International evaluation of the Microscale Audit of Pedestrian Streetscapes (MAPS) Global instrument: comparative assessment between local and remote online observers.

OBJECTIVES: The use of online imagery by non-local observers to conduct remote, centralized collection of streetscape audit data in international studies has the potential to enhance efficiency of collection and comparability of such data for research on built environments and health. The objectives of the study were to measure (1) the consistency in responses between local in-field observers and non-local remote online observers and (2) the reliability between in-country online observers and non-local remote online observers using the Microscale Audit of Pedestrian Streetscapes Global tool to characterize pedestrian-related features along streets in five countries. METHODS: Consistency and inter-rater reliability were analyzed between local and non-local observers on a pooled database of 200 routes in five study regions (Melbourne, Australia; Ghent, Belgium; Curitiba, Brazil; Hong Kong, China; and Valencia, Spain) for microscale environmental feature subscales and item-level variables using the intraclass correlation coefficient (ICC). RESULTS: A local in-field versus remote online comparison had an ICC of 0.75 (95 % CI: 0.68-0.80) for the grand total score. An ICC of 0.91 (95 % CI: 0.88-0.93) was found for the local online versus remote online comparison. Positive subscales yielded stronger results in comparison to negative subscales, except for the similarly poor-performing positive aesthetics/social characteristics. CONCLUSIONS: This study demonstrated remote audits of microscale built environments using online imagery had good reliability with local in-field audits and excellent reliability with local online audits. Results generally supported remote online environmental audits as comparable to local online audits. This identification of low-cost and efficient data acquisition methods is important for expanding research on microscale built environments and physical activity globally.

Associations of built environment and proximity of food outlets with weight status: Analysis from 14 cities in 10 countries.

The study aimed to examine associations of neighborhood built environments and proximity of food outlets (BE measures) with body weight status using pooled data from an international study (IPEN Adult). Objective BE measures were calculated using geographic information systems for 10,008 participants (4463 male, 45%) aged 16-66 years in 14 cities. Participants self-reported proximity to three types of food outlets. Outcomes were body mass index (BMI) and overweight/obesity status. Male and female weight status associations with BE measures were estimated by generalized additive mixed models. Proportion (95% CI) of overweight (BMI 25 to <30) ranged from 16.6% (13.1, 19.8) to 41.1% (37.3, 44.7), and obesity (BMI ≥ 30) from 2.9% (1.3, 4.4) to 31.3% (27.7, 34.7), with Hong Kong being the lowest and Cuernavaca, Mexico highest for both proportions. Results differed by sex. Greater street intersection density, public transport density and perceived proximity to restaurants (males) were associated with lower odds of overweight/obesity (BMI ≥ 25). Proximity to public transport stops (females) was associated with higher odds of overweight/obesity. Composite BE measures were more strongly related to BMI and overweight/obesity status than single variables among men but not women. One standard deviation improvement in the composite measures of BE was associated with small reductions of 0.1-0.5% in BMI but meaningful reductions of 2.5-5.3% in the odds of overweight/obesity. Effects were linear and generalizable across cities. Neighborhoods designed to support public transport, with food outlets within walking distance, may contribute to global obesity control.

The Health and economic effects of light rail lines: design, methods, and protocol for a natural experiment.

BACKGROUND: The health impacts of community design have been studied extensively over the past two decades. In particular, public transportation use is associated with more walking between transit stops and shops, work, home and other destinations. Change in transit access has been linked with physical activity and obesity but seldom to health outcomes and associated costs, especially within a causal framework. Health related fiscal impacts of transit investment should be a key consideration in major transit investment decisions. METHODS: The Rails & Health study is a natural experiment evaluating changes in clinical measures, health care utilization and health care costs among Kaiser Permanente Northwest (KPNW) members following the opening of a new light rail transit (LRT) line in Portland, Oregon. The study is prospectively following 3036 adults exposed to the new LRT line and a similar cohort of 4386 adults who do not live close to the new line. Individual-level outcomes and covariates are extracted from the electronic medical record at KPNW, including member demographics and comorbidities, blood pressure, body mass index, lipids, glycosylated hemoglobin, and health care utilization and costs. In addition, participants are surveyed about additional demographics, travel patterns, physical activity (PA), and perceived neighborhood walkability. In a subsample of the study population, we are collecting direct measures of travel-related behavior-physical activity (accelerometry), global positioning system (GPS) tracking, and travel diaries-to document mechanisms responsible for observed changes in health outcomes and cost. Comprehensive measures of the built environment at baseline and after rail construction are also collected. Statistical analyses will (1) examine the effects of opening a new LRT line on chronic disease indicators, health care utilization, and health care costs and (2) evaluate the degree to which observed effects of the LRT line on health measures and costs are mediated by changes in total and transportation-associated PA. DISCUSSION: The results of the Rails & Health study will provide urban planners, transportation engineers, health practitioners, developers, and decision makers with critical information needed to document how transit investments impact population health and related costs.

