Active living environments, physical activity and premature cardiometabolic mortality in Canada: a nationwide cohort study. Issue 11 (20th November 2020)

• Record Type: Journal Article
• Authors: Mah, Sarah M; Sanmartin, Claudia; Riva, Mylène; Dasgupta, Kaberi; Ross, Nancy A
• Is Part Of: BMJ open. Volume 10:Issue 11(2020)
• Publication Date: 2020-11-20
• Subjects: public health -- epidemiology -- social medicine; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2019-035942
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: To evaluate sex-specific and age-specific associations of active living environments (ALEs) with premature cardiometabolic mortality. Design: Population-based retrospective cohort study. Setting: Residential neighbourhoods (1000-metre circular buffers from the centroids of dissemination areas) across Canada for which the Canadian ALE Measure was derived, based on intersection density, points of interest and dwelling density. Participants: 249 420 survey respondents from an individual-level record linkage between the Canadian Community Health Survey (2000–2010) and the Canadian Mortality Database until 2011, comprised of older women (65–85 years), older men (65–81 years), middle-aged women (45–64 years) and middle-aged men (45–64 years). Primary outcome measures: Premature cardiometabolic mortality and average daily energy expenditure attributable to walking. Multivariable proportional hazards regression models were adjusted for age, educational attainment, dissemination area-level median income, smoking status, obesity, the presence of chronic conditions, season of survey response and survey cycle. Results: Survey respondents contributed a total of 1 451 913 person-years. Greater walking was observed in more favourable ALEs. Walking was associated with lower cardiometabolic death in all groups except for middle-aged men. Favourable ALEs conferred a 22% reduction in death from cardiometabolic causes (HR 0.78, 95% CI 0.63 to 0.97) for older women. Conclusions: On average, people walk more in favourable ALEs, regardless of sex and age. With the exception of middle-aged men, walking is associated with lower premature cardiometabolic death. Older women living in neighbourhoods that favour active living live longer.