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Neighbourhood Walkability and Physical Activity Levels in Canadian Communities. Justin Thielman Michael Lebenbaum Laura Rosella Ray Copes Heather Manson. Outline of Presentation. Background and Research Gaps Data Sources and Methods Results Discussion. Background and Research Gaps. - PowerPoint PPT Presentation
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Neighbourhood Walkability and Physical Activity Levels in Canadian Communities
Justin ThielmanMichael LebenbaumLaura RosellaRay CopesHeather Manson
PublicHealthOntario.ca
Outline of Presentation
• Background and Research Gaps
• Data Sources and Methods
• Results
• Discussion
2
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Background and Research Gaps
3
HIGH WALKABILITY
LOW WALKABILITY
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Background and Research Gaps
• Recent systematic reviews show some evidence of associations between walkability and some types of physical activity, but not conclusive [12-19]
• Non-significant estimates of associations identified in many studies may be due to type II error [16,18]
• Almost all studies done in one or two large metropolitan cities, so not generalizable to smaller centres [15,16,18-20]
4
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Background and Research Gaps• Our study uses national-level data sources that cover all of
Canada• Large sample size• Diverse range of city sizes• Cross-Canada representation
• Research Questions: • Is walkability associated with walking for transportation or total leisure
and transportation physical activity among Canadians aged 12 and older?
• How, and to what extent are these associations affected by variables such as age of respondent and city size?
5
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Data Sources and Methods• Canadian Community Health Survey (CCHS):• The CCHS is a national survey of health, health determinants, and health
care utilization among Canadians aged 12 and older
• Primary outcomes:• Walking to work or school • Energy expenditure on transportation and leisure physical activity
• Covariates:• Age, sex, race, immigration, income, education level, children in household,
location, work or school attendance, population centre size class
6
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Data Sources and Methods
7
Walkability data: Street Smart Walk Score (SSWS) (www.walkscore.com)
Grocery stores
For given locations, SSWS algorithm based
on number and proximity of amenities
Parks
Schools
Book storesBanks
Entertainment
Coffee shops
Clothing/gift shops
Restaurants/bars
Penalties for lower intersection densities and longer block lengths
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Data Sources and Methods
8
SSWSLatitude/longitude
CCHSPostal code
Postal Code Conversion FileLatitude/longitudePostal code
2007-08 CCHS + 2009-10 CCHS + 2011-12 CCHS - Rural residents - Respondents missing data on SSWS, primary outcomes, key covariates
= Final sample size: 240,595
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Results
9
Forest plot based on multivariable analyses adjusting for age, sex, race, working or attending school, immigration to Canada, highest level of education, household income, number of children under 12, population centre size category
Odds Ratio
SSW
S Q
uinti
leAll Respondents: Walked to Work or School in Past 3 Months
PublicHealthOntario.ca 10Each analysis adjusted for sex, race, working or attending school, immigration to Canada, highest level of education, household income, number of children under 12, population centre size category
Age 12-17: Walked to Work or School in Past 3 Months
Age 65+: Walked to Work or School in Past 3 MonthsAge 30-64: Walked to Work or School in Past 3 Months
Age 18-29: Walked to Work or School in Past 3 MonthsSS
WS
Qui
ntile
SSW
S Q
uinti
leSS
WS
Qui
ntile
SSW
S Q
uinti
le
Odds Ratio Odds Ratio
Odds RatioOdds Ratio
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Each analysis adjusted for age, sex, race, working or attending school, immigration to Canada, highest level of education, household income, number of children under 12
Population 1,000-29,999: Walked to Work or School
Population 100,000+ : Walked to Work or School
Population 30,000-99,999: Walked to Work or School
SSW
S Q
uinti
le
SSW
S Q
uinti
le
SSW
S Q
uinti
le
Odds Ratio
Odds Ratio
Odds Ratio
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Results
12
Forest plot based on multivariable analyses adjusting for age, sex, race, working or attending school, immigration to Canada, highest level of education, household income, number of children under 12, population centre size category
Similar results in age and population subgroups:
+ve assoc. for Q4 & Q5: • Age 30-64 • Pop. 1,000-29,999
+ve assoc. for Q5 only:• Age 18-29 • Pop. 100,000+
No significant assoc. • Remaining groups
Difference in Energy Expenditure (kcal/kg/hr)
SSW
S Q
uinti
le
All Respondents: Transport and Leisure Physical Activity
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Discussion
• Limitations:• Information bias due to self-reported outcomes
• Selection bias due to residential self-selection
• Residual confounding
• Cross-sectional study design precludes inference of causality
13
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Discussion
• SSWS and walking to work or school:• Positive associations identified for all quintile comparisons, increasing
strength in each successive quintile• Consistent across age groups and population centre sizes
• SSWS and energy expenditure on all leisure and transport activities:• Compared to lowest quintile, only top quintile shows positive
association
• Next steps:• Findings can be used to justify more resource-intensive longitudinal
studies in a variety of age and population groups
14
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Thank you!