Development and reliability of a streetscape observation instrument for international use: MAPS-global.

BACKGROUND: Relationships between several built environment factors and physical activity and walking behavior are well established, but internationally-comparable built environment measures are lacking. The Microscale Audit of Pedestrian Streetscapes (MAPS)-Global is an observational measure of detailed streetscape features relevant to physical activity that was developed for international use. This study examined the inter-observer reliability of the instrument in five countries. METHODS: MAPS-Global was developed by compiling concepts and items from eight environmental measures relevant to walking and bicycling. Inter-rater reliability data were collected in neighborhoods selected to vary on geographic information system (GIS)-derived macro-level walkability in five countries (Australia, Belgium, Brazil, Hong Kong-China, and Spain). MAPS-Global assessments (n = 325) were completed in person along a ≥ 0.25 mile route from a residence toward a non-residential destination, and a commercial block was also rated for each residence (n = 82). Two raters in each country rated each route independently. A tiered scoring system was created that summarized items at multiple levels of aggregation, and positive and negative valence scores were created based on the expected effect on physical activity. The intraclass correlation coefficient (ICC) was computed for scales and selected items using one-way random models. RESULTS: Overall, 86.6% of individual items and single item indicators showed excellent agreement (ICC ≥ 0.75), and 13.4% showed good agreement (ICC = 0.60-0.74). All subscales and overall summary scores showed excellent agreement. Six of 123 items were too rare to compute the ICC. The median ICC for items and scales was 0.92 with a range of 0.50-1.0. Aesthetics and social characteristics showed lower ICCs than other sub-scales, but reliabilities were still in the excellent range (ICC ≥ 0.75). CONCLUSION: Evaluation of inter-observer reliability of MAPS-Global across five countries indicated all items and scales had "good" or "excellent" reliability. The results demonstrate that trained observers from multiple countries were able to reliably conduct observations of both residential and commercial areas with the new MAPS-Global instrument. Next steps are to evaluate construct validity in relation to physical activity in multiple countries and gain experience with using MAPS-Global for research and practice applications.

Neighborhood built environment and socioeconomic status in relation to physical activity, sedentary behavior, and weight status of adolescents.

INTRODUCTION: The study examined the association of neighborhood walkability to multiple activity-related outcomes and BMI among adolescents and evaluated socioeconomic status as an effect modifier. METHOD: Cross-sectional study, with adolescents recruited from neighborhoods that met criteria for a 2 × 2 matrix defined by high/low GIS-defined walkability and high/low median income. Adolescents aged 12-16 years (n = 928) were recruited from selected neighborhoods in Maryland and King County, Washington regions in 2009-2011. There were 50.4% girls, and 66.3% were non-Hispanic white, with no medical restrictions on physical activity (PA) or diets. Total PA and sedentary time was assessed by 7 days of accelerometer monitoring. Adolescents self-reported active transport, time spent on 6 sedentary behaviors, and height and weight, used to compute BMI percentiles. Mixed model linear and logistic regressions examined outcomes for association with walkability and income, adjusting for demographic covariates and clustering within block groups. RESULTS: Walkability was positively and significantly related to objectively-measured PA (p < .001) and more frequent walking for transportation (p < .001). Total self-reported sedentary time (p = .048) and TV time (p < .007) were negatively related to walkability. Time in vehicles was negatively related to walkability only among higher-income adolescents. CONCLUSIONS: Neighborhood walkability was strongly and consistently associated with adolescents' objectively-assessed total physical activity and reported active transportation. A novel finding was that adolescents living in walkable neighborhoods reported less television time and less time in vehicles. Most results were similar across income categories. Results strengthen the rationale for recommendations to improve walkability.

Preserving older adults' routine outdoor activities in contrasting neighborhood environments through a physical activity intervention.

