Walking, obesity and urban design in Chinese neighborhoods

•Neighborhoods of similar types varied in their built environment characteristics.•Walkable urban design was tied to walking for commuting, non-commuting and exercise.•The relationship between walking and Body Mass Index (BMI) was moderated by income.

ObjectiveWe examined the connections (1) between the design of the built environment and walking, (2) between the design of the built environment and obesity, and (3) between walking and obesity and income in urban settings in China.MethodsSix neighborhoods with different built environment characteristics, located in the Chinese cities of Shanghai and Hangzhou, were studied. Data on walking and other physical activity and obesity levels from 1070 residents were collected through a street intercept survey conducted in 2013. Built environment features of 527 street segments were documented using the Irvine–Minnesota Inventory-China (IMI-C) environmental audit. Data were analyzed using the State of Place™ Index.ResultsWalking rates, household income and Body Mass Index (BMI) were related; neighborhoods with a higher State of Place™ Index were associated with higher rates of walking.ConclusionThis study began to establish an evidence base for the association of built environment features with walking in the context of Chinese urban design. Findings confirmed that the associations between “walkable” built environment features and walking established in existing research in other countries, also held true in the case of Chinese neighborhoods.