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An international comparative study of active living environments and hospitalization for Wales and Canada

Sarah M. Mah, Kaberi Dasgupta Orcid Logo, Ashley Akbari Orcid Logo, Nancy A. Ross, Rich Fry Orcid Logo

SSM - Population Health, Volume: 18, Start page: 101048

Swansea University Authors: Ashley Akbari Orcid Logo, Rich Fry Orcid Logo

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DOI (Published version): 10.1016/j.ssmph.2022.101048

Abstract

RATIONALE Previous studies indicate active living environments (ALEs) are associated with higher physical activity levels across different geographic contexts, and could lead to reductions in hospital burden. Both Wales UK and Canada have advanced data infrastructure that allows record linkage betwe...

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Published in: SSM - Population Health
ISSN: 2352-8273
Published: Elsevier BV 2022
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Both Wales UK and Canada have advanced data infrastructure that allows record linkage between survey data and administrative health information.ObjectiveTo assess the relationship between ALEs and hospitalization in Wales and Canada.MethodsWe performed a population-based comparison using individual-level survey data from the Welsh Health Survey (N&#x202F;=&#x202F;9968) linked to the Patient Episode Database for Wales and the Canadian Community Health Survey (N&#x202F;=&#x202F;40,335) linked to the Discharge Abstract Database. Using equivalent protocols and open-source data for street networks, destinations, and residential density, we derived 5-class measures of the ALE for Wales and Canada (classed 1 through 5, considered least favourable to most favourable for active living, respectively). We evaluated relationships of ALEs to health, behaviours and hospitalization using multivariate regression (reference group was the lowest ALE class 1, i.e., considered least favourable for active living).ResultsFor Canada, those living in the highest ALE class 5 had lower odds of all-cause hospitalization (OR 0.66, 95% CI 0.54 to 0.81; as compared to the lowest ALE class 1). In contrast, those living in the highest ALE class 5 in Wales had higher odds of all-cause hospitalization (OR 1.37, 95% CI 1.04 to 1.80). The relationship between ALEs and cardiometabolic hospitalization was inconclusive for Canada (OR 0.75, 95% CI 0.50 to 1.12), but we observed higher odds of cardiometabolic hospitalization for respondents living in higher ALE classes for Wales (OR 1.46, 95% CI 1.10 to 1.78; comparing ALE class 4 to ALE class 1).ConclusionCanadian respondents living in high ALE neighbourhoods that are understood to be more favourable for active living had lower odds of all-cause hospitalization, whereas Welsh respondents living in high ALEs that were deemed favourable for active living exhibited higher odds of all-cause hospitalization. Environments which promote physical activity in one geographic context may not do so in another. 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spelling 2022-10-26T15:54:40.6992589 v2 59490 2022-03-03 An international comparative study of active living environments and hospitalization for Wales and Canada aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false 2022-03-03 HDAT RATIONALE Previous studies indicate active living environments (ALEs) are associated with higher physical activity levels across different geographic contexts, and could lead to reductions in hospital burden. Both Wales UK and Canada have advanced data infrastructure that allows record linkage between survey data and administrative health information.ObjectiveTo assess the relationship between ALEs and hospitalization in Wales and Canada.MethodsWe performed a population-based comparison using individual-level survey data from the Welsh Health Survey (N = 9968) linked to the Patient Episode Database for Wales and the Canadian Community Health Survey (N = 40,335) linked to the Discharge Abstract Database. Using equivalent protocols and open-source data for street networks, destinations, and residential density, we derived 5-class measures of the ALE for Wales and Canada (classed 1 through 5, considered least favourable to most favourable for active living, respectively). We evaluated relationships of ALEs to health, behaviours and hospitalization using multivariate regression (reference group was the lowest ALE class 1, i.e., considered least favourable for active living).ResultsFor Canada, those living in the highest ALE class 5 had lower odds of all-cause hospitalization (OR 0.66, 95% CI 0.54 to 0.81; as compared to the lowest ALE class 1). In contrast, those living in the highest ALE class 5 in Wales had higher odds of all-cause hospitalization (OR 1.37, 95% CI 1.04 to 1.80). The relationship between ALEs and cardiometabolic hospitalization was inconclusive for Canada (OR 0.75, 95% CI 0.50 to 1.12), but we observed higher odds of cardiometabolic hospitalization for respondents living in higher ALE classes for Wales (OR 1.46, 95% CI 1.10 to 1.78; comparing ALE class 4 to ALE class 1).ConclusionCanadian respondents