While neighborhood design can potentially influence routine outdoor physical activities (PA), little is known concerning its effects on such activities among older adults attempting to increase their PA levels. We evaluated the effects of living in neighborhoods differing in compactness on changes in routine outdoor activities (e.g., walking, gardening, yard work) among older adults at increased mobility disability risk participating in the LIFE-Pilot PA trial (2003-07; ages 70-89years; from Dallas, TX, San Francisco Bay area, Pittsburgh, PA, and Winston-Salem, NC). Analyses were conducted on the 400 LIFE-Pilot participants randomized to a one-year endurance-plus-strengthening PA intervention or health education control that completed one-year PA assessment (CHAMPS questionnaire). Outcomes of interest were exercise and leisure walking, walking for errands, and moderate-intensity gardening. Neighborhood compactness was assessed objectively using geographic information systems via a subsequent grant (2008-12). PA increased weekly exercise and leisure walking relative to control, irrespective of neighborhood compactness. However, walking for errands decreased significantly more in PA relative to control (net mean [SD] difference=16.2min/week [7.7], p=0.037), particularly among those living in less compact neighborhoods (net mean [SD] difference=29.8 [10.8] minutes/week, p=0.006). PA participants living in less compact neighborhoods maintained or increased participation in gardening and yard work to a greater extent than controls (net mean [SD] difference=29.3 [10.8] minutes/week, p=0.007). The results indicate that formal targeting of active transport as an adjunct to structured PA programs may be important to diminish potential compensatory responses in functionally impaired older adults. Structured endurance-plus-strengthening PA may help older adults maintain or increase such routine activities over time. TRIAL REGISTRATION: clinicaltrials.gov Identifier=NCT01072500.

International comparison of observation-specific spatial buffers: maximizing the ability to estimate physical activity.

BACKGROUND: Advancements in geographic information systems over the past two decades have increased the specificity by which an individual's neighborhood environment may be spatially defined for physical activity and health research. This study investigated how different types of street network buffering methods compared in measuring a set of commonly used built environment measures (BEMs) and tested their performance on associations with physical activity outcomes. METHODS: An internationally-developed set of objective BEMs using three different spatial buffering techniques were used to evaluate the relative differences in resulting explanatory power on self-reported physical activity outcomes. BEMs were developed in five countries using 'sausage,' 'detailed-trimmed,' and 'detailed,' network buffers at a distance of 1 km around participant household addresses (n = 5883). RESULTS: BEM values were significantly different (p < 0.05) for 96% of sausage versus detailed-trimmed buffer comparisons and 89% of sausage versus detailed network buffer comparisons. Results showed that BEM coefficients in physical activity models did not differ significantly across buffering methods, and in most cases BEM associations with physical activity outcomes had the same level of statistical significance across buffer types. However, BEM coefficients differed in significance for 9% of the sausage versus detailed models, which may warrant further investigation. CONCLUSIONS: Results of this study inform the selection of spatial buffering methods to estimate physical activity outcomes using an internationally consistent set of BEMs. Using three different network-based buffering methods, the findings indicate significant variation among BEM values, however associations with physical activity outcomes were similar across each buffering technique. The study advances knowledge by presenting consistently assessed relationships between three different network buffer types and utilitarian travel, sedentary behavior, and leisure-oriented physical activity outcomes.

From neighborhood design and food options to residents' weight status.

This study examined associations of accessibility, availability, price, and quality of food choices and neighborhood urban design with weight status and utilitarian walking. To account for self-selection bias, data on adult residents of a middle-to-high-income neighborhood were used. Participants kept a 2-day activity/travel diary and self-reported socio-demographics, height, and weight. Geographic Information Systems data were used to objectively quantify walking-related aspects of urban design, and number of and distance to food outlets within respondents' 1km residential buffers. Food outlets were audited for availability, price, and quality of healthful food choices. Number of convenience stores and in-store healthful food choices were positively related to walking for errands which, in turn, was predictive of lower risk of being overweight/obese. Negative associations with overweight/obesity unexplained by walking were found for number of grocery stores and healthful food choices in sit-down restaurants. Aspects of urban form and food environment were associated with walking for eating purposes which, however, was not predictive of overweight/obesity. Access to diverse destinations, food outlets and healthful food choices may promote pedestrian activity and contribute to better weight regulation. Accessibility and availability of healthful food choices may lower the risk of overweight/obesity by providing opportunities for healthier dietary patterns.

Neighborhood built environment and income: examining multiple health outcomes.

