Diabetes risk, physical activity, and the physical environment

The current exploratory study investigated the relationships among subjective and objective physical environment ratings, physical activity, and diabetes status. The basic question was whether diabetics were less physically active than non-diabetics and if this lack of physical activity was due to different perceptions of the same environment or due to non-diabetics living on less walkable streets than diabetics. Surveyed participants (N=937) were assigned to four groups, based on their self-reported diabetes status: nondiabetics, pre-diabetics, and diabetics living on the same blocks, and non-diabetics living on other blocks. Participants were selected from the same street segments to equate groups on their neighborhood's "walkability." This allowed comparison of these three groups on participant's perceptions of the environment in relation to their physical activity. Objective ratings of the physical environment were completed to assess "walkability" of participants' physical environments. This allowed comparison of nondiabetics and diabetics living on different blocks to determine if diabetics lived on less walkable blocks. Accelerometer data indicated the proportion of time spent without activity (sedentary proportion) and the proportion of time they spent engaged in healthy levels of physical activity (moderate/vigorous proportion). Diabetics had significantly higher levels of sedentary time and lower levels of moderate activity. Neither the rated walkability of the physical environment nor perceptions of the environment accounted for these significant differences in activity levels.