Questions?
15
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References[1] Chronic Diseases and Their Common Risk Factors. (n.d.). In World Health Organization. Retrieved July 8, 2011 from http://www.who.int/chp/chronic_disease_report/media/Factsheet1.pdf
[2] Lynch, B.M., Neilson, H.K., Friedenreich, C.M. (2011). Physical activity and breast cancer prevention Recent Results in Cancer Research. 186:13-42.
[3] Lee, L.L., Watson, M.C., Mulvaney, C.A., Tsai, C.C., Lo, S.F. (2010). The effect of walking intervention on blood pressure control: a systematic review. International Journal of Nursing Studies. 47(12):1545-1561.
[4] Murtagh, E.M., Murphy, M.H., Boone-Heinonen, J. (2010). Walking: the first steps in cardiovascular disease prevention. Current Opinion in Cardiology. 25(5):490-6.
[5] Halle M, Schoenberg MH. (2009). Physical activity in the prevention and treatment of colorectal carcinoma. Deutsches Aerzteblatt International. 106(44):722-7.
[6] Caspersen CJ, Fulton JE. (2008). Epidemiology of walking and type 2 diabetes. Medical & Science in Sports & Exercise. 40(7 Suppl):S519-28.
[7] Ferrier, S., Blanchard, C.M., Vallis, M., Giacomantonio, N. (2011). Behavioural interventions to increase the physical activity of cardiac patients: A review. European Journal of Cardiovascular Prevention and Rehabilitation. 18(1):15-32.
[8] Foster, D.D., Summers, A.A. (2008). State executive/legislative and judicial activities and the strength of local regulation of residential housing. Urban Lawyer 40(1):1-16.
16
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References[9] Hui, E.C.M., Lam, M.C.M., Ho, V.S.M. (2006). Market disequilibrium and urban land shortages: Analysis of policy and patterns
in Hong Kong. Journal of Urban Planning and Development. 132(2):80-88.
[10] Hiwasaki, L. (2005). Toward sustainable management of national parks in Japan: Securing local community and stakeholder participation. Environmental Management. 35(6):753-764.
[11] De Vries, M.S. (2002). The changing functions of laws and its implication for government and governance. International Review of Administrative Sciences. 68(4):599-618.
[12] Wendel-Vos W, Droomers M, Kremers S, Brug J, van Lenthe F. Potential environmental determinants of physical activity in adults: a systematic review. Obesity Reviews. 2007; 8(5):425-440.
[13] Durand, C.P., Andalib, M., Dunton, G.F., Wolch, J., Pentz, M.A. A systematic review of built environment factors related to physical activity and obesity risk: Implications for smart growth urban planning. Obesity Reviews. 2011; 12(501):e173-e182.
[14] Foster, C., Hillsdon, M. Changing the environment to promote health-enhancing physical activity. Journal of Sports Sciences. 2004; 22:755-769.
[15] Saelens, B.E., Handy, S.L. Built Environment Correlates of Walking: A Review. Medicine and Science in Sports and Exercise. 2008; 40(7):S550-S566.
[16] Sugiyama T, Neuhaus M, Cole R, Giles-Corti B, and Owen N. Destination and Route Attributes Associated with Adults’ Walking: A Review. Med. Sci. Sports Exerc. 2012; 44(7):1275-1286
17
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References[17] McCormack C, and Shiell A. In search of causality: a systematic review of the relationship between the built environment and physical activity behaviour. International Journal of Behavioral Nutrition and Physical Activity. 2011; 8:125.