There is growing interest in the relation of built environments to physical activity, obesity, and other health outcomes. The purpose of the present study was to test associations of neighborhood built environment and median income to multiple health outcomes and examine whether associations are similar for low- and high-income groups. This was a cross-sectional study of 32 neighborhoods in Seattle, WA and Baltimore, MD regions, stratified by income and walkability, and conducted between 2001 and 2005. Participants were adults aged 20-65years (n=2199; 26% ethnic minority). The main outcomes were daily minutes of moderate-to-vigorous physical activity (MVPA) from accelerometer monitoring, body mass index (BMI) based on self-report, and mental and physical quality of life (QoL) assessed with the SF-12. We found that MVPA was higher in high- vs. low-walkability neighborhoods but did not differ by neighborhood income. Overweight/obesity (BMI > or = 25) was lower in high-walkability neighborhoods. Physical QoL was higher in high-income neighborhoods but unrelated to walkability. Adjustment for neighborhood self-selection produced minor changes. We concluded that living in walkable neighborhoods was associated with more physical activity and lower overweight/obesity but not with other benefits. Lower- and higher-income groups benefited similarly from living in high-walkability neighborhoods. Adults in higher-income neighborhoods had lower BMI and higher physical QoL.

Income and racial disparities in access to public parks and private recreation facilities.

BACKGROUND: Disparities in health outcomes and health behaviors may be partially explained by neighborhood environments that are poor in resources that could support healthy behaviors. The purpose of this study was to test the hypothesis that low-income and high-minority neighborhoods have less access to public parks, open space, and private recreation facilities. METHODS: From 2004 to 2005, an inventory of 351 private recreation facilities and 465 public parks was conducted in 833 Census block groups in Maryland. In 2-way ANCOVAs, numbers of private facilities and public parks, as well as maximum park size, were studied in relation to categories of median income and percent non-white population in the block groups. RESULTS: For the number of private recreation facilities, there was no significant effect of income or percent minority. For number and size of parks, the interaction between income and percent minority was significant. Mixed-race neighborhoods had the highest number of parks, regardless of income. Low- and middle-income groups living in mostly-white block groups and high-income groups living in mostly-minority block groups had the lowest access to public parks. CONCLUSIONS: The expected deprivation of recreation facilities in low-income and high-minority neighborhoods was not found. There are exceptions to the inequalities found nationally, so the policies or practices associated with a fairer distribution of recreation resources in some local areas need to be better understood.

Stepping towards causation: do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity?

Evidence documents associations between neighborhood design and active and sedentary forms of travel. Most studies compare travel patterns for people located in different types of neighborhoods at one point in time adjusting for demographics. Most fail to account for either underlying neighborhood selection factors (reasons for choosing a neighborhood) or preferences (neighborhoods that are preferred) that impact neighborhood selection and behavior. Known as self-selection, this issue makes it difficult to evaluate causation among built form, behavior, and associated outcomes and to know how much more walking and less driving could occur through creating environments conducive to active transport. The current study controls for neighborhood selection and preference and isolates the effect of the built environment on walking, car use, and obesity. Separate analyses were conducted among 2056 persons in the Atlanta, USA based Strategies for Metropolitan Atlanta's Regional Transportation and Air Quality (SMARTRAQ) travel survey on selection factors and 1466 persons in the SMARTRAQ community preference sub-survey. A significant proportion of the population are "mismatched" and do not live in their preferred neighborhood type. Factors influencing neighborhood selection and individual preferences, and current neighborhood walkability explained vehicle travel distance after controlling for demographic variables. Individuals who preferred and lived in a walkable neighborhood walked most (33.9% walked) and drove 25.8 miles per day on average. Individuals that preferred and lived in car dependent neighborhoods drove the most (43 miles per day) and walked the least (3.3%). Individuals that do not prefer a walkable environment walked little and show no change in obesity prevalence regardless of where they live. About half as many participants were obese (11.7%) who prefer and live in walkable environments than participants who prefer car dependent environments (21.6%). Findings suggest that creating walkable environments may result in higher levels of physical activity and less driving and in slightly lower obesity prevalence for those preferring walkability.

The unmet demand for walkability: Disparities between preferences and actual choices for residential environments in Toronto and Vancouver.

