Gender, socioeconomic, and built environment differences in the association of participation in an incentivized walking program with physical and social activity: A prospective cohort study among older adults in Japan

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-04-23 DOI:10.1016/j.socscimed.2025.118093

Zhen Du , Koryu Sato , Kimihiro Hino , Katsunori Kondo , Naoki Kondo

{"title":"Gender, socioeconomic, and built environment differences in the association of participation in an incentivized walking program with physical and social activity: A prospective cohort study among older adults in Japan","authors":"Zhen Du , Koryu Sato , Kimihiro Hino , Katsunori Kondo , Naoki Kondo","doi":"10.1016/j.socscimed.2025.118093","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Physical inactivity and social isolation are key obstacles to achieving healthy and active aging. This study evaluated the association between participation in a citywide economic incentive Yokohama Walking Point (YWP) program with walking time, the risk of being homebound, and social isolation. We also explored the heterogeneities in the association across gender, socioeconomic status (SES), and built environment (BE).</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted on 3,171 residents aged ≥65 years from the Japan Gerontological Evaluation Study. YWP participation status was confirmed in 2016, outcomes were measured in 2020, and covariates were obtained in 2013. Built environment variables were measured based on geographic information system. General linear regression and modified Poisson regression models were performed using doubly robust estimation with inverse probability of treatment weighting.</div></div><div><h3>Results</h3><div>Participation in YWP was associated with an increase of 6.83 min per day of walking time, and a 21 % decreased risk of social isolation. The associations showed heterogeneity; participants with low income and those living near parks had lower risks of being homebound. Men, participants with low education levels, and those living in high population density areas exhibited lower risks of social isolation compared with their counterparts.</div></div><div><h3>Conclusions</h3><div>Participation in YWP was associated with improved physical and social activity. Gender, SES, and BE moderated these associations, highlighting their potential role in reducing social health disparity. These findings emphasized the need for integrated policy interventions incorporating program design and urban planning to create an age-friendly community fostering healthy and inclusive aging.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"377 ","pages":"Article 118093"},"PeriodicalIF":4.9000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Social Science & Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S027795362500423X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Physical inactivity and social isolation are key obstacles to achieving healthy and active aging. This study evaluated the association between participation in a citywide economic incentive Yokohama Walking Point (YWP) program with walking time, the risk of being homebound, and social isolation. We also explored the heterogeneities in the association across gender, socioeconomic status (SES), and built environment (BE).

Methods

A prospective cohort study was conducted on 3,171 residents aged ≥65 years from the Japan Gerontological Evaluation Study. YWP participation status was confirmed in 2016, outcomes were measured in 2020, and covariates were obtained in 2013. Built environment variables were measured based on geographic information system. General linear regression and modified Poisson regression models were performed using doubly robust estimation with inverse probability of treatment weighting.

Results

Participation in YWP was associated with an increase of 6.83 min per day of walking time, and a 21 % decreased risk of social isolation. The associations showed heterogeneity; participants with low income and those living near parks had lower risks of being homebound. Men, participants with low education levels, and those living in high population density areas exhibited lower risks of social isolation compared with their counterparts.

Conclusions

Participation in YWP was associated with improved physical and social activity. Gender, SES, and BE moderated these associations, highlighting their potential role in reducing social health disparity. These findings emphasized the need for integrated policy interventions incorporating program design and urban planning to create an age-friendly community fostering healthy and inclusive aging.

查看原文本刊更多论文

性别、社会经济和建筑环境差异在参与激励步行计划与身体和社会活动之间的关系：日本老年人的前瞻性队列研究

目的缺乏身体活动和社会孤立是实现健康和积极老龄化的主要障碍。本研究评估了参与全市经济激励横滨步行点（YWP）计划与步行时间、回家风险和社会孤立之间的关系。我们还探讨了性别、社会经济地位（SES）和建筑环境（BE）之间关联的异质性。方法对来自日本老年学评价研究的3171名年龄≥65岁的居民进行前瞻性队列研究。2016年确定青年行动计划参与情况，2020年测量结果，2013年获得协变量。基于地理信息系统对建筑环境变量进行了测量。一般线性回归和修正泊松回归模型采用双鲁棒估计与逆概率处理权。结果参加YWP与每天步行时间增加6.83分钟相关，社会孤立风险降低21%。相关性呈现异质性；低收入和住在公园附近的参与者回家的风险较低。男性、受教育程度低的参与者以及生活在人口密度高的地区的参与者与同行相比，表现出较低的社会孤立风险。结论参加YWP与改善身体和社会活动有关。性别、SES和BE调节了这些关联，突出了它们在减少社会健康差距方面的潜在作用。这些研究结果强调，需要采取综合政策干预措施，将方案设计和城市规划结合起来，创建一个对老年人友好的社区，促进健康和包容的老龄化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.