[18] Van Cauwenberg J, De Bourdeaudhuij I, De Meester F, Van Dyck D, Salmon J, Clarys P, Deforche B. Relationship between the physical environment and physical activity in older adults: A systematic review. Health & Place. 2011; 17:458-469.
[19] Frost, SS, Goins RT, Hunter RH, Hooker SP, Bryant LL, Kruger J, Pluto D. Effects of the Built Environment on Physical Activity of Adults Living in Rural Settings. American Journal of Health Promotion. 2010; 24(4):267-283.
[20] Sallis JF, Floyd MF, Rodriguez DA, Saelens BE. Role of Built Environments in Physical Activity, Obesity, and Cardiovascular Disease. Circulation. 2012; 125:729-737.
[21] Statistics Canada. Canadian Community Health Survey, 2009-2010: Annual component [Data file and code book]. 2011.
[22] Statistics Canada. Canadian Community Health Survey, 2007-2008: Annual component [Data file and code book]. 2009.
[23] Statistics Canada. Canadian Community Health Survey, 2009-2010: Annual component [User Guide]. 2011.
[24] Walk Score. Walk Score Methodology. 2012.
[25] Duncan DT, Aldstadt J, Whalen J, Melly SJ, Gortmaker SL. Validation of walk score for estimating neighborhood walkability: an analysis of four US metropolitan areas. Int J Environ Res Public Health. 2011 Nov;8(11):4160-79.
[26] Carr LJ, Dunsiger SI, Marcus BH. Validation of Walk Score for estimating access to walkable amenities. Br J Sports Med. 2011 Nov;45(14):1144-8.
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Data Sources and Methods
20
Quintile SSWS Range
1 0 – 19
2 20 – 36
3 37 – 53
4 54 – 71
5 72 - 100
2007-08 CCHS + 2009-10 CCHS + 2011-12 CCHS = 361,126
- Rural residents = 262,630
- Respondents missing SSWS data = 253,457 (3.5%)
- Respondents missing data on key covariates: immigrant, cultural origin, education =
(age, sex, children <12 missing none) 245,595 (3.1%) (6.5% overall)
- Respondents missing data on primary outcomes =Final sample size:240,595 (2.0%)
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Appendix A: Table 1
21
Categorical Variables: Total N (PERCENT), N of each category Variable Total Q1 Q2 Q3 Q4 Q5
Urban category (GEODUR) 240397, 46123, 47509, 48304, 49009, 49452, 1 – Urban core 205538 (85.5) 36055 (78.2) 40411 (85.1) 41580 (86.1) 42494 (86.7) 44999 (91.0) 2 – Urban fringe 6233 (2.6) 2213 (4.8) 1676 (3.5) 1334 (2.8) 666 (1.4) 344 (0.7) 4 – UA outside CMA/CA 13579 (5.6) 3194 (6.9) 2454 (5.2) 2572 (5.3) 3193 (6.5) 2166 (4.4) 6 – Secondary urban core 4832 (2.0) 1622 (3.5) 1052 (2.2) 959 (2.0) 787 (1.6) 412 (0.8) 9 – NR (mix of urban/rural) 10215 (4.2) 3039 (6.6) 1917 (4.0) 1859 (3.8) 1869 (3.8) 1531 (3.1) Age category (Agecat) 240397, 46123, 47509, 48304, 49009, 49452, 0 – 12 to 17 20229 (8.4) 4734 (10.3) 4700 (9.9) 4244 (8.8) 3743 (7.6) 2808 (5.7) 1 – 18 to 29 48725 (20.3) 8245 (17.9) 9086 (19.1) 9662 (20.0) 10356 (21.1) 11376 (23.0) 2 – 30 to 64 136946 (57.0) 27653 (60.0) 27259 (57.4) 27062 (56.0) 27187 (55.5) 27785 (56.2) 3 – 