Presenting Author: Usama Bilal, MD, MPH, PhD, Drexel University Urban Health Collaborative

ABSTRACT

Background: Urban health studies usually focus on the differences between neighborhoods over the same city; however, this approach lacks understanding of the mass forces affecting the whole city.

Objectives: To evaluate cross-national differences in the walking and cycling environment between Madrid and Philadelphia comparing streets' functionality, safety, aesthetics and destinations.

Methods: A buffer of census section (~15.000 population area for each setting) was selected using the Median Neighborhood Index (MNI). MNI is a summary index that averages Euclidean distances of socio-demographic (aging, education, racial/ethnic composition) and urban form (population density) features to the median neighborhood. M-SPACES audit tool was used to measure function, safety, aesthetics and destinations in each street segment. Mixed models were fit, and interaction analysis by the type of street was performed.

Results: 378 street segments were measured using Google Street View. Philadelphia showed a higher punctuation in safety for walking (b=0.61 IC 95% 0.48-0.74), as on function (b=0.11 IC 95% 0.05-0.17) and aesthetics (b=0.04 IC 95% 0.01-0.07) for biking. By contrast, Philadelphia streets had less odds of having any destination (OR=0.09 IC 95% 0.03-0.27). There was a significant interaction by the type of street; Philadelphia had better aesthetics for walking only in main streets, and better aesthetics for cycling only in secondary streets.

Implications:Madrid had a denser urban design with more walking and cycling destinations than Philadelphia characterized by a more residential design, with better function and safety. These specific aspects of the urban environment supporting physical activity should be considered when designing healthier cities.

Authors: Usama Bilal, MD, MPH, PhD; Pedro Gullón, MD; Gina S. Lovasi, PhD, MPH; F. Escobar, PhD; HM Badland, PhD; I. Galán; and Manuel Franco, MD, PhD.