Introduction: Neighborhood social cohesion is associated with physical activity (PA), but prior studies have used local population samples and presented results in aggregate across racial/ethnic groups.
Hypothesis: Neighborhood social cohesion is associated with PA in a large, nationally representative dataset and may be modified by race/ethnicity.
Methods: Data from the National Health Interview Survey (NHIS) 2013-14 survey waves were combined (n=64,754). NHIS 2013-14 included four questions on neighborhood social cohesion - participants rated agreement/disagreement with the following statements (scale: 1-strongly disagree, 2-disagree, 3-agree, 4-strongly agree): 1) people in this neighborhood help each other out; 2) there are people I can count on in this neighborhood; 3) people in this neighborhood can be trusted; and 4) this is a close-knit neighborhood. A neighborhood cohesion score was constructed by summing the responses to the questions (range: 4 to 16). The primary outcome of meeting aerobic PA guidelines (150 minutes/week of moderate or 75 minutes/week of vigorous PA) was calculated using self-reported moderate or vigorous minutes/week. Multivariable regression models for meeting PA guidelines were run, adjusting for age, race/ethnicity, sex, education, income, nativity (U.S.- or foreign-born), and English proficiency; additional models were run with neighborhood cohesion as a binary variable (above/below median) to assess potential effect modification by race/ethnicity. All data were analyzed using complex survey weighting in STATA 12.1 and SUDAAN 10.0.
Results: About half of U.S. adults reported meeting PA guidelines (49.6). Neighborhood social cohesion was fairly high, with a median value of 12 (IQR: 11-15) and was higher in those 65+ years of age, and with higher education, income and length of time living in one’s neighborhood. In adjusted analyses, a one-unit increase in neighborhood social cohesion was associated with an increased odds of meeting PA guidelines (OR:1.04 (1.03, 1.05), p<0.001). Neighborhood social cohesion and PA was associated in whites and Hispanics (OR:1.30 (1.20, 1.42), p<0.001; OR: 1.18 (1.03, 1.34), p<0.001, respectively), and not in blacks or Asian American subgroups (Chinese, Filipino and Asian Indians).
Conclusions: Neighborhood social cohesion was associated with meeting PA guidelines in this nationally representative sample of U.S. adults. However this association appears to be driven by whites and Hispanics. While neighborhood characteristics may be an important aspect of public health planning and epidemiologic inquiry, additional studies are needed to further investigate which neighborhood factors affect ability to meet PA guidelines for blacks and Asian Americans.