Living near a trail is associated with increased odds of walking among patients using community clinics

We tested the hypothesis that living near a walking or cycling trail was associated with greater odds of walking. This has been previously studied in healthy and unselected populations, but to our knowledge has not been studied in patients attending community clinics. A cross-sectional survey was completed by 1211 persons in five community clinics that serve poor populations. We performed univariate analysis and developed a multivariate logistic regression model for walking adjusting for 12 independent variables including self-rated health, frequent mental distress, lifestyle and demographic variables, and environmental characteristics of the neighborhood including perceived proximity to a walking or cycling trail. Compared to those who reported not living close to a trail, persons who reported living near a trail were more likely to meet recommended levels of walking of at least 30 minutes fives times per week (unadjusted odds ratio = 1.49, 95% confidence intervals = 1.04-2.13). In the multivariate model, male gender (unadjusted odds ratio = 1.63, 95% confidence intervals = 1.15-2.30), having three or more convenient destinations (unadjusted odds ratio = 1.78, 95% confidence intervals = 1.37-2.32), and living near a trail (unadjusted odds ratio = 1.45, 95% confidence intervals = 1.01-2.09) were positively associated with walking at statistically significant levels. The odds of walking were lower in non-Hispanic blacks (odds ratio = 0.59, 95% confidence intervals = 0.40-0.87) and current smokers (odds ratio = 0.66, 95% confidence intervals = 0.57-0.76). For patients attending community clinics, environmental strategies to encourage walking may include mixed-land-use neighborhoods and construction of trails.