The determinants of physical activity are numerous and complex. Intra-personal, environmental and social factors includi
The effect of urban crime and perceived safety on urban levels of physical activity: a review Claire BOULANGE, Dr. Francisco ARMADA World Health Organization Kobe Centre for Health Development The views presented herein are those of the authors and do not necessary reflect the decisions, policies or views of the World Health Organization. The use of particular designations of countries or territories does not imply any judgement as to the legal status of such countries.
Noncommunicable diseases: a global epidemic
Physical activity: a public health priority
Noncommunicable diseases (NCDs) are diseases of long duration and generally slow progression (WHO, 2011).
Although the benefits of physical activity on health are well known a growing number of people living in cities are found insufficiently active for optimal health benefit.
NCDs now account for nearly half of the global burden of disease (WHO, 2011). NCDs affect people of all ages, nationalities and socioeconomic levels.
The determinants of physical activity are numerous and complex. Intra-personal, environmental and social factors including age, gender, climate and safety all impact on people’s decision to participate in physical activities. In cities worldwide some people do not get the opportunity to participate in physical activity and some communities are insufficiently active.
Better diet, healthier lifestyles and more physical activity could prevent millions of premature death each year.
To encourage people to exercise more, local governments need to consider a variety of factors related to participation in physical activities including accessibility of facilities, opportunity for exercise, aesthetics and safety. Heavy traffic can bring pollution, injury, and risks to pedestrians and cyclists and inhibits physical activity. WHO/Euro
Overweight and obesity are linked to more deaths worldwide than underweight. WHO/ Marko Kokic
However, taking action is not necessary simple. In any location there are a number of factors that may pose barriers to the implementation of policies that aim to promote physical activity.
80% of NCDs deaths occur in low- and middle-income countries. WHO/C. de Bode 60 minutes per day or 150 minutes per week of moderate to vigorous physical activity could offer substantial health benefits to any individual and reduces the incidence of NCDs. WHO
Crime: a significant barrier to active living It is acknowledged that concerns about personal safety are obstacles to regular participation in physical activity and local walking (Duncan and Mummery 2005; Van Cauwenberg et al. 2011). Nevertheless, the impact of crime on physical activity has thus far received little attention. Since crime and violence are a fact of life for many people living in cities (WHO, 2010) there is an urgent need to investigate the relation between crime and participation to physical activities in urban settings and further, its implications for urban planning. In places afflicted by crime governments may face greater difficulties for promoting physical activity.
Results
Literature review: objectives and method
Crime and fear of crime inhibit physical activity While it is widely recognized that crime is a threat for health and well-being the review also indicates that crime and fear of crime are significant barrier to physical activities: out of 54 studies 35 found that real or perceived crime was correlated with participation in physical activities. From this review it appears that people are likely to be active if they perceive their neighbourhood as being safe from crime and that people have lower rates of physical activities when they fear crime.
Urban design matters
People who have access to a safe place appear to be more likely to participate in physical activities and therefore maintain good health. WHO
After statistical adjustments, a number of studies found that perception of crime and fear of crime were not evenly distributed among population groups. For example, we found evidence that gender, age, and socioeconomic status are strongly correlated with the perception of crime. Women, children, older people and those of lower socio-economic status are less likely to do physical activity when there is crime or a fear of crime.
WHO/Euro
Focus: Bogotá
We searched the following electronic databases: Science Direct, WHOLIS, Pub Med and Google Scholar to identify potentially relevant articles published in the English language between 1997 and 2011.
54 original studies met inclusion criteria for this review. The review includes qualitative (2 papers) and quantitative (53 papers) methodology. The review includes 8 studies published in 2010-2011; 6 studies published in 2009 and 40 studies published before 2009.
Conclusion Fear of crime increases the probability of sedentary lifestyles and due to socio-environmental factors certain populations are more exposed to that threat. There is evidence that the perception of safety can be altered by environmental factors and that urban renewal strategy focussing on crime reduction can have a positive impact on physical activity.
