Background
Methods
Sampling and data collection
Measures
Analyses
Results
Descriptive statistics
Demographics
| Total sample N = 48879 | Urban N = 15444 | Semi-urban N = 17996 | Rural N = 15439 |
---|---|---|---|---|
age (years) | 74.4 ± 6.7 | 74.5 ± 6.8 | 74.3 ± 6.6 | 74.3 ± 6.6 |
% female | 55.7 | 56.7 | 55.3 | 55.2 |
% higher education | 9.6 | 12.9 | 8.8 | 7.4 |
number of limitations | 2.5 ± 2.6 | 2.5 ± 2.5 | 2.5 ± 2.6 | 2.6 ± 2.6 |
Municipalities' characteristics
| ||||
residential density (inh./km2) | 577.0 ± 508.5 | 1112.6 ± 604.9 | 420.4 ± 86.9 | 223.7 ± 59.7 |
mean annual income (euro) | 16438.6 ± 1728.8 | 17138.2 ± 1795.1 | 16468.6 ± 1718.5 | 15703.9 ± 1328.7 |
Walking/cycling behavior
| ||||
% daily walking for transportation | 35.9 | 40.9 | 34.4 | 32.4 |
% daily cycling for transportation | 23.7 | 20.6 | 25.7 | 24.5 |
% weekly walking or cycling for recreation | 53.8 | 54.3 | 54 | 52.9 |
Environmental factors | Total sample | Urban | Semi-urban | Rural | < 75 years | ≥ 75 years | Males | Females |
---|---|---|---|---|---|---|---|---|
Access to services
| ||||||||
Short distances to services (/5)1
| 3.9 ± 1.4 | 4.0 ± 1.4 | 3.9 ± 1.4 | 3.8 ± 1.5 | 4.0 ± 1.4 | 3.8 ± 1.5 | 4.0 ± 1.4 | 3.8 ± 1.5 |
Number of shops (/13) | 9.7 ± 3.7 | 9.9 ± 3.5 | 9.5 ± 3.8 | 9.6 ± 3.8 | 9.8 ± 3.7 | 9.5 ± 3.7 | 9.7 ± 3.7 | 9.6 ± 3.7 |
Public transport (/5) | 3.6 ± 1.1 | 3.8 ± 1.1 | 3.5 ± 1.1 | 3.4 ± 1.2 | 3.6 ± 1.1 | 3.6 ± 1.1 | 3.6 ± 1.1 | 3.5 ± 1.1 |
Walking facilities
| ||||||||
Presence of public toilets (%)2
| 57.5 | 55.0 | 57.9 | 59.7 | 56.7 | 58.6 | 56.0 | 58.7 |
Presence of benches (%) | 61.0 | 62.5 | 60.2 | 60.6 | 61.4 | 60.6 | 61.2 | 60.7 |
Presence of crossings (%) | 74.7 | 77.4 | 73.6 | 73.1 | 75.3 | 74.0 | 75.4 | 74.1 |
Condition of sidewalks (/5) | 2.9 ± 1.3 | 2.7 ± 1.3 | 2.9 ± 1.2 | 3.0 ± 1.2 | 2.9 ± 1.2 | 2.9 ± 1.3 | 2.9 ± 1.2 | 2.8 ± 1.3 |
Absence of high ramps (/5) | 4.6 ± 1.0 | 4.6 ± 1.0 | 4.6 ± 1.0 | 4.5 ± 1.0 | 4.6 ± 1.0 | 4.5 ± 1.0 | 4.6 ± 1.0 | 4.5 ± 1.0 |
Safety
| ||||||||
Traffic safety (%) | 67.9 | 67.3 | 67.9 | 68.7 | 69.7 | 65.7 | 70.7 | 65.6 |
Feelings of unsafety (/8) | 3.5 ± 1.1 | 3.6 ± 1.1 | 3.4 ± 1.1 | 3.4 ± 1.1 | 3.4 ± 1.0 | 3.5 ± 1.1 | 3.3 ± 1.0 | 3.6 ± 1.1 |
Street lighting (%) | 81.4 | 83.9 | 80.6 | 79.8 | 81.8 | 80.9 | 81.7 | 81.2 |
Aesthetics
| ||||||||
Absence of decay (%) | 92.9 | 90.7 | 93.5 | 94.6 | 92.4 | 93.6 | 92.8 | 93.1 |
Absence of noise (%) | 80.9 | 78.7 | 80.9 | 83.2 | 80.1 | 81.9 | 80.1 | 81.6 |
Greenery (/5) | 3.7 ± 1.0 | 3.7 ± 1.1 | 3.6 ± 1.0 | 3.7 ± 1.0 | 3.7 ± 1.0 | 3.6 ± 1.0 | 3.7 ± 1.0 | 3.6 ± 1.0 |
Objective data
| ||||||||
Public transportation subscriptions (% of older adults) | 0.7 ± 0.6 | 1.0 ± 0.8 | 0.6 ± 0.4 | 0.6 ± 0.3 | / | / | / | / |
Analyses in the total sample
Relationships between area of residence and walking and cycling behaviors
Daily walking for transportation | Daily cycling for transportation | Weekly walking or cycling for recreation | |
