A new study by scientists in the Columbia University Mailman School of Public Health’s Built Environment and Health Research Group finds that higher neighbourhood walkability is associated with a lower risk of gestational diabetes (GD). The study results are published in the peer-reviewed journal Paediatric and Perinatal Epidemiology.

GD increases infants’ risk of being large for gestational age, may increase the risk of unhealthy weight gain during childhood, and increases the pregnant individual’s risk for future type 2 diabetes.

Working with the New York City Department of Health and Mental Hygiene, the researchers analyzed the relationships between neighbourhood walkability for pregnant New Yorkers. The Neighborhood Walkability Index they used to measure walkability includes data on residential density, land use mix, street connectivity, and access to public transit.  They analyzed city data from more than 109,000 births in 2015.

They found that the risk of GD decreased with increases in Neighborhood Walkability Index score by as much as 20 per cent between areas in the highest and lowest quartiles of walkability. Similarly, when the researchers assessed the density of walkable destinations, another measure of neighbourhood walkability, pregnant individuals in the highest quartile of walkable destinations had a 23 per cent lower risk of GD than those living in the lowest quartile. The analyses adjusted for the pregnant individual’s age, race and ethnicity, parity, education, place of birth, marital status, and the neighbourhood’s poverty rate.

An earlier study by a research team found that neighbourhood walkability is associated with a lower risk of excess weight gain during pregnancy; almost 50 per cent of pregnant individuals gain more weight than is recommended for healthy pregnancies.  The researchers theorize that neighbourhood walkability is associated with higher levels of walking and physical activity in pregnant individuals, reducing the risk of GD and excess weight gain during pregnancy. Pregnant individuals are known to favour lower-intensity forms of exercise such as walking during pregnancy, and in New York City neighborhood walkability is positively associated more walking and total physical activity.

“The study highlights the importance of urban planning, particularly neighbourhood walkability, in promoting health,” says study co-first author Andrew Rundle, DrPH, an epidemiology professor at Columbia Mailman. “Creating opportunities for pregnant individuals to meet recommendations for healthy physical activity during pregnancy is expected to have long-lasting positive benefits for both parent and child.”

Rundle says “We plan to continue our research on how urban design can support health during pregnancy so that these benefits are included in cost-benefit analyses and decision-making for how we design new neighbourhoods and re-design existing neighbourhoods.”