Supportive environments and communities may help people to be more physically active. WHO/V. Collazos
For local government, addressing crime issues can be an opportunity to develop intersectoral actions (ISA) that also increase opportunities for physical activity, improve urban health and urban welfare.
Interventions aiming to support PA in cities may also be effective for addressing crime and fear of crime.
Nevertheless, to date, a number of links between crime and physical activity remain unclear. In particular the relative importance of social and geographical exposure to crime and fear of crime.
In one of the most dangerous cities of the world, the local government took direct actions to encourage personal mobility, recover the public space and create safe and accessible parks (Velásquez 2003). WHO
This intervention not only supports physical activities but also has a positive impact on the quality of life overall: the city has undergone a notable decrease in violence and now hosts an efficient public transportation network that includes bike paths and pedestrian areas. The city’s transformation and its efforts to reduce crime had a positive impact on opportunities for participation to physical activity. Strong associations were found between perception of safety during the day and high levels of walking as a mode of transportation (L. F. Gomez et al. 2010; Parra et al. 2010).
References
We reviewed the findings of both qualitative and quantitative studies focused on urban settings that addressed the relationship between physical activity and crime. Our objectives were to review the associations that have thus far been identified and to highlight the implications for public policies at the local level.
The keywords used for the search were the following:crime, perception, safety, urban, physical activity, exercise. The literature search generated 152 records and we also manually examined the reference lists of review articles and retrieved an additional 5 articles. Only original studies examining the association between crime and physical activities were included. Reviews, reports and case studies were excluded.
Findings indicated that the perception of safety can be altered by the environment. For example, lack of street lighting or presence of graffiti can lead to greater fear of crime and consequently lower participation in physical activities.
Some are more vulnerable than others
The aim of this study was to review the relationship between crime and physical activity, its consequences for health and wellbeing and its implication for urban policies.
Duncan, Mitch and Mummery, Kerry (2005), ‘Psychosocial and environmental factors associated with physical activity among city dwellers in regional Queensland’, Preventive Medicine, 40 (4), 363-72. Gomez, L. F., et al. (2010), ‘Characteristics of the built environment associated with leisure-time physical activity among adults in Bogota, Colombia: a multilevel study’,J Phys Act Health, 7 Suppl 2, S196-203. Parra, Diana C., et al. (2010), ‘Perceived and objective neighborhood environment attributes and health related quality of life among the elderly in Bogotá, Colombia’, Social Science & Medicine, 70 (7), 1070-76. V an Cauwenberg, Jelle, et al. (2011), ‘Relationship between the physical environment and physical activity in older adults: A systematic review’, Health & Place, 17 (2), 458-69. Velásquez, Hugo Acero (2003), Violencia y Delincuencia en Contextos Urbanos. La Experiencia de Bogotá en la Reducción de la Criminalidad 1994 - 2002. (Alcaldía Mayor. Secretaría de Gobierno). World Health Organization. Dept. of Chronic Diseases and Health Promotion. (2004), Global strategy on diet, physical activity and health (Geneva: World Health Organization) 18 p. World Health Organization. Centre for Health Development. and United Nations. Human Settlements Programme. (2010), Hidden cities: unmasking and overcoming health inequities in urban settings. (Kobe, Japan: WHO Centre for Health Development) 16p. World Health Organization | Chronic Diseases. World Health Organization. WHO. Web. 12 Sept. 2011. http://www.who.int/topics/chronic_diseases/en/.
A better understanding of the multilevel impacts of crime is necessary and future research should investigate how people respond to this threat: for example whether they avoid public spaces, join a private club to exercise or restrict their children’s outdoor play. Finally, studies are predominantly reporting experiences from developed countries. Consideration of the association of crime-related safety with physical activity in developing countries could enhance the evidence base and provide a focus to local governments for increasing inspiration and innovation.
Acknowledgments We would like to thank the Institut d’Urbanisme de Grenoble (IUG) for giving us the opportunity to participate in the International Conference on Urban Health. We would also like to express our appreciation to Riikka RANTALA and Lori SLOATE (WKC) for providing editing support.