Regular physical activity fosters good physical and mental health.1 Described as “today’s best buy in public health,”2 one needs to accumulate only 30 minutes per day, 5 days per week, of moderately intense physical activity, such as brisk walking.3 For almost everyone, walking is a familiar activity performed in the conduct of normal daily activities. Nevertheless, only 25% to 30% of Americans report doing activities that meet current recommendations for physical activity, and 30% to 40% report no participation in physical activities away from their work.4,5 These data have not changed over at least the past decade.5
The availability6–8 and awareness9 of places conducive to physical activity are associated with higher levels of physical activity. To guide our efforts to promote regular physical activity, we used the Georgia Behavioral Risk Factor Surveillance System to determine (1) whether adult Georgians were aware of safe and convenient places for walking, (2) what places they most commonly envisioned, and (3) whether the proximity of those places was associated with self-reported physical activity behaviors.
METHODS
Data were collected via the Georgia Behavioral Risk Factor Surveillance System, a random-digit-dialed telephone survey of health-related behaviors of adults aged 18 years and older.10 The 2001 questionnaire (available at http://www.cdc.gov/brfss/pdf-ques/2001brfs.pdf) asked about the frequency and duration of both moderate and vigorous physical activity. Respondents were categorized as meeting current recommendations for activity or not (moderate activity for at least 30 minutes per day, 5 days per week, or vigorous activity for at least 20 minutes per day, 3 days per week).
In Georgia, we added questions about safe and convenient places to walk. Respondents were informed that they would be asked “about places where people can walk for exercise or recreation, such as trails, parks, sidewalks, and treadmills” and that the survey was concerned with “their convenience and safety for you, whether or not you actually use them.” Respondents were then asked, “Is there a place you could go where you would feel safe walking for exercise or recreation?” If they responded, “yes,” they were asked, “What is the most convenient place? Is it . . . ?,” and they were read the places listed in Table 1 ▶. If the place was their neighborhood or a home treadmill, we assumed that the respondent could walk to the place in less than 10 minutes. All others were asked, “How many minutes would it take to get there from your home?” and “How would you get there?” Three categories of convenience were created based on time and mode of travel to the place: (1) less than 10 minutes walking, (2) less than 10 minutes not walking, and (3) 10 minutes or greater regardless of mode.
TABLE 1—
Walking Places, by Time and Method to Reach Place: Georgia Behavioral Risk Factor Surveillance System, 2001
| Time and Method to Reach Place | ||||
| Walking Places | N | < 10 Min Walk % (95% CI) | < 10 Min Do Not Walk % (95% CI) | ≥ 10 Min All Methods % (95% CI) |
| No place to walk | 382 | NA | NA | NA |
| Some place to walk | 3949 | 47.1 (45.1, 49.1) | 21.1 (19.5, 22.8) | 31.8 (45.1, 49.1) |
| Not home based | 2472 | 16.2 (14.2, 18.2) | 33.5 (31.0, 36.0) | 50.3 (47.7, 52.8) |
| Public park | 1017 | 13.3 (10.5, 16.0) | 35.4 (31.5, 39.2) | 51.4 (47.4, 55.5) |
| School track | 416 | 10.7 (7.2, 14.2) | 43.0 (37.2, 48.9) | 46.1 (40.3, 52.0) |
| Gym or fitness center | 279 | 11.1 (5.5, 16.6) | 29.6 (22.2, 37.0) | 59.4 (51.5, 67.3) |
| Walking or jogging trail | 263 | 28.5 (21.5, 35.6) | 31.7 (24.9, 38.5) | 39.7 (32.7, 46.8) |
| Shopping mall | 120 | a | 21.5 (12.2, 30.9) | 72.0 (60.8, 83.1) |
| Other placeb | 377 | 30.6 (23.1, 38.1) | 25.0 (18.6, 31.4) | 44.2 (36.3, 52.2) |
| Home based | 1477 | 100.0c | 0c | 0c |
| Neighborhood streets or roads | 680 | 100.0c | 0c | 0c |
| Neighborhood sidewalk | 638 | 100.0c | 0c | 0c |
| Treadmill at home | 159 | 100.0c | 0c | 0c |
Note. % = percent weighted to Georgia population; CI = confidence interval; NA = not applicable, no walking place reported.
aNot calculated, < 10 respondents in cell.
bNo specific information was obtained about other place.
cAssumed to be 100% or 0%.
In 2001, 4532 persons responded to the survey. Responses were weighted to provide population-based estimates for Georgia. Data were analyzed with SUDAAN software to account for the complex survey design.11 Tests for linear trend across categories of convenience were done according to the method of Fisher and Yates.12
RESULTS
An estimated 91.8% (95% confidence interval [CI] = 90.8%, 92.8%) of Georgians had a place where they would feel safe walking for exercise or recreation. The most commonly reported place was neighborhood streets or sidewalks (32.0%; 95% CI = 30.2%, 33.8%), followed by public parks (26.8%; 95% CI = 25.0%, 28.6%), school track (10.2%; 95% CI = 9.1%, 11.4%), gym or fitness center (7.8%; 95% CI = 6.6%, 9.0%), walking or jogging trail (6.6%; 95% CI = 5.7%, 7.6%), treadmill at home (4.1%; 95% CI = 3.3%, 4.9%), or shopping mall (2.9%; 95% CI = 2.2%, 3.5%). Omitting those whose place was their neighborhood or treadmill at home, 49.7% (95% CI = 47.2%, 52.3%) reported that they could reach the place in less than 10 minutes; 75.9% (95% CI = 73.6%, 78.1%) reported that they would drive there, and 22.4% (95% CI = 20.2%, 24.6%) reported that they would walk.
