Street Connectivity as a Determinant of Health in Canadian Youth
Mecredy, Graham C.
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Background: Street connectivity, an important aspect of the built environment, refers to the directness of links and the density of connections in road networks. Street connectivity of youth’s neighborhoods may impact upon both physical activity patterns and the occurrence of physical activity injuries in street locations. Objectives: The objectives of the two studies comprising this thesis were to examine, among Canadian youth in grades 6 to 10: (1) the relationship between street connectivity and physical activity, and (2) the relationship between street connectivity and physical activity injuries occurring in the street. Methods: 9,717 youth in grades 6-10 from 188 schools across Canada participated in the 2006 Health Behaviour in School-aged Children (HBSC) survey. A street connectivity composite measure was gathered objectively using a geographic information system database, and was based on intersection density, average block length, and connected node ratio in a 5km radius around each school. Physical activity was measured via students’ self-reported hours of moderate-to-vigorous physical activity per week outside of school hours. Injury was measured via students’ self-reports to questions regarding whether they had suffered an injury while playing in the street in the past 12 months. Multi-level regression analyses were used to examine the relations between street connectivity and both physical activity and injury. Results: Compared to students living in the highest street connectivity quartile, those in the second (Relative Risk (RR) 1.22; 95% confidence interval (CI) 1.10-1.35), third (RR 1.25; 95% CI 1.13-1.37), and fourth (lowest; RR 1.21; 95% CI 1.09-1.34) quartiles reported considerably higher levels of physical activity outside of school hours. Conversely, students living in neighbourhoods with low street connectivity reported higher occurrence of physical activity injuries occurring in the street relative to students living in highly connected neighbourhoods (Odds Ratio (OR) 1.47; 95% CI 0.94 -2.31). Conclusions: Neighbourhoods with low street connectivity may be conducive to youth physical activity, yet they may also result in an increased risk of injury. Further, the relationship between street connectivity and physical activity reported in Canadian youth is not consistent with the relationship reported for adult populations. This variation requires consideration in applied health policy.