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Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Physical Environment and Physical Activity
Preliminary Results from the Finnish Regional Health and Welfare Study
29.3.2012
Tomi Mäkinen, PhD
Senior researcher
Population Health Research Unit
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Adaption of Socioecological Model for Physical Activity among Adults
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PERSONALAge, Health, Skills,
Preferences, Motivation, SEP
SOCIAL/CULTURAL
PHYSICAL ENVIRONMENT
Social support (family and friends)
Ethnicity/Cultural norms
MACRO LEVEL /PUBLIC POLICY
Time Constraints
(work, family)
Design (streets, parks,
facilities etc)
Connectivity(streets,
sidewalks, bicycle-lanes)
Proximity(density, land
use mix, access)
Policies
Regulations
Laws
International
Local
TaxationUrban planning
National
Life-course & selection
Distance: (home to work, to
recreation)
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Sociodemographic, Social and Physical environment determinants for walking and cycling among Adults
PERSONALAge(-), Health(+),
Skills(+), Preferences(+),
Motivation(+), SEP(+)
SOCIAL/CULTURAL
PHYSICAL ENVIRONMENT
Social support from family and friends (+)
Ethnicity/Cultural
norms (-)Time
Constraints(-)
Design: Streets (0), Parks/open space (0),
Lightning (0),Safety (0)
Connectivity:Streets (+),
sidewalks (+), bicycle-lanes (+)
Proximity: Density (+),land use mix
(+), access (+)
Wendel-Vos et al Obesity 2007
Trost et al MSSE 2002
McCormack et al IJBNPA 2011
Saelens et al MSSE 2008
0 = inconsistent- = negative+ = positive,
Social participation (+)
Distance :Work-home (?),
to recreational area (+),
Self-selection
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Our aims are:
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a) How social and physical environment are associated with physical activity (e.g. cycling and walking)?
b) Are there area-level and neighborhood-level inequalities in physical activity?
c) Can these inequalities be explained with social and physical environments?
Nordic Behavioral Medicine Symposium / Tomi Mäkinen29.3.2012
Preliminary results from:
29.3.2012 Nordic Behavioral Medicine Symposium / Tomi Mäkinen
a) How social and physical environment are associated with commuting among women and men?
b) Are there area-level and neighborhood-level inequalities in physical activity?
c) Can these inequalities be explained with social and physical environments?
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Our hypotheses were:
• Good walking and cycling infrastructure, green environment and physical activity facilities are positively associated with walking and cycling.
• Social support and other forms of social participation are positively associated with walking and cycling.
• There are area- and neighborhood-level inequalities in walking and cycling.
• These inequalities are mainly due to better physical and social environments in urban areas compared to semi-urban areas and rural areas.
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Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Materials and Methods• The Regional Health and Wellbeing Study (ATH)
– Cross-sectional, year 2010, Finns aged 20 years and over – Response rate varied from 55 to 65 %, – Conducted in year 2010 – Areas included
• Turku (n=9000), • The regions Kainuu (n=9000)• Northern Ostrobothnia (n=8000) • Random sample of Finnish continent (n=5000)
– Self-assessed physical environment and physical activity
• Statistical analyses and sample weight– preliminary results presented in unadjusted frequencies, Chi2-test
statistics for gender differences. Regression and spatial modelling to be done in the future.
