Health, built environment, and environmental perceptions in relation to non-commute walking among middle-aged adults

Promoting walking is a public health priority for enhancing health and well-being. However, the influence of people's health on environment-walking associations and its possible moderating role remains uncertain. Our aim was to 1) examine how selected health-related indicators, specifically body mass index (BMI) and self-perceived health, together with objective and perceived environmental features were associated with non-commute walking behaviour; and 2) investigate the potential moderating role of health on the environment-walking association; and 3) compare the relative explanatory roles of the health indicators, objective and perceived environmental characteristics. We used survey data from 366 adults aged 45–65 in Rotterdam and Maastricht, the Netherlands. Our outcome variable was self-reported walking frequency for non-commute trips. Data on neighbourhood environmental perceptions were also self-reported, while objective environmental characteristics were measured within 300 m, 600 m, and 1000 m of respondents' homes. Zero-inflated Poisson regression models showed that the BMI was negatively associated with non-commute walking frequency, accounting for socio-demographics and objective and perceived environmental features. Address density and perceived safety were positively associated with non-commute walking, whereas street connectivity and perceived neighbourhood aesthetics were inversely associated. Objective and perceived environmental features contributed to a similar extent to explaining non-commute walking behaviours. We found no evidence that BMI or self-perceived health moderated the association between the environment and non-commute walking. Our findings suggest that selected health-related indicators and objective and perceived environmental features independently influence non-commute walking behaviour. Objective and perceived environments seem equally important in explaining non-commute walking.