Housing, neighbourhood and sociodemographic associations with adult levels of physical activity and adiposity: baseline findings from the ENABLE London study

Objectives The neighbourhood environment is increasingly shown to be an important correlate of health. We assessed associations between housing tenure, neighbourhood perceptions, sociodemographic factors and levels of physical activity (PA) and adiposity among adults seeking housing in East Village (formerly London 2012 Olympic/Paralympic Games Athletes' Village). Setting Cross-sectional analysis of adults seeking social, intermediate and market-rent housