An international comparative study of active living environments and hospitalization for Wales and Canada
Rationale: Previous studies indicate active living environments (ALEs) are associated with higher physical activity levels across different geographic contexts, and could lead to reductions in hospital burden. Both Wales UK and Canada have advanced data infrastructure that allows record linkage betw...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | SSM: Population Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827322000271 |
| _version_ | 1818219115122262016 |
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| author | Sarah M. Mah Kaberi Dasgupta Ashley Akbari Nancy A. Ross Richard Fry |
| author_facet | Sarah M. Mah Kaberi Dasgupta Ashley Akbari Nancy A. Ross Richard Fry |
| author_sort | Sarah M. Mah |
| collection | DOAJ |
| description | Rationale: Previous studies indicate active living environments (ALEs) are associated with higher physical activity levels across different geographic contexts, and could lead to reductions in hospital burden. Both Wales UK and Canada have advanced data infrastructure that allows record linkage between survey data and administrative health information. Objective: To assess the relationship between ALEs and hospitalization in Wales and Canada. Methods: We performed a population-based comparison using individual-level survey data from the Welsh Health Survey (N = 9968) linked to the Patient Episode Database for Wales, and the Canadian Community Health Survey (N = 40,335) linked to the Discharge Abstract Database. Using equivalent protocols and open-source data for street networks, destinations, and residential density, we derived 5-class measures of the ALE for Wales and Canada (classed 1 through 5, considered least favourable to most favourable for active living, respectively). We evaluated relationships of ALEs to health, behaviours and hospitalization using multivariate regression (reference group was the lowest ALE class 1, considered least favourable for active living). Results: For Canada, those living in the highest ALE class 5 had lower odds of all-cause hospitalization (OR 0.66, 95% CI 0.54 to 0.81; as compared to the lowest ALE class 1). In contrast, those living in the highest ALE class 5 in Wales had higher odds of all-cause hospitalization (OR 1.37, 95% CI 1.04 to 1.80). The relationship between ALEs and cardiometabolic hospitalization was inconclusive for Canada (OR 0.75, 95% CI 0.50 to 1.12), but we observed higher odds of cardiometabolic hospitalization for respondents living in higher ALE classes for Wales (OR 1.46, 95% CI 1.10 to 1.78; comparing ALE class 4 to ALE class 1). Conclusion: Canadian respondents living in high ALE neighbourhoods that are understood to be favourable for active living had lower odds of all-cause hospitalization, whereas Welsh respondents living in high ALEs that were deemed favourable for active living exhibited higher odds of all-cause hospitalization. Environments which promote physical activity in one geographic context may not do so in another. There remains a need to identify relevant context-specific factors that encourage active living. |
| first_indexed | 2024-12-12T07:34:31Z |
| format | Article |
| id | doaj.art-df788895e2fd4ae392a51803d4118062 |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-12-12T07:34:31Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-df788895e2fd4ae392a51803d41180622022-12-22T00:32:57ZengElsevierSSM: Population Health2352-82732022-06-0118101048An international comparative study of active living environments and hospitalization for Wales and CanadaSarah M. Mah0Kaberi Dasgupta1Ashley Akbari2Nancy A. Ross3Richard Fry4Department of Geography, McGill University, 705-805 Sherbrooke Street West, Montreal, Quebec, H3A 0B9, Canada; Dalla Lana School of Public Health, University of Toronto, Health Sciences Building 155 College Street, 6th Floor Toronto, ON M5T 3M7, CanadaDivisions of Internal Medicine, Divisions of Clinical Epidemiology, Divisions of Endocrinology and Metabolism. McGill University Health Centre, 1001 Decarie Boulevard, D02.3312, Montreal, Quebec, H4A 3J1, CanadaPopulation Data Science, Swansea University Medical School, Swansea, UKDepartment of Geography, McGill University, 705-805 Sherbrooke Street West, Montreal, Quebec, H3A 0B9, Canada; Department of Public Health Sciences, School of Medicine, Queen's University, Carruthers Hall, 62 Fifth Field Company Lane, Kingston, ON, K7L 3N6, CanadaPopulation Data Science, Swansea University Medical School, Swansea, UK; Corresponding author. Data Science Building, Swansea University Singleton Campus, UK.Rationale: Previous studies indicate active living environments (ALEs) are associated with higher physical activity levels across different geographic contexts, and could lead to reductions in hospital burden. Both Wales UK and Canada have advanced data infrastructure that allows record linkage between survey data and administrative health information. Objective: To assess the relationship between ALEs and hospitalization in Wales and Canada. Methods: We performed a population-based comparison using individual-level survey data from the Welsh Health Survey (N = 9968) linked to the Patient Episode Database for Wales, and the Canadian Community Health Survey (N = 40,335) linked to the Discharge Abstract Database. Using equivalent protocols and open-source data for street networks, destinations, and residential density, we derived 5-class measures of the ALE for Wales and Canada (classed 1 through 5, considered least favourable to most favourable for active living, respectively). We evaluated relationships of ALEs to health, behaviours and hospitalization using multivariate regression (reference group was the lowest ALE class 1, considered least favourable for active living). Results: For Canada, those living in the highest ALE class 5 had lower odds of all-cause hospitalization (OR 0.66, 95% CI 0.54 to 0.81; as compared to the lowest ALE class 1). In contrast, those living in the highest ALE class 5 in Wales had higher odds of all-cause hospitalization (OR 1.37, 95% CI 1.04 to 1.80). The relationship between ALEs and cardiometabolic hospitalization was inconclusive for Canada (OR 0.75, 95% CI 0.50 to 1.12), but we observed higher odds of cardiometabolic hospitalization for respondents living in higher ALE classes for Wales (OR 1.46, 95% CI 1.10 to 1.78; comparing ALE class 4 to ALE class 1). Conclusion: Canadian respondents living in high ALE neighbourhoods that are understood to be favourable for active living had lower odds of all-cause hospitalization, whereas Welsh respondents living in high ALEs that were deemed favourable for active living exhibited higher odds of all-cause hospitalization. Environments which promote physical activity in one geographic context may not do so in another. There remains a need to identify relevant context-specific factors that encourage active living.http://www.sciencedirect.com/science/article/pii/S2352827322000271Population healthLinked DataBuilt environmentWalkabilityCanadaWales UK |
| spellingShingle | Sarah M. Mah Kaberi Dasgupta Ashley Akbari Nancy A. Ross Richard Fry An international comparative study of active living environments and hospitalization for Wales and Canada SSM: Population Health Population health Linked Data Built environment Walkability Canada Wales UK |
| title | An international comparative study of active living environments and hospitalization for Wales and Canada |
| title_full | An international comparative study of active living environments and hospitalization for Wales and Canada |
| title_fullStr | An international comparative study of active living environments and hospitalization for Wales and Canada |
| title_full_unstemmed | An international comparative study of active living environments and hospitalization for Wales and Canada |
| title_short | An international comparative study of active living environments and hospitalization for Wales and Canada |
| title_sort | international comparative study of active living environments and hospitalization for wales and canada |
| topic | Population health Linked Data Built environment Walkability Canada Wales UK |
| url | http://www.sciencedirect.com/science/article/pii/S2352827322000271 |
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