A new study conducted by researchers in the Columbia University Mailman School of Public Health’s Built Environment and Health Research Group has found that higher neighborhood walkability is associated with a lower risk of gestational diabetes. The results of this study are published in the peer-reviewed journal Paediatric and Perinatal Epidemiology.
New Study Links Neighborhood Walkability to Gestational Diabetes Risk
Gestational diabetes increases infants’ risk of being large for gestational age, may raise the risk of unhealthy weight gain during childhood, and elevates the pregnant individual’s risk for future type 2 diabetes. The research team partnered with the New York City Department of Health and Mental Hygiene to analyze relationships between neighborhood walkability and health outcomes for pregnant New Yorkers.
To measure walkability, the researchers utilized a Neighborhood Walkability Index that incorporates data on residential density, land use mix, street connectivity, and access to public transit. Analyzing city data from more than 109,000 births in 2015, the investigators discovered that the risk of gestational diabetes decreased with increases in the Neighborhood Walkability Index score. Specifically, the risk dropped by as much as 20 percent between areas in the highest and lowest quartiles of walkability.
When assessing the density of walkable destinations as another measure of neighborhood walkability, pregnant individuals in the highest quartile of walkable destinations experienced a 23 percent lower risk of gestational diabetes compared to those living in the lowest quartile. These analyses adjusted for multiple factors, including the pregnant individual’s age, race and ethnicity, parity, education, place of birth, marital status, and the poverty rate of the neighborhood.
The Role of Physical Activity and Urban Planning
An earlier study by the research team established that neighborhood walkability is also associated with a lower risk of excess weight gain during pregnancy. According to the data, almost 50 percent of pregnant individuals gain more weight than is recommended for healthy pregnancies.
Researchers theorize that neighborhood walkability encourages higher levels of walking and overall physical activity among pregnant individuals, which in turn reduces the risk of gestational diabetes and excess weight gain. Because pregnant individuals are known to favor lower-intensity forms of exercise such as walking, high neighborhood walkability in New York City is positively associated with more walking and total physical activity.
The study highlights the importance of urban planning, particularly neighborhood walkability, in promoting health,
said study co-first author Andrew Rundle, DrPH, an epidemiology professor at Columbia Mailman, as reported by Columbia University Mailman School of Public Health. Rundle added that creating opportunities for pregnant individuals to meet recommendations for healthy physical activity during pregnancy is expected to yield long-lasting positive benefits for both parent and child.
Looking forward, the research team plans to continue studying how urban design can support health during pregnancy so that these advantages are incorporated into cost-benefit analyses and decision-making for designing new neighborhoods and redesigning existing ones.
Broader Research on Postpartum Diabetes and Socioeconomic Factors
In related research published in Diabetes Care, Columbia Mailman researchers examined whether walkable neighborhoods affect the risk of developing postpartum type 2 diabetes among women who had gestational diabetes mellitus. Utilizing a retrospective cohort of women who gave birth in New York City between 2009 and 2011, the study followed participants through 2021.
The findings indicated that women living in neighborhoods with medium levels of walkability had a 15 percent lower rate of developing type 2 diabetes after gestational diabetes mellitus compared with women living in less-walkable neighborhoods.
