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标题：Area-Level Social Fragmentation and Walking for Exercise: Cross-Sectional Findings From the Quebec Adipose and Lifestyle Investigation in Youth Study
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作者：Roman Pabayo ; Tracie A. Barnett ; Geetanjali D. Datta 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：102
期号：9
页码：e30-e37
DOI：10.2105/AJPH.2012.300868
语种：English
出版社：American Public Health Association
摘要：Objectives. We determined whether social fragmentation, which is linked to the concept of anomie (or normlessness), was associated with a decreased likelihood of willingness to walk for exercise. Methods. Data were collected from mothers and fathers of 630 families participating in the Quebec Adipose and Lifestyle Investigation in Youth Cohort, an ongoing longitudinal study investigating the natural history of obesity and insulin resistance in children. Social fragmentation was defined as the breakdown of social bonds between individuals and their communities. We used log-binomial multiple regression models to estimate the association between social fragmentation and walking for exercise. Results. Higher social fragmentation was associated with a decreased likelihood of walking for exercise among women but not men. Compared with women living in neighborhoods with the lowest social fragmentation scores (first quartile), those living in neighborhoods in the second (relative risk [RR] = 0.91; 95% confidence interval [CI] = 0.78, 1.05), third (RR = 0.83; 95% CI = 0.70, 1.00), and fourth (RR = 0.80; 95% CI = 0.65, 0.99) quartiles were less likely to walk for exercise ( P = .02). Conclusions. Social fragmentation is associated with reduced walking among women. Increasing neighborhood stability may increase walking behavior, especially among women. Features of the social and physical environment influence physical activity behavior over and above individual characteristics. 1–4 More specifically, features of the built environment—such as greater density of destinations, 5–8 population density, 5,6,9,10 greater street connectivity, 9,11,12 access to transit, 10,13 and mixed land use in residential neighborhoods 6,9,10,14,15 —are associated with greater frequency and duration of walking. A meta-analysis of studies identified job–housing balance and intersection density as being associated with the decision to walk. 13 Conversely, lack of neighborhood safety was associated with a decreased likelihood of walking. 8,14,16–27 However, the built environment represents only 1 dimension of the neighborhood environment that promotes or hinders walking. Conceptually, neighborhood environments consist of not only physical dimensions (walkability) but also social (interactions between neighbors) and service (access to physical activity amenities and resources) dimensions. Although these 3 dimensions tend to cluster by neighborhood socioeconomic level, they have different implications for interventions. For example, even if an intervention such as installing sidewalks to increase walking was implemented, it might not promote walking if other elements, such as crime rate, remain high. In this study, we focused on whether social fragmentation, an indicator of the social environment, relates to walking for exercise. Social fragmentation is linked to the concept of anomie, which Durkheim defined as a state of normlessness, 28 or the breakdown of social bonds between individuals and their communities, with fragmentation of social identity and rejection of self-regulatory values. 28 Researchers have used census variables to describe specific social conditions, such as using the proportion of residents moving out of a residential area within the past 5 years to describe stability. Rather than being a proxy for poverty, these variables relate to rapid population turnover, single-person households, and rented tenancy (which is thought to be associated with greater residential instability). Building on work by Congdon, 29 researchers have used census indicators such as proportion of residents living in the same area within the past 5 years, proportion of residents who are foreign born; proportion of owner-occupied houses, proportion of single-person households, proportion of unmarried people, and fewer school-aged children 30–35 to develop a social fragmentation index. Although researchers have identified social fragmentation as a risk factor for suicide and poor mental health, 31–33 only 1 previous study has been conducted in the United States that examined the relationship between social fragmentation and physical activity among adolescents. 32 In theory, social fragmentation might be linked to physical activity by its association with neighborhood crime rate. That is, high social fragmentation may lead to a higher rate of crime, which may then lead to a low rate of walking. Alternatively, residents in a socially fragmented neighborhood may not have the social ties or exposure to norms that support regular physical activity. In this study, we investigated the relationship between social fragmentation and the willingness to walk for exercise among mothers and fathers of children who responded to a baseline questionnaire in a cohort study conducted in Quebec, Canada. We tested the hypothesis that high social fragmentation is associated with a decreased likelihood of willingness to walk for exercise.