Including persons whose place to walk was their neighborhood or home treadmill, 47.1% (95% CI = 45.1%, 49.1%) of persons could walk to their place in less than 10 minutes (Table 1 ▶). However, fewer than 15% of the persons whose place was a public park, school track, gym or fitness center, or shopping mall could walk to their place in less than 10 minutes.
Persons reporting a place to walk were significantly more likely to meet current recommendations for regular physical activity (41.5%; 95% CI = 39.4%, 43.6%) than were those reporting no place to walk (27.4%; 95% CI = 21.2%, 33.7%) (Table 2 ▶). There was a direct relation between the convenience of the walking place and the proportion of respondents meeting current activity recommendations. The trend across categories of convenience was significant for all places combined, places not home based, and public parks (Table 2 ▶). The same direct pattern was seen for other specified places, but the trend was not significant.
TABLE 2—
Percent Meeting Physical Activity Recommendations, by Walking Place and Time and Method to Reach Place: Georgia Behavioral Risk Factor Surveillance System, 2001
| Time and Method to Reach Place | |||||
| Walking Places | All Times All Methods % (95% CI) | < 10 Min Walk % (95% CI) | < 10 Min Do Not Walk % (95% CI) | ≥ 10 Min All Methods % (95% CI) | P for Trend |
| No place to walk | 27.4 (21.2, 33.7) | NA | NA | NA | |
| Some place to walk | 41.5 (39.4, 43.6) | 43.0 (40.1, 46.0) | 42.5 (37.9, 47.0) | 38.1 (34.3, 41.9) | .04 |
| Not home based | 41.6 (38.9, 44.3) | 49.4 (42.5, 56.3) | 42.5 (37.9, 47.0) | 38.1 (34.3, 41.9) | .005 |
| Public park | 39.6 (35.6, 43.6) | 51.8 (40.3, 63.4) | 39.2 (32.6. 45.7) | 36.7 (31.1, 42.3) | .02 |
| School track | 42.7 (36.5, 48.8) | 48.4 (30.2, 66.5) | 47.8 (38.3, 57.3) | 36.8 (28.1, 45.6) | .26 |
| Gym or fitness center | 45.3 (37.2, 53.4) | 52.7 (25.0, 80.5) | 54.2 (38.9, 69.5) | 37.4 (28.3, 46.4) | .30 |
| Walking or jogging trail | 45.1 (37.5, 52.7) | 51.6 (35.9, 67.2) | 45.0 (31.4, 58.5) | 40.2 (29.1, 51.3) | .24 |
| Shopping mall | 32.1 (21.0, 43.1) | a | 48.4 (22.4, 74.5) | 28.5 (16.8, 40.3) | |
| Other placeb | 43.4 (35.6, 51.1) | 46.1 (33.0, 59.1) | 27.5 (14.7, 40.4) | 49.4 (36.0, 62.7) | .73 |
| Home based | 41.3 (38.1, 44.6) | 41.3 (38.1, 44.6) | NA | NA | |
| Neighborhood streets or roads | 41.8 (37.0, 46.6) | 41.8 (37.0, 46.6) | NA | NA | |
| Neighborhood sidewalk | 41.3 (36.3, 46.3) | 41.3 (36.3, 46.3) | NA | NA | |
| Treadmill at home | 39.7 (29.8, 49.6) | 39.7 (29.8, 49.6) | NA | NA | |
Note. % = percentage weighted to Georgia population; CI = confidence interval; NA = not applicable, no respondents in cell.
aNot calculated, < 10 respondents in cell.
bNo specific information was obtained about other place.
DISCUSSION
Most adult Georgians can envision a safe and convenient place for walking. In addition, a direct relation exists between the convenience of the place and meeting activity recommendations. Those able to walk to the place in less than 10 minutes are most likely to be active. These data support previous reports6–8 indicating the value of convenient places for activity. Our findings provide specificity to that knowledge by confirming the association between awareness of places and physical activity practices,9 noting that neighborhood streets and sidewalks and public parks are the most commonly reported safe and convenient places for walking,8 noting the association between self-reported convenience (time and method of getting to place) and physical activity, and suggesting that the association holds for most places included in the survey.
Our conclusions might be strengthened if we had evidence that the respondents actually used the place they envisioned for walking. However, the questions we asked were simple, have construct validity, and, based on their association with self-reported behaviors, have predictive validity. It is programmatically helpful to know that most Georgians can envision and identify a safe and convenient place to walk.
The data suggest that proximity is an important factor in the identification of a safe and convenient place to walk. The most commonly mentioned place was the respondent’s neighborhood. Public parks were the next most commonly mentioned place. Efforts to design new and to retrofit old neighborhoods with sidewalks and streets that make them easily walkable and the development of nearby park space would appeal to residents and be beneficial from a public health perspective.
Acknowledgments
The Georgia Behavioral Risk Factor Surveillance System is supported in part through Centers for Disease Control and Prevention Cooperative Agreement U58/CCU400591.
Human Participant Protection The Georgia Behavioral Risk Factor Surveillance System was determined to be exempt from institutional review board review.
Contributors K. E. Powell and L. M. Martin recognized the opportunity to obtain helpful programmatic information and designed the questions. L. M. Martin and P. P. Chowdhury analyzed the data. K. E. Powell drafted the article that was revised by all 3 authors.
Peer Reviewed
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