Feelings of safety during daytime walking: associations with mental health, physical activity and cardiometabolic health in high vacancy, low-income neighborhoods in Detroit, Michigan.

INTRODUCTION: Individuals living in low-income neighborhoods have disproportionately high rates of obesity, Type-2 diabetes, and cardiometabolic conditions. Perceived safety in one's neighborhood may influence stress and physical activity, with cascading effects on cardiometabolic health. METHODS: In this study, we examined relationships among feelings of safety while walking during the day and mental health [perceived stress (PSS), depression score], moderate-to-vigorous physical activity (PA), Body Mass Index (BMI), and hemoglobin A1C (A1C) in low-income, high-vacancy neighborhoods in Detroit, Michigan. We recruited 69 adults who wore accelerometers for one week and completed a survey on demographics, mental health, and neighborhood perceptions. Anthropometrics were collected and A1C was measured using A1CNow test strips. We compiled spatial data on vacant buildings and lots across the city. We fitted conventional and multilevel regression models to predict each outcome, using perceived safety during daytime walking as the independent variable of interest and individual or both individual and neighborhood-level covariates (e.g., number of vacant lots). Last, we examined trends in neighborhood features according to perceived safety. RESULTS: In this predominantly African American sample (91%), 47% felt unsafe during daytime walking. Feelings of perceived safety significantly predicted PSS (ß = - 2.34, p = 0.017), depression scores (ß = - 4.22, p = 0.006), and BMI (ß = - 2.87, p = 0.01), after full adjustment. For PA, we detected a significant association for sex only. For A1C we detected significant associations with blighted lots near the home. Those feeling unsafe lived in neighborhoods with higher park area and number of blighted lots. CONCLUSION: Future research is needed to assess a critical pathway through which neighborhood features, including vacant or poor-quality green spaces, may affect obesity-via stress reduction and concomitant effects on cardiometabolic health.

Four recommendations to tackle the complex reality of transdisciplinary, natural experiment research.

Natural experiments are often used to study interventions in which randomization to control versus intervention conditions are impossible. Nature-based interventions (i.e., programs designed to increase human interaction with nature and improve human health) are commonly studied as natural experiments. We used a natural experiment design to explore the benefits of ecological rehabilitation of parks on biodiversity and resident health in low-income, minoritized neighborhoods in Detroit, MI. Given the complexities and interconnectedness of lived experiences, community needs, and ecological health, this research design has presented challenges. Based on our experiences, we pose four key recommendations for researchers and practitioners conducting natural experiments, nature-based interventions, and those working in low-income, minoritized neighborhoods. We use the explicit examples of challenges faced as rationale for these recommendations. The key recommendations are (1) Engage with community leaders; (2) Build a transdisciplinary team and work closely; (3) Examine privilege; and (4) Create a unified vision.