65 and up 34498 (14.4) 5492 (11.9) 6465 (13.6) 7335 (15.2) 7722 (15.8) 7483 (15.1) Sex (DHH_SEX) 240397, 46123, 47509, 48304, 49009, 49452, 1 - Male 117085 (48.7) 22842 (49.5) 22991 (48.4) 23543 (48.7) 23635 (48.2) 24074 (48.7) 2 - Female 123312 (51.3) 23280 (50.5) 24518 (51.6) 24761 (51.3) 25374 (51.8) 25378 (51.3) Race (RACE) 240397, 46123, 47509, 48304, 49009, 49452, 0 – White 183455 (76.3) 39239 (85.1) 37644 (79.2) 36426 (75.4) 35418 (72.3) 34728 (70.2) 1 – South Asian 10684 (4.4) 1349 (2.9) 2169 (4.6) 2486 (5.1) 2561 (5.2) 2119 (4.3) 2 – Aboriginal 7593 (3.2) 1364 (3.0) 1448 (3.0) 1497 (3.1) 1768 (3.6) 1517 (3.1) 3 – Asian 16194 (6.7) 1821 (3.9) 2522 (5.3) 3369 (7.0) 3737 (7.6) 4745 (9.6) 4 – Black 6795 (2.8) 597 (1.3) 1131 (2.4) 1496 (3.1) 1671 (3.4) 1901 (3.8) 5 – Other 15676 (6.5) 1754 (3.8) 2595 (5.5) 3030 (6.3) 3855 (7.9) 4442 (9.0) Immigrant (SDCFIMM) 240397, 46123, 47509, 48304, 49009, 49452, 1 - Yes 63087 (26.2) 7769 (16.8) 10795 (22.7) 12609 (26.1) 14746 (30.1) 17169 (34.7) 2 - No 177310 (73.8) 38354 (83.2) 36715 (77.3) 35695 (73.9) 34263 (69.9) 32283 (65.3)
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Appendix A: Table 1
22
Income quintile (INC_QUINTILE) 240397, 46123, 47509, 48304, 49009, 49452, 1 – 42146 (17.5) 4754 (10.3) 6402 (13.5) 8200 (17.0) 10356 (21.1) 12434 (25.1) 2 – 42915 (17.9) 7025 (15.2) 7998 (16.8) 8775 (18.2) 9524 (19.4) 9594 (19.4) 3 – 44883 (18.7) 8849 (19.2) 9220 (19.4) 9375 (19.4) 9386 (19.2) 8053 (16.3) 4 – 44002 (18.3) 9975 (21.6) 9649 (20.3) 8724 (18.1) 8066 (16.5) 7588 (15.3) 5 – 43975 (18.3) 11195 (24.3) 9507 (20.0) 8537 (17.7) 7038 (14.4) 7698 (15.6) Missing 22477 (9.3) 4326 (9.4) 4734 (10.0) 4693 (9.7) 4639 (9.5) 4086 (8.3) EDUDR04 - Highest level/edu. 240397, 46123, 47509, 48304, 49009, 49452, 1 - < High school 46292 (19.3) 8455 (18.3) 9302 (19.6) 9800 (20.3) 10206 (20.8) 8528 (17.2) 2 - High school grad 37704 (15.7) 7092 (15.4) 7752 (16.3) 8191 (17.0) 7953 (16.2) 6717 (13.6) 3 - Some post-secon. 19511 (8.1) 3568 (7.7) 3859 (8.1) 3989 (8.3) 3969 (8.1) 4126 (8.3) 4 - Post-secon. Grad 136891 (56.9) 27008 (58.6) 26596 (56.0) 26324 (54.5) 26881 (54.8) 30082 (60.8) Worked at job (GEN_08) 240397, 46123, 47509, 48304, 49009, 49452, 1 – Yes 168847 (70.2) 33580 (72.8) 33584 (70.7) 33537 (69.4) 33677 (68.7) 34470 (69.7) 2 – No 49022 (20.4) 8593 (18.6) 9398 (19.8) 9996 (20.7) 10507 (21.4) 10529 (21.3) NA/missing (6, 7, 8) 22528 (9.4) 3951 (8.5) 4527 (9.5) 4771 (9.9) 4825 (9.8) 4453 (9.0) No. pers. < 12 years old in hhld (DHHDL12) 240397, 46123, 47509, 48304, 49009, 49452, 0 184148 (76.6) 33800 (73.3) 35426 (74.6) 36505 (75.6) 37922 (77.4) 40495 (81.9) 1 30541 (12.7) 6228 (13.5) 6416 (13.5) 6506 (13.5) 6205 (12.7) 5185 (10.5) 2 19854 (8.3) 4666 (10.1) 4368 (9.2) 4079 (8.4) 3711 (7.6) 3030 (6.1) 3 4694 (2.0) 1130 (2.5) 1064 (2.2) 977 (2.0) 920 (1.9) 603 (1.2) 4+ 1159 (0.5) 299 (0.7) 235 (0.5) 236 (0.5) 250 (0.5) 138 (0.3) Leis. or