, ranging from 553.8 min/day in Chile to 596.7 min/day in Peru. Average levels of light, moderate-to-vigorous physical activity (MVPA) and total PA were 311.1 min/day (95% CI: 307.7; 314.5), 34.9 min/day (95% CI: 34.0; 35.9) and 7531.2 MET-min/week (95% CI: 7450.4; 7611.9), respectively. MVPA and total PA were higher in men than women. The prevalence of physical inactivity was 40.6%, ranging from 26.9% (Chile) to 47% (Costa Rica and Venezuela). Women were more physically inactive than men (47.7% versus 33.0%). SB levels were highest among those with higher education; PA graded positively with socioeconomic level. Our findings can inform the planning of health policies and programmes designed to reduce levels of physical inactivity, as well as inform the local and cultural adaptation of these policies and programmes for implementation in Latin America. Highlights Worldwide studies of physical activity (PA) and sedentary behaviours (SB) have historically under-represented Latin American countries due to the lack of surveillance data. Across eight Latin American countries, the ELANS study collected data on PA and SB using an objective method (accelerometers) which we have analysed to quantify and characterise socio-demographic patterns. Over four-in-ten participants were physically inactive (40.6%); with a gender gap (47.7% women; 33.0% men); and striking differences between countries (47% Costa Rica and Venezuela; 26.9% Chile). In all countries, levels of moderate-to-vigorous physical activity (MVPA) were lowest, and levels of SB were highest, among participants in the higher education groups. Our findings on the unequal distribution of PA and SB increases the evidence base and can help to inform future intervention strategies in Latin America.