In a recent study published in the journal Environmental Health Perspectives, researchers have found that women living in neighborhoods characterized as walkable, based on factors like population density and accessibility to destinations, have a reduced risk of obesity-related cancers, including postmenopausal breast cancer, as well as multiple myeloma, ovarian, and endometrial cancers.

Study: Long-Term Exposure to Walkable Residential Neighborhoods and Risk of Obesity-Related Cancer in the New York University Women's Health Study (NYUWHS). Image Credit: Brocreative/Shutterstock.com

Background

Obesity is a growing health concern, with over 40% of adults in the United States being obese or overweight. This condition also significantly increases the risk of various cancers, particularly among women. About 55% of diagnosed cancers in women are linked to obesity, while the figure is approximately 24% for men. Inactivity among women is believed to further exacerbate the risk of obesity-related cancers.

Increasing evidence highlights walking as a moderate-intensity physical activity that contributes significantly to recommended exercise levels for maintaining good health. Recent research has focused on how the built environment affects physical activity and, subsequently, health and disease.

About the study

This study investigated the relationship between neighborhood walkability and the risk of obesity-related cancers in women. "Neighborhood walkability" refers to urban landscape characteristics that facilitate walking and pedestrian activity, considering factors like population density and destination accessibility.

The study participants were part of the New York University Women’s Health Study, a cohort of over 14,000 women in New York City recruited between 1985 and 1991, followed for nearly 30 years. They completed baseline assessments, with subsequent questionnaires sent every three to five years to collect health, lifestyle, and socio-demographic information.

Residential addresses were verified every two years, and over 30 years, the areas were geocoded to calculate annual neighborhood walkability based on destination accessibility and population density.

The primary outcome examined was the incidence of obesity-related cancers, including postmenopausal breast, colorectal, endometrial, pancreatic, renal, ovarian, thyroid, esophageal, gallbladder, and liver cancers. Medical records and ICD-9 codes were used to confirm cancer diagnoses and subtypes.

Results

The study found that neighborhoods with high walkability levels were associated with lower risks of site-specific and overall obesity-related cancers among women. Additionally, neighborhoods with lower poverty levels were linked to reduced cancer risks.

The incidence of postmenopausal breast cancer was notably lower among women living in areas with higher walkability over a 24-year follow-up period. The study also identified moderate associations between neighborhood walkability and multiple myeloma, endometrial, and ovarian cancers.

These findings underscore the impact of urban landscape designs on the health and disease patterns in aging populations. While it's well-established that low physical activity and obesity increase cancer risk in women, interventions to address these issues are often short-term or costly.

Walkable neighborhoods can promote walking as a habit, potentially as a social activity, increase physical activity, and reduce reliance on vehicles.

The inverse link between walkable spaces and obesity-related cancer incidence held true even after adjusting for variables like BMI. However, the researchers suggest that increased walkability may also encourage more strenuous activities like running and biking, which could further influence the results.

Conclusions

In summary, the study concludes that women residing in neighborhoods with greater walkability are at a reduced risk of obesity-related cancers, including postmenopausal breast cancer.

The lower incidence of multiple myeloma, ovarian, and endometrial cancers was also associated with more walkable residential areas. Furthermore, neighborhood poverty levels appeared to modify the relationship between walkability and cancer risk among women.

Journal reference:

• Sandra, I., et al. Long-Term Exposure to Walkable Residential Neighborhoods and Risk of ObesityRelated Cancer in the New York University Women’s Health Study (NYUWHS). Environmental Health Perspectives, doi: https://doi.org/10.1289/EHP11538. https://pubmed.ncbi.nlm.nih.gov/37791759/