trans. phys. act., past 3 months (PACFLTI) 240397, 46123, 47509, 48304, 49009, 49452, Yes (1) 223108 (92.8) 43608 (94.5) 44293 (93.2) 44654 (92.4) 45092 (92.0) 45461 (91.9) No (2) 17289 (7.2) 2515 (5.5) 3216 (6.8) 3650 (7.6) 3917 (8.0) 3991 (8.1) Walked to work/school, past 3 months (PAC_7) 240397, 46123, 47509, 48304, 49009, 49452, Yes (1) 46603 (19.4) 5979 (13.0) 7748 (16.3) 8664 (17.9) 10037 (20.5) 14175 (28.7) No (2) 135594 (56.4) 30151 (65.4) 28721 (60.5) 27693 (57.3) 26154 (53.4) 22875 (46.3) Does not work/attend school (3) 58200 (24.2) 9992 (21.7) 11040 (23.2) 11947 (24.7) 12817 (26.2) 12403 (25.1)
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Appendix A: Table 1
23
Time spent walking to work/school (PAC_7B) 240397, 46123, 47509, 48304, 49009, 49452, 1 – 15 mins (1) 16988 (7.1) 2212 (4.8) 2973 (6.3) 3208 (6.6) 3819 (7.8) 4775 (9.7) 16 – 30 mins (2) 17828 (7.4) 2208 (4.8) 2901 (6.1) 3459 (7.2) 3772 (7.7) 5488 (11.1) 31 – 60 mins (3) 8782 (3.7) 1195 (2.6) 1357 (2.9) 1476 (3.1) 1819 (3.7) 2935 (5.9) > 60 mins (4) 2447 (1.0) 313 (0.7) 415 (0.9) 410 (0.8) 534 (1.1) 775 (1.6) NA/missing (6, 7, 9) 194351 (80.8) 40194 (87.1) 39863 (83.9) 39751 (82.3) 39066 (79.7) 35478 (71.7) Biked to work/school, past 3 months (PAC_8) 240397, 46123, 47509, 48304, 49009, 49452, Yes (1) 9558 (4.0) 1496 (3.2) 1572 (3.3) 1646 (3.4) 1793 (3.7) 3051 (6.2) No (2) 171748 (71.4) 34511 (74.8) 34700 (73.0) 34543 (71.5) 34196 (69.8) 33799 (68.3) Does not work/attend school (3) 59092 (24.6) 10116 (21.9) 11238 (23.7) 12115 (25.1) 13020 (26.6) 12603 (25.5) Time spent biking to work/school (PAC_8B) 240397, 46123, 47509, 48304, 49009, 49452, 1 – 15 mins (1) 3677 (1.5) 570 (1.2) 659 (1.4) 659 (1.4) 703 (1.4) 1085 (2.2) 16 – 30 mins (2) 3036 (1.3) 466 (1.0) 437 (0.9) 530 (1.1) 579 (1.2) 1025 (2.1) 31 – 60 mins (3) 1976 (0.8) 278 (0.6) 327 (0.7) 324 (0.7) 369 (0.8) 678 (1.4) > 60 mins (4) 772 (0.3) 170 (0.4) 135 (0.3) 118 (0.2) 124 (0.3) 224 (0.5) Missing (6, 7, 9) 230936 (96.0) 44638 (96.8) 45951 (96.7) 46673 (96.6) 47234 (96.3) 46439 (93.8) BMI category (bmicateg) 240397, 46123, 47509, 48304, 49009, 49452, Underweight 10568 (4.4) 1962 (4.3) 2099 (4.4) 2034 (4.2) 2177 (4.4) 2296 (4.6) Normal weight 111603 (46.4) 20510 (44.5) 21516 (45.3) 22037 (45.6) 22430 (45.8) 25110 (50.8) Overweight 73130 (30.4) 14771 (32.0) 14659 (30.9) 15020 (31.1) 14957 (30.5) 13722 (27.7) Obese 36916 (15.4) 7415 (16.1) 7605 (16.0) 7504 (15.5) 7756 (15.8) 6637 (13.4) NA/missing 8180 (3.4) 1465 (3.2) 1630 (3.4) 1710 (3.5) 1690 (3.4) 1686 (3.4) Diabetes (diab) 240397, 46123, 47509, 48304, 49009, 49452, No 226373 (94.2) 43717 (94.8) 45027 (94.8) 45188 (93.5) 45878 (93.6) 46563 (94.2) Yes 13886 (5.8) 2385 (5.2) 2463 (5.2) 3094 (6.4) 3104 (6.3) 2839 (5.7) NA/missing 138 (0.1) 21 (0.0) 19 (0.0) 22 (0.0) 27 (0.1) 50 (0.1)
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Appendix A: Table 1
24
Continuous Variables: N, MEAN (S.D.) , MEDIAN (I.Q.R.)