living in high ALE neighbourhoods that are understood to be more favourable for active living had lower odds of all-cause hospitalization, whereas Welsh respondents living in high ALEs that were deemed favourable for active living exhibited higher odds of all-cause hospitalization. Environments which promote physical activity in one geographic context may not do so in another. There remains a need to identify relevant context-specific factors that encourage active living. Journal Article SSM - Population Health 18 101048 Elsevier BV 2352-8273 Population health; Linked Data; Built environment; Walkability; Canada; Wales UK; Hospitalization; Morbidity 1 6 2022 2022-06-01 10.1016/j.ssmph.2022.101048 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU College/Department paid the OA fee ESRC ES/S007393/1 2022-10-26T15:54:40.6992589 2022-03-03T18:18:03.0330925 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Sarah M. Mah 1 Kaberi Dasgupta 0000-0002-2447-3553 2 Ashley Akbari 0000-0003-0814-0801 3 Nancy A. Ross 4 Rich Fry 0000-0002-7968-6679 5 59490__23748__b66d473aee53426fa262e5914b123689.pdf 59490.pdf 2022-03-31T11:03:19.1903223 Output 1060974 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the CC BY license true eng http://creativecommons.org/licenses/by/4.0/ 96 SAIL databank true www.saildatabank.com true
title An international comparative study of active living environments and hospitalization for Wales and Canada
spellingShingle An international comparative study of active living environments and hospitalization for Wales and Canada
Ashley Akbari
Rich Fry
title_short An international comparative study of active living environments and hospitalization for Wales and Canada
title_full An international comparative study of active living environments and hospitalization for Wales and Canada
title_fullStr An international comparative study of active living environments and hospitalization for Wales and Canada
title_full_unstemmed An international comparative study of active living environments and hospitalization for Wales and Canada
title_sort An international comparative study of active living environments and hospitalization for Wales and Canada
author_id_str_mv aa1b025ec0243f708bb5eb0a93d6fb52
d499b898d447b62c81b2c122598870e0
author_id_fullname_str_mv aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
d499b898d447b62c81b2c122598870e0_***_Rich Fry
author Ashley Akbari
Rich Fry
author2 Sarah M. Mah
Kaberi Dasgupta
Ashley Akbari
Nancy A. Ross
Rich Fry
format Journal article
container_title SSM - Population Health
container_volume 18
container_start_page 101048
publishDate 2022
institution Swansea University
issn 2352-8273
doi_str_mv 10.1016/j.ssmph.2022.101048
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description RATIONALE Previous studies indicate active living environments (ALEs) are associated with higher physical activity levels across different geographic contexts, and could lead to reductions in hospital burden. Both Wales UK and Canada have advanced data infrastructure that allows record linkage between survey data and administrative health information.ObjectiveTo assess the relationship between ALEs and hospitalization in Wales and Canada.MethodsWe performed a population-based comparison using individual-level survey data from the Welsh Health Survey (N = 9968) linked to the Patient Episode Database for Wales and the Canadian Community Health Survey (N = 40,335) linked to the Discharge Abstract Database. Using equivalent protocols and open-source data for street networks, destinations, and residential density, we derived 5-class measures of the ALE for Wales and Canada (classed 1 through 5, considered least favourable to most favourable for active living, respectively). We evaluated relationships of ALEs to health, behaviours and hospitalization using multivariate regression (reference group was the lowest ALE class 1, i.e., considered least favourable for active living).ResultsFor Canada, those living in the highest ALE class 5 had lower odds of all-cause hospitalization (OR 0.66, 95% CI 0.54 to 0.81; as compared to the lowest ALE class 1). In contrast, those living in the highest ALE class 5 in Wales had higher odds of all-cause hospitalization (OR 1.37, 95% CI 1.04 to 1.80). The relationship between ALEs and cardiometabolic hospitalization was inconclusive for Canada (OR 0.75, 95% CI 0.50 to 1.12), but we observed higher odds of cardiometabolic hospitalization for respondents living in higher ALE classes for Wales (OR 1.46, 95% CI 1.10 to 1.78; comparing ALE class 4 to ALE class 1).ConclusionCanadian respondents living in high ALE neighbourhoods that are understood to be more favourable for active living had lower odds of all-cause hospitalization, whereas Welsh respondents living in high ALEs that were deemed favourable for active living exhibited higher odds of all-cause hospitalization. Environments which promote physical activity in one geographic context may not do so in another. There remains a need to identify relevant context-specific factors that encourage active living.
published_date 2022-06-01T04:16:50Z
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