– Weights used to take into account the sampling and make data representative for the whole population
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Northern Ostrobothnia, area 1
Research areas of ATH-Study in year 2010
Northern Ostrobothnia, area 2 Kainuu, area 1
Turku
Kainuu, area 2
Kainuu, area 3
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Short statistics of the two areas examined:
TURKU (2010)• Population = 177 326• Tertiary education = 39,6 %• Total area, km2 = 306,4• www.turku.fi
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KAINUU (2010)
• Population = 83 160
• Tertiary education = 21,3%
• Total area, km2 = 24 453
• www.kainuu.fi
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Physical environment, question I
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Physical Environment, question II
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Physical Activity: Commuting Physical Activity (CPA)
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We examined CPA = over 30 minutes a day
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Results I: Physical Environment and CPA among MEN
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Dangerous intersection and/or traffic routes
Slippery footpaths in winter
Poorly lit traffic routes/road and paths
Vandalism, crime or threat of same
Traffic noise, smell or dust
Industrial noise, smell or dust
Long distances to services (e.g. shops)
Poor public transport
Litter (a lot of waste)
Unattractive housing district
Satisfied with the safety of the area/neighbourhood
Satisfied with neighbours
Satisfied with the location of the dwelling
0% 20% 40% 60% 80% 100%
No
Yes, but does not bother me
Bothers me
*
*
*
*
* = statistically significant difference between inactive and active commuting
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Results II: Physical Environment and CPA among WOMEN
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Dangerous intersection and/or traffic routes
Slippery footpaths in winter
Poorly lit traffic routes/road and paths
Vandalism, crime or threat of same
Traffic noise, smell or dust
Industrial noise, smell or dust
Long distances to services (e.g. shops)
Poor public transport
Litter (a lot of waste)
Unattractive housing district
Satisfied with the safety of the area/neighbourhood
Satisfied with neighbours
Satisfied with the location of the dwelling
0% 20% 40% 60% 80% 100%
No
Yes, but does not bother me
Bothers me
**
**
*
**
*
*
* = statistically significant difference between inactive and active commuting
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Results III: physical environment and CPA in Turku
Dangerous intersection and/or traffic routes
Slippery footpaths in winter
Poorly lit traffic routes/road and paths
Vandalism, crime or threat of same
Traffic noise, smell or dust
Industrial noise, smell or dust
Long distances to services (e.g. shops)
Poor public transport
Litter (a lot of waste)
Unattractive housing district
Satisfied with the safety of the area/neighbourhood
Satisfied with neighbours
Satisfied with the location of the dwelling
0% 20% 40% 60% 80% 100%
No
Yes, but does not bother me
Bothers me
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*
*
*
**
*
**
* = statistically significant difference between inactive and active commuting
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Results IV: Physical Environment and CPA in Regions of Kainuu
Dangerous intersection and/or traffic routes
Slippery footpaths in winter
Poorly lit traffic routes/road and paths
Vandalism, crime or threat of same
Traffic noise, smell or dust
Industrial noise, smell or dust
Long distances to services (e.g. shops)
Poor public transport
Litter (a lot of waste)
Unattractive housing district
Satisfied with the safety of the area/neighbourhood
Satisfied with neighbours
Satisfied with the location of the dwelling
0% 20% 40% 60% 80% 100%
No
Yes, but does not bother me
Bothers me
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All are statistically significant!)
Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Preliminary results suggests that
• Physical environment is associated with CPA among men and women
• Both genders: Good infrastructure, Enjoyable environment
• Women: safety, satisfaction of the location• Turku: Enjoyable environment, good
infrastructure, safety • Regions of Kainuu: Enjoyable environment
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Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Limitations:
• Age and education distributions differ between gender and areas, and this might explain some of the observed associations between physical environment and CPA
• Commuting physical activity include both cycling and walking
• Association different in cycling and walking?• Elderly prefer walking over cycling
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Nordic Behavioral Medicine Symposium / Tomi Mäkinen
Tack så mycket! Thank you! Kiitos!
• For the invitation to speak in the symposium!
• For the members of our research group: Heli Valkeinen, Esko Levälahti, Jukka Murto, Risto Kaikkonen, Susanna Raulio, Katja Borodulin and Ritva Prättälä
• For any further comments or interests, please don’t hesitate to contact by email:
Tomi Mäkinen, PhD (Public Health)
Senior researcher
Population Health Research Unit
National Institute for Health and Welfare
Helsinki, Finland
Phone: +358 20 610 8690
Email: tomi.makinen[at]thl.fi
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