We used linked administrative data from nearly 250,000 respondents of the Canadian Community Health Survey and death records in the Canadian Mortality Database to conduct a population-based retrospective cohort study. This rich linked dataset contains information on social and demographic characteristics as well as the health behaviours of the cohort – including leisure-time physical activity and walking. We then linked these individuals’ neighbourhoods with the Canadian Active Living Environments (Can-ALE) database to see whether living in communities that are more conducive for active living is related to physical activity, walking, and premature cardiometabolic death.
Results indicate that, on average, people tend to walk more in neighbourhoods with favourable conditions, and that more walking is associated with lower premature cardiometabolic death (with the exception of middle-aged men in this study).
Survival analysis showed that more favourable ALEs were associated with a 22% reduction in premature cardiometabolic-related death rates in older women.
These conclusions underscore the importance of the built environment in shaping both behaviour and downstream health. Urban planning that prioritizes quality active living environments may be an effective way to encourage physical activity and reduce premature cardiometabolic death. Our study indicates that decision-makers seeking to improve health outcomes in their communities should consider supporting interventions aimed at making neighborhoods more conducive to active living.