Variable Total Q1 Q2 Q3 Q4 Q5
Age (DHH_AGE)
240592, 43.1 (18.7), 42.0 (30.0)
52454, 42.4 (16.9), 43.0 (29.0)
48714, 42.8 (18.5), 43.0 (29.0)
48555, 43.4 (19.0), 43.0 (30.0)
48326, 43.6 (19.2), 43.0 (30.0)
42543, 43.1 (20.1), 41.0 (28.0)
Income (income_equivalized)
219712, 49436.9 (57430.8), 40414.5 (38890.9)
47825, 57145.2 (63043.2), 49296.1 (38956.4)
44279, 52259.2 (58893.8), 44721.4 (38797.8)
44120, 48567.6 (45418.2), 40414.5 (37500.0)
44199, 44499.3 (43926.8), 36000.0 (34568.5)
39289, 45338.9 (71353.6), 35000.0 (37735.0)
Leis. or trans. phys. act. daily energy expen. (PACDTLE)
239101, 2.4 (2.5), 1.7 (2.6)
52162, 2.5 (2.4), 1.8 (2.6)
48415, 2.4 (2.6), 1.7 (2.6)
48248, 2.4 (2.6), 1.6 (2.7)
48001, 2.2 (2.4), 1.6 (2.5)
42275, 2.3 (2.6), 1.7 (2.6)
Number of times walked to work/school, past 3 mo. (PAC_7A)
40136, 47.6 (42.5), 48.0 (46.0)
6361, 42.4 (37.9), 36.0 (50.0)
7300, 44.1 (38.7), 40.0 (48.0)
7946, 44.3 (38.5), 40.0 (48.0)
8424, 48.3 (42.8), 48.0 (45.0)
10105, 53.2 (49.1), 60.0 (45.0)
Number of times biked to work/school, past 3 months (PAC_8A)
8175, 24.6 (30.0), 13.0 (32.0)
1535, 20.6 (26.2), 10.0 (27.0)
1568, 21.3 (26.0), 12.0 (27.0)
1572, 23.1 (25.8), 12.0 (32.0)
1544, 24.5 (29.4), 14.0 (32.0)
1956, 29.2 (37.5), 20.0 (43.0)
Body Mass Index (HWTDBMI)
231640, 25.5 (5.1), 24.9 (6.1)
50505, 25.6 (4.8), 24.9 (6.2)
46905, 25.6 (5.1), 24.9 (6.3)
46734, 25.5 (5.1), 24.9 (6.2)
46488, 25.5 (5.2), 24.9 (6.2)
41008, 25.0 (5.4), 24.2 (5.8)
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Appendix B: Results Tables
25
SSWS and Daily Energy Expenditure for All Resondents
WS Quintile
N Estimate LowerCL UpperCL P-valueQ1
REF REF REF REFQ2
0.128869 -0.03478 0.292517 0.122729Q3
0.024102 -0.1174 0.165604 0.738498Q4
0.02316 -0.1348 0.181117 0.773826Q5
0.320969 0.110406 0.531532 0.002811
PublicHealthOntario.ca 26
SSWS and Daily Energy Expenditure by Age Category
Age Category WS Quintile
N Estimate LowerCL UpperCL P-value12-17 Q1 REF REF REF REF
Q20.470359 -0.49718 1.437898 0.340684
Q30.251054 -0.65164 1.153751 0.585687
Q4-0.25968 -1.11259 0.593219 0.550674
Q5-0.22748 -1.18826 0.733307 0.642615
18-29 Q1 REF REF REF REFQ2
0.041075 -0.3829 0.465048 0.849402Q3
-0.0309 -0.43389 0.372083 0.880523Q4
-0.08857 -0.54162 0.364474 0.701587Q5
0.91461 0.259204 1.570017 0.00623630-64 Q1 REF REF REF REF
Q20.133481 -0.03222 0.299178 0.114363