---|---|---|---|
Age
| 1.04 (0.99, 1.09) | 0.60 (0.57, 0.64)* | 0.63 (0.60, 0.67)* |
Gender
1
| 0.79 (0.76, 0.83)* | 0.69 (0.66, 0.73)* | 0.75 (0.71, 0.78)* |
Education
2
| 1.11 (1.03, 1.19)* | 0.68 (0.63, 0.75)* | 1.05 (0.98, 1.14) |
Number of functional limitations
| 0.85 (0.85, 0.86)* | 0.81 (0.80, 0.82)* | 0.77 (0.76, 0.78)* |
Area of residence:
| |||
semi-urban
3
| 1.09 (0.96, 1.25) | 1.08 (0.81, 1.44) | 1.05 (0.90, 1.22) |
urban
3
| 1.43 (1.22, 1.67)* | 0.81 (0.54, 1.21) | 1.11 (0.94, 1.31) |
urban
4
| 1.32 (1.13, 1.54)* | 0.72 (0.56, 0.92)* | 1.04 (0.88, 1.22) |
Daily walking for transportation
Daily cycling for transportation
Weekly walking/cycling for recreation
Main effects of environmental factors in total sample
PA domain | Environmental factors | Main effect (OR, 95%C.I.)1
|
---|---|---|
Walking for transportation
| Short distances to services | 1.19 (1.17, 1.21)* |
Public transport | 1.13 (1.11, 1.16)* | |
Quality of sidewalks | 0.94 (0.92, 0.96)* | |
Absence of high ramps | 1.01 (0.99, 1.03) | |
Feelings of unsafety | 0.93 (0.91, 0.95)* | |
Greenery | 1.01 (0.99, 1.04) | |
Cycling for transportation
| Number of shops | 1.03 (1.02, 1.04)* |
Public transport | 1.08 (1.05, 1.11)* | |
Greenery | 1.01 (0.98, 1.04) | |
Walking/cycling for recreation
| Number of shops | 1.02 (1.01, 1.03)* |
Feelings of unsafety | 0.95 (0.92, 0.97)* |
Daily walking for transportation
Daily cycling for transportation
Weekly walking/cycling for recreation
Analyses in subgroups
Main effects for environmental factors with significant 3rd order interaction effects
Environmental factors | Interaction effect (β, SE) | Main effect in subgroups (OR, 95%C.I.)1
| ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Environmental factor * urbanization * age * gender | Rural | Semi-urban | Urban | |||||||||||
< 75 | ≥ 75 | < 75 | ≥ 75 | < 75 | ≥ 75 | |||||||||
Males | Females | Males | Females | Males | Females | Males | Females | Males | Females | Males | Females | |||
Cycling for transportation
| Absence of decay | 0.33 (0.14) | 0.91 (0.66, 1.24) | 1.43 (0.94, 2.18) | 0.78 (0.47, 1.30) | 0.64 (0.37, 1.11) | 1.26 (0.91, 1.74) | 1.16 (0.84, 1.59) | 0.75 (0.49, 1.15) | 0.96 (0.66, 1.41) | 0.73 (0.57, 0.94)* | 1.17 (0.85, 1.61) | 1.13 (0.73, 1.75) | 1.00 (0.53, 1.89) |
Absence of noise | 0.37 (0.15) | 1.13 (0.93, 1.38) | 1.27 (1.01, 1.59)* | 1.03 (0.76, 1.40) | 0.85 (0.58, 1.25) | 1.04 (0.87, 1.24) | 1.14 (0.92, 1.41) | 0.81 (0.61, 1.07) | 0.87 (0.64, 1.20) | 0.78 (0.64, 0.94)* | 1.13 (0.92, 1.40) | 1.17 (0.86, 1.61) | 0.73 (0.50, 1.07) | |
Public transportation subscriptions | -1.10 (0.34) | 1.43 (0.74, 2.78) | 1.73 (0.81, 3.70) | 1.40 (0.70, 2.78) | 2.07 (0.99, 4.34) | 1.49 (0.92, 2.40) | 1.26 (0.76, 2.08) | 1.29 (0.78, 2.13) | 1.41 (0.76, 2.60) | 0.83 (0.52, 1.35) | 1.04 (0.54, 2.02) | 0.91 (0.55, 1.48) | 0.73 (0.46, 1.15) | |
Walking/cycling for recreation
