Abstract

A higher Body Mass Index (BMI) is often associated with higher risks for health-related issues (e.g., arthritis, cancer). Lifestyle behaviors (e.g., healthy diet) are believed to be important factors closely related to people’s BMI and health. Among the behaviors, active travel modes (e.g., walking and bicycling) may be an important factor correlated with BMI. Such travel behaviors can somehow be affected by community design (e.g., walkability) and environmental features (e.g., air quality). These factors exhibit complex relationships with a person’s health as they may either directly or indirectly correlate with health through travel behaviors. To this end, this study employed a pathway analysis approach to unveil potential health benefits relating to community living environments and travel behaviors to BMI and health. Specifically, this study integrated national-level health and travel behavior datasets and developed rigorous multi-level hierarchical models to explore and explain how the health pathways are related to community living environments, travel behaviors, and BMI. The modeling results showed that limited walking facilities and unhealthy air quality could significantly associate with people’s reduced willingness to engage in active travel modes, which correlated with subsequent higher obesity risk, and a higher risk of poor health. More importantly, if walking or bicycling facilities were not fully utilized, health benefits gained from these facilities were found to be substantially reduced. Other significant health-related behaviors (e.g., sleep/exercise time, fruit consumption, smoking) are also discussed in detail.

摘要

较高的体重指数（BMI）通常与健康相关问题（例如，关节炎，癌症）的较高风险相关。生活方式行为（例如健康饮食）被认为是与人们的BMI和健康密切相关的重要因素。在这些行为中，主动出行方式（例如步行和骑自行车）可能是与BMI相关的重要因素。这样的旅行行为可能会受到社区设计（例如，步行能力）和环境特征（例如，空气质量）的影响。这些因素与人的健康之间存在复杂的关系，因为它们可能通过旅行行为与健康直接或间接相关。为此，本研究采用了一种途径分析方法，以揭示与社区生活环境以及BMI和健康出行行为有关的潜在健康益处。特别，这项研究整合了国家级的健康和旅行行为数据集，并开发了严格的多级分层模型，以探索和解释健康途径与社区生活环境，旅行行为和BMI的关系。建模结果表明，步行设施有限和空气质量不健康可能与人们减少主动出行方式的意愿显着相关，这与随后的更高肥胖风险和更高的不良健康风险相关。更重要的是，如果步行或骑自行车的设施没有得到充分利用，从这些设施获得的健康益处将大大减少。还详细讨论了其他与健康有关的重要行为（例如睡眠/锻炼时间，水果消费，吸烟）。