OBJECTIVES: Individual preferences for residential location, neighbourhood character and travel options are not always met. The availability and cost of housing and several other factors often require compromise. The primary objectives of this study were to examine neighbourhood preferences, quantify unmet demand for more walkable environments and explore associations between the built environment, travel behaviour and health after controlling for neighbourhood preference. METHODS: A web-based, visually oriented residential preference survey was conducted with 1,525 adults in the Greater Toronto Area and 1,223 adults in Metro Vancouver aged 25 and older (5.8% and 11.8% of total potential recruits, respectively). Participants were randomly selected from a pre-recruited panel across a range of objectively calculated walkability and income levels at the forward sortation area level. RESULTS: Depending on the neighbourhood design attribute, between 45% and 64% of residents in the cities of Toronto and Vancouver strongly preferred living in walkable settings, compared with between 6% and 15% who strongly preferred auto-oriented places. Of participants who perceived their current neighbourhood as very auto-oriented, between 11% and 20% of City of Toronto participants and 6% and 30% of City of Vancouver participants strongly preferred a very walkable neighbourhood. Residents of highly walkable neighbourhoods reported walking significantly more for utilitarian purposes, taking public transit more frequently and driving fewer kilometres. CONCLUSION: Strong preferences for walking and transit-supportive neighbourhoods exist in two of Canada's largest metropolitan regions, with considerable unmet demand observed for such environments. The findings provide evidence for policies that enable walkability and inform market analysis, planning and regulatory approaches that better align with the supply and demand of more walkable neighbourhood environments. Providing increased opportunities for active transportation can have positive impacts on health-enhancing behaviours.

Application of an evidence-based tool to evaluate health impacts of changes to the built environment.

OBJECTIVES: To create and apply an empirically based health and greenhouse gas (GHG) impact assessment tool linking detailed measures of walkability and regional accessibility with travel, physical activity, health indicators and GHG emissions. METHODS: Parcel land use and transportation system characteristics were calculated within a kilometre network buffer around each Toronto postal code. Built environment measures were linked with health and demographic characteristics from the Canadian Community Health Survey and travel behaviour from the Transportation Tomorrow Survey. Results were incorporated into an existing software tool and used to predict health-related indicators and GHG emissions for the Toronto West Don Lands Redevelopment. RESULTS: Walkability, regional accessibility, sidewalks, bike facilities and recreation facility access were positively associated with physical activity and negatively related to body weight, high blood pressure and transportation impacts. When applied to the West Don Lands, the software tool predicted a substantial shift from automobile use to walking, biking and transit. Walking and biking trips more than doubled, and transit trips increased by one third. Per capita automobile trips decreased by half, and vehicle kilometres travelled and GHG emissions decreased by 15% and 29%, respectively. CONCLUSION: The results presented are novel and among the first to link health outcomes with detailed built environment features in Canada. The resulting tool is the first of its kind in Canada. This tool can help policy-makers, land use and transportation planners, and health practitioners to evaluate built environment influences on health-related indicators and GHG emissions resulting from contrasting land use and transportation policies and actions.

Neighborhood environment and psychosocial correlates of adults' physical activity.

BACKGROUND: There is growing interest in identifying neighborhood environment factors related to physical activity. PURPOSE: This study aimed to examine whether objective built (e.g., residential density) and perceived (e.g., aesthetics) environment factors around adults' residence are correlates of their physical activity and reported walking behavior after accounting for known psychosocial (e.g., self-efficacy, barriers to physical activity) and demographic correlates of physical activity. METHODS: Objective built environment characteristics were created through network buffers around individual participants (n = 2199) selected from neighborhoods differing on walkability characteristics and household income. Participants wore accelerometers to obtain a more objective measure of overall physical activity and self-reported on leisure and transportation-related walking, perceptions of neighborhood environment, psychosocial factors related to physical activity, and demographic factors. Census-level demographic factors were also considered. RESULTS: Retail floor area ratio, a metric combining land use mix and pedestrian design factors, was the environmental factor most related to accelerometry-measured physical activity and self-reported transportation-related walking after accounting for psychosocial and demographic factors. Street connectivity was also related to transportation-related walking, whereas perceived aesthetics was positively related to leisure walking. CONCLUSIONS: Environmental factors, particularly the availability of proximal nonresidential destinations designed for pedestrian access, were related to adults' physical activity and walking after accounting for psychosocial and demographic correlates, including reasons for residential selection.

Income disparities in perceived neighborhood built and social environment attributes.

The present study explored whether perceived neighborhood environmental attributes associated with physical activity differ by neighborhood income. Adults aged 20-65 years (n=2199; 48% female; mean age=45 years; 26% ethnic minority) were recruited from 32 neighborhoods from the Seattle, WA and Baltimore, MD regions that varied in objectively measured walkability and neighborhood income. Perceived built and social environment variables were assessed with the Neighborhood Environment Walkability Scale. There were neighborhood income disparities on 10 of 15 variables. Residents from high-income neighborhoods reported more favorable esthetics, pedestrian/biking facilities, safety from traffic, safety from crime, and access to recreation facilities than residents of low-income areas (all p's <0.001). Low-income neighborhoods may lack amenities and safety attributes that can facilitate high levels of physical activity for both transportation and recreation purposes.

