Neighborhood Walkability and Gestational Diabetes

USA: Despite the links between neighbourhood walkability and physical activity, body size, and risk of diabetes, there are few studies of neighbourhood walkability and risk of gestational diabetes (GD). Researchers at Columbia University Mailman School of Public Health’s Built Environment and Health Research Group have found in a new study that higher neighbourhood walkability is associated with a lower risk of gestational diabetes (GD).

The study is published in the journal Paediatric and Perinatal Epidemiology. Gestational diabetes increases infants’ risk of being large for gestational age, may increase the risk of unhealthy weight gain during childhood, and increases the pregnant individual’s risk for future type 2 diabetes. The researchers, working in partnership with the New York City Department of Health and Mental Hygiene, analyzed the relationships between neighborhood walkability for pregnant New Yorkers. The Neighborhood Walkability Index used to measure walkability includes data on residential density, land use mix, street connectivity, and access to public transit. They analyzed city data from more than 109,000 births in 2015.

They found that the risk of GD decreased with increases in Neighborhood Walkability Index score by as much as 20 percent between areas in the highest and lowest quartiles of walkability. Similarly, when the researchers assessed the density of walkable destinations, another measure of neighborhood walkability, pregnant individuals in the highest quartile of walkable destinations had a 23 percent lower risk of GD than those in the lowest quartile. The analyses adjusted for the pregnant individual’s age, race and ethnicity, parity, education, place of birth, and marital status, along with the neighbourhood's poverty rate.

An earlier study by the research team found that neighborhood walkability is associated with a lower risk of excess weight gain during pregnancy; almost 50 percent of pregnant individuals gain more weight than is recommended for healthy pregnancies. The researchers theorize that neighborhood walkability is associated with higher levels of walking and physical activity in pregnant individuals, reducing the risk of GD and excess weight gain during pregnancy. Pregnant individuals are known to favor lower-intensity forms of exercise, such as walking during pregnancy, and in New York City neighborhood walkability is positively associated with more walking and total physical activity.

“The study highlights the importance of urban planning, particularly neighborhood walkability, in promoting health,” says study co-first author Andrew Rundle, DrPH, an epidemiology professor at Columbia Mailman. “Creating opportunities for pregnant individuals to meet recommendations for healthy physical activity during pregnancy is expected to have long-lasting positive benefits for both parent and child.”

Going forward, Rundle says “We plan to continue our research on how urban design can support health during pregnancy so that these benefits are included in cost-benefit analyses and decision making for how we design new neighborhoods and re-design existing neighborhoods.”

Reference

• Andrew G. Rundle
• Eliza W. Kinsey
• Elizabeth M. Widen
• James W. Quinn
• Mary Huynh
• Gina S. Lovasi
• Kathryn M. Neckerman
• Gretchen Van Wye

First published: 12 January 2023 https://doi.org/10.1111/ppe.12952