| Presence of public toilets | 0.38 (0.17) | 0.95 (0.81, 1.11) | 0.99 (0.84, 1.16) | 1.14 (0.93, 1.39) | 0.84 (0.70, 1.01) | 1.05 (0.90, 1.21) | 0.99 (0.86, 1.15) | 0.88 (0.73, 1.06) | 0.84 (0.71, 1.00)* | 0.93 (0.79, 1.10) | 0.90 (0.77, 1.05) | 0.88 (0.72, 1.08) | 0.89 (0.75, 1.06) |
Greenery | -0.30 (0.15) | 1.04 (0.95, 1.13) | 0.97 (0.88, 1.07) | 0.93 (0.82, 1.05) | 1.04 (0.93, 1.17) | 1.06 (0.97, 1.15) | 1.05 (0.97, 1.15) | 1.04 (0.93, 1.17) | 1.07 (0.97, 1.18) | 1.01 (0.92, 1.10) | 1.05 (0.96, 1.15) | 0.96 (0.86, 1.07) | 0.90 (0.81, 0.99)* |
Cycling for transportation
Weekly walking/cycling for recreation
Main effects for environmental factors with significant 2nd order interaction effects
PA domain | Environmental factors | Interaction effect (β, SE) | Main effect in subgroups (OR, 95%C.I.)1
| |||||
---|---|---|---|---|---|---|---|---|
Environmental factor * urbanization * age
| Rural | Semi-urban | Urban | |||||
< 75
|
≥ 75
|
< 75
|
≥ 75
|
< 75
|
≥ 75
| |||
Walking for transportation
| Number of shops | 0.04 (0.02) | 1.02 (1.01, 1.04)* | 1.01 (0.99, 1.02) | 1.05 (1.04, 1.07)* | 1.04 (1.02, 1.05)* | 1.03 (1.01, 1.04)* | 1.05 (1.04, 1.07)* |
Public transportation subscriptions | 0.49 (0.17) | 1.00 (0.75, 1.32) | 0.79 (0.58, 1.07) | 0.79 (0.56, 1.13) | 0.85 (0.63, 1.15) | 1.36 (1.13, 1.62)* | 1.39 (1.12, 1.73)* | |
Walking/cycling for recreation
| Short distances to services | -0.14 (0.06) | 1.07 (1.03, 1.11)* | 1.12 (1.07, 1.17)* | 1.12 (1.08, 1.16)* | 1.06 (1.02, 1.11)* | 1.04 (1.00, 1.09)* | 1.02 (0.97, 1.06) |
% public transportation subscriptions | 0.67 (0.21) | 1.37 (0.90, 2.07) | 0.91 (0.59, 1.40) | 1.34 (0.88, 2.05) | 1.18 (0.86, 1.63) | 0.92 (0.77, 1.11) | 1.13 (0.91, 1.39) | |
Environmental factor * urbanization * gender
|
Rural
|
Semi-urban
|
Urban
| |||||
Males
|
Females
|
Males
|
Females
|
Males
|
Females
| |||
Cycling for transportation
| Presence of public toilets | -0.27 (0.11) | 1.07 (0.93, 1.23) | 1.00 (0.87, 1.16) | 1.09 (0.97, 1.23) | 0.98 (0.87, 1.11) | 0.98 (0.86, 1.12) | 0.86 (0.74, 1.00) |
Presence of benches | -0.25 (0.11) | 1.02 (0.89, 1.17) | 1.21 (1.04, 1.41)* | 1.09 (0.97, 1.24) | 0.93 (0.82, 1.06) | 1.06 (0.92, 1.23) | 1.01 (0.86, 1.19) | |
Presence of street lighting | -0.28 (0.10) | 0.85 (0.73, 1.00) | 1.31 (1.07, 1.60)* | 0.89 (0.76, 1.04) | 0.97 (0.83, 1.14) | 1.16 (0.95, 1.41) | 1.00 (0.82, 1.23) | |
Walking/cycling for recreation
| Public transport | 0.15 (0.08) | 1.09 (1.02, 1.16)* | 1.05 (1.00, 1.12) | 1.11(1.05, 1.18)* | 1.12 (1.06, 1.18)* | 1.07 (1.00, 1.14)* | 1.09 (1.02, 1.15)* |
Presence of crossings | -0.17 (0.08) | 0.94 (0.82, 1.07) | 1.00 (0.88, 1.13) | 1.03 (0.90, 1.18) | 0.95 (0.84, 1.07) | 1.05 (0.90, 1.21) | 0.98 (0.85, 1.13) | |
Environmental factor * age * gender
|
< 75
|
≥ 75
| ||||||
Males
|
Females
|
Males
|
Females
| |||||
Walking for transportation
| Absence of decay | -0.21 (0.10) | 0.71 (0.61, 0.83)* | 0.70 (0.61, 0.81)* | 0.74 (0.59, 0.92)* | 0.82 (0.67, 1.00) | ||