Aging in neighborhoods differing in walkability and income: associations with physical activity and obesity in older adults.

While there is a growing literature on the relations between neighborhood design and health factors such as physical activity and obesity, less focus has been placed on older adults, who may be particularly vulnerable to environmental influences. This study evaluates the relations among objectively measured neighborhood design, mobility impairment, and physical activity and body weight in two U.S. regional samples of community dwelling older adults living in neighborhoods differing in walkability and income levels. An observational design involving two time points six months apart was employed between 2005 and 2008. U.S. Census block groups in Seattle-King County, Washington and Baltimore, Maryland-Washington DC regions were selected via geographic information systems to maximize variability in walkability and income. Participants were 719 adults ages 66 years and older who were able to complete surveys in English and walk at least 10 feet continuously. Measurements included reported walking or bicycling for errands (i.e., transport activity) and other outdoor aerobic activities measured via the CHAMPS questionnaire: accelerometry-based moderate-to-vigorous physical activity; reported body mass index; and reported lower extremity mobility impairment measured via the Late-Life Function and Disability Instrument. Across regions, time, and neighborhood income, older adults living in more walkable neighborhoods had more transport activity and moderate-to- vigorous physical activity and lower body mass index relative to those living in less walkable neighborhoods. The most mobility-impaired adults living in more walkable neighborhoods reported transport activity levels that were similar to less mobility-impaired adults living in less walkable neighborhoods. The results add to the small literature aimed at understanding how neighborhood design may influence physical activity and related aspects of health linked with day-to-day function and independence as people age.

Assessing health-related resources in senior living residences.

This study evaluated a new tool, "The Audit of Physical Activity Resources for Seniors" (APARS), which assesses the physical activity environment in Senior Living Residences (SLRs). Audits were conducted in 29 SLRs and inter-rater reliability was assessed. Pearson correlations were examined between APARS items and objectively measured physical activity and sedentary time, and self-rated health, collected from residents at a subset of 12 SLRs (N=147). Eighty-nine of the 90 items (98.9%) demonstrated Kappa or ICC values above .70 and/or percent agreement above 80%. The 90 items were summarized into nine scales. Two scales (outside supportive physical activity features/functionality and outside exercise facilities) were related to greater physical activity and less sedentary time. Four scales (inside social facilities, onsite services, exercise programs, and social activities) were related to greater sedentary time and better self-rated health. APARS items demonstrated adequate inter-rater reliability and some evidence for construct validity to assess health-related environments in retirement facilities. Social activities in SLRs could benefit residents by incorporating more physical activity. Use of APARS could inform more health-promoting designs of senior living facilities.

Age differences in the relation of perceived neighborhood environment to walking.

PURPOSE: The strength of the relationship of environment to physical activity may differ by age group. Older adults were expected to be more affected by environmental attributes than younger adults. The present study examined age-related differences in associations between perceived neighborhood environment and physical activity. METHODS: Participants were 1623 adults aged 20 to 97 yr divided into five groups: ages 20-39, 40-49, 50-65, 66-75, and 76+. They were recruited from King County/Seattle, WA, neighborhoods selected to vary in land use and median income. Participants completed questionnaires about neighborhood environment attributes and walking for transportation and for leisure purposes. Neighborhood environment, within a 15- to 20-min walk from home, was measured on nine attributes with the validated Neighborhood Environment Walkability Scale questionnaire: residential density, proximity to nonresidential land uses, ease of access to nonresidential uses, street connectivity, walking/cycling facilities, esthetics, pedestrian traffic safety, crime safety, and proximity to recreation facilities. Participants reported frequency and duration of walking using the validated International Physical Activity Questionnaire and the Community Healthy Activities Model Program for Seniors. Partial correlations were computed, adjusting for demographics. RESULTS: Walking for transportation was significantly related to multiple perceived neighborhood attributes in all age groups, although walking for leisure was not. Walking for transportation was significantly related to almost all neighborhood environment variables in the youngest age group. In contrast, only two environmental attributes, proximity to nonresidential uses (like shops) and recreation facilities, were moderately correlated with walking for transportation in the two oldest groups. CONCLUSION: Communities need to be designed with many favorable environmental attributes to support walking for transportation among younger adults. Having nonresidential destinations and recreation facilities within walking distance may be among the most important attributes to support older adults' physical activity.