Accounting for residential and non-residential environments to measure contextual effects on health behavior : the case of recreational walking behavior

Background: Previous studies on place effect on health focused on the residential neighborhood. This approach was criticized for not considering non-residential geographic life environments. While mobility is a key determinant of exposure, few studies accounted for daily mobility to evaluate environmental effects on health.    Purpose: The overarching aim of this dissertation is to estimate whether accounting for people’s network of activity places and their resulting exposure allows improving the understanding of environmental influences on recreational walking behavior. The specific objectives are: i) to identify types of spatial behavior of individuals living in the Ile-de-France region and their socio-demographic correlates; ii) to assess whether the exposure to supportive walking environments differs depending on the geographic definition of the exposure area and varies by the socioeconomic status and the degree of urbanicity; iii) to evaluate which residential and non-residential neighborhood characteristics are associated with recreational walking.  Methods: Three cross sectional studies were conducted on the second wave of the RECORD Cohort Study (Residential Environment and CORonary heart Disease). Information on participants’ regular activity places and perceived residential neighborhood were collected through the VERITAS application (Visualization and Evaluation of Regular Individual Travel destinations and Activity Spaces).    Result: In the first study, I identified a typology of individuals’ patterns of mobility characterized by: i) the size of the activity space, ii) the elongation of the activity space, iii) the centering of the activity space on the residential neighborhood, iv) the volume of activity, and v) the type of activity performed. The individual-level socio-economic status and degree of urbanicity of the place of residence in the Ile-de-France region are strong determinants of individuals’ spatial behavior. Results from the second study provide evidence that exposure to environmental characteristics supportive to walking highly differs between the residential neighborhood, the perceived residential neighborhood and the activity space. The measurement error resulting from the sole use of residential measures of exposure varies among SES groups and among categories of the degree of urbanicity of the residence. In the third empirical study a high density of destinations, the presence of a lake or waterway, and a high neighborhood education are associated with recreational walking. Finally, this study provides evidence of a strong influence of the environmental condition around the home and the recreational activity locations on the practice of recreational walking.    Conclusion: This dissertation strengthen the conceptual grounds and empirical evidence that accounting for both residential and non-residential geographical environments individual get exposed is required to i) better proxy the true environmental exposure, ii) estimate environmental influences on health behaviors. In order to investigate the mechanisms through which environmental exposure influence physical activity, it is relevant to examine where people go, and what people actually do in terms of type of activity and constraints related to the activity performed. Identifying which activity places is most influential on physical activity informs on the geographical contexts health promotion interventions should target.

Keyphrases: Daily mobility, Activity space, Physical activity, Residential trap, Selective daily mobility bias, Recreational walking