Q30.060961 -0.0741 0.196026 0.376361
Q40.237715 0.059469 0.415961 0.008952
Q50.455608 0.219263 0.691954 0.000158
65+ Q1 REF REF REF REFQ2
-0.03701 -0.22585 0.151831 0.700881Q3
-0.09176 -0.24037 0.056858 0.226235Q4
-0.11545 -0.25608 0.025178 0.107603Q5
-0.09807 -0.24869 0.052545 0.201883
PublicHealthOntario.ca 27
SSWS and Daily Energy Expenditure by Population Centre Size ClassPopulation
ClassWS
QuintileN Estimate LowerCL UpperCL P-value
1,000 – 29,999 Q1 REF REF REF REFQ2 0.197115 -0.09331 0.487536 0.183429Q3 0.169152 -0.0681 0.406403 0.162296Q4 0.678292 0.179869 1.176714 0.007647Q5 0.460043 0.185392 0.734694 0.001027
30,000 – 99,999
Q1 REF REF REF REFQ2 0.386996 -0.17701 0.951007 0.17868Q3 -0.13839 -0.46298 0.186195 0.403351Q4 -0.12908 -0.44318 0.185016 0.420545Q5 -0.17223 -0.53075 0.186302 0.346446
100,000+ Q1 REF REF REF REFQ2 0.065253 -0.1289 0.259402 0.51006Q3 -0.00033 -0.17746 0.176802 0.997105Q4 -0.06352 -0.25174 0.124705 0.508358Q5 0.317782 0.068136 0.567428 0.012599
Appendix B: Results Tables
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SSWS and Walking to Work/School for All Respondents
WS Quintile
N Odds Ratio LowerCL UpperCL P-valueQ1
REF REF REFQ2
1.38 1.29 1.48Q3
1.64 1.52 1.76Q4
2.06 1.91 2.21Q5
3.54 3.29 3.81
Appendix B: Results Tables
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SSWS and Walking to Work/School by Age Category
Age Category WS Quintile
N Odds Ratio LowerCL UpperCL P-value12-17 Q1 REF REF REF
Q2 1.69 1.49 1.92Q3 1.84 1.61 2.1Q4 2.25 1.94 2.6Q5 2.39 2.02 2.82
18-29 Q1 REF REF REFQ2 1.29 1.13 1.46Q3 1.52 1.33 1.73Q4 1.81 1.6 2.05Q5 3.01 2.64 3.43
30-64 Q1 REF REF REFQ2 1.34 1.19 1.51Q3 1.75 1.56 1.97Q4 2.36 2.1 2.65Q5 4.54 4.06 5.07
65+ Q1 REF REF REFQ2 1.28 0.82 2.01Q3 1.41 0.93 2.13Q4 2.41 1.63 3.56Q5 3.87 2.65 5.64
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SSWS and Walking to Work/School by Population Centre Size ClassPopulation
ClassWS
QuintileN Odds Ratio LowerCL UpperCL P-value
1,000 – 29,999 Q1 REF REF REFQ2 1.39 1.19 1.63Q3 1.73 1.48 2.03Q4 2 1.73 2.33Q5 2.53 2.13 3.01
30,000 – 99,999
Q1 REF REF REFQ2 1.49 1.26 1.75Q3 1.7 1.44 2.02Q4 2.18 1.85 2.58Q5 3.33 2.73 4.07
100,000+ Q1 REF REF REFQ2 1.37 1.26 1.5Q3 1.63 1.49 1.78Q4 2.07 1.9 2.26Q5 3.69 3.38 4.03
Appendix B: Results Tables
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PublicHealthOntario.ca 38