Absence of noise | -0.23 (0.11) | 0.87 (0.79, 0.97)* | 0.73 (0.66, 0.81)* | 0.81 (0.71, 0.93)* | 0.77 (0.68, 0.87)* | |||
Cycling for transportation
| Presence of public toilets | -0.79 (0.15) | 1.06 (0.97, 1.16) | 0.93 (0.84, 1.03) | 1.04 (0.91, 1.18) | 1.00 (0.86, 1.16) | ||
Presence of benches | -0.73 (0.13) | 1.10 (1.00, 1.20) | 1.05 (0.95, 1.16) | 0.96 (0.84, 1.10) | 1.01 (0.87, 1.18) | |||
Presence of crossings | -0.81 (0.14) | 1.03 (0.93, 1.14) | 1.00 (0.89, 1.12) | 1.08 (0.93, 1.25) | 0.96 (0.81, 1.13) | |||
Traffic safety | -0.76 (0.11) | 0.77(0.70, 0.85)* | 0.84 (0.76, 0.94)* | 0.79 (0.69, 0.90)* | 0.74 (0.64, 0.86)* | |||
Presence of street lighting | -0.79 (0.12) | 1.00 (0.88, 1.12) | 1.16 (1.03, 1.30)* | 0.87 (0.74, 1.03) | 0.92 (0.76, 1.11) | |||
Walking/cycling for recreation
| Presence of benches | -0.38 (0.10) | 1.01 (0.92, 1.12) | 1.02 (0.93, 1.12) | 1.00 (0.89, 1.13) | 0.89 (0.81, 0.99)* | ||
Presence of crossings | -0.44 (0.09) | 1.05 (0.94, 1.16) | 1.03 (0.93, 1.14) | 0.97 (0.84, 1.12) | 0.90 (0.81, 1.00) | |||
Traffic safety | -0.54 (0.11) | 0.84 (0.76, 0.92)* | 0.86 (0.79, 0.95)* | 0.86 (0.77, 0.97)* | 0.67 (0.61, 0.74)* | |||
Presence of street lighting | -0.34 (0.10) | 1.00 (0.90, 1.11) | 1.19 (1.05, 1.35)* | 0.93 (0.80, 1.07) | 1.00 (0.88, 1.14) | |||
Absence of decay | -0.41 (0.10) | 1.07 (0.91, 1.26) | 0.85 (0.71, 1.01) | 0.72 (0.58, 0.90)* | 0.79 (0.65, 0.95)* | |||
Absence of noise | -0.39 (0.10) | 1.02 (0.93, 1.13) | 0.95 (0.85, 1.06) | 0.85 (0.75, 0.97)* | 0.86 (0.76, 0.98)* |
Walking for transportation
Cycling for transportation
Weekly walking/cycling for recreation
Main effects for environmental factors with significant 1st order interaction effects
PA domain | Environmental factors | Interaction effect (β, SE) | Main effect in subgroups (OR, 95%C.I.)1
| ||
---|---|---|---|---|---|
Environmental factor * urbanization
| Rural | Semi-urban | Urban | ||
Walking for transportation
| Presence of crossings | 0.28 (0.08) | 0.86 (0.78, 0.94)* | 1.11 (1.03, 1.21)* | 1.03 (0.93, 1.13) |
Environmental factor * age
|
< 75 years
|
≥ 75 years
| |||
Walking for transportation
| Presence of public toilets | 0.17 (0.08) | 0.80 (0.75, 0.85)* | 0.83 (0.77, 0.89)* | |
Presence of benches | 0.18 (0.08) | 0.98 (0.92, 1.04) | 0.99 (0.92, 1.07) | ||
Presence of crossings | 0.17 (0.08) | 0.98 (0.92, 1.05) | 1.03 (0.94, 1.12) | ||
Presence of street lighting | 0.20 (0.09) | 1.08 (1.00, 1.16)* | 1.10 (1.01, 1.21)* | ||
Environmental factor * gender
|
Males
|
Females
| |||
Walking for transportation
| Traffic safety | 0.19 (0.09) | 0.83 (0.77, 0.89)* | 0.89 (0.83, 0.95)* | |
Presence of street lighting | 0.17 (0.07) | 1.03 (0.95, 1.12) | 1.14 (1.05, 1.24)* | ||
Cycling for transportation
| Short distances to services | 0.10 (0.04) | 1.08 (1.05, 1.11)* | 1.14 (1.11, 1.18)* | |
Feelings of unsafety | -0.11 (0.05) | 0.97 (0.93, 1.01) | 0.94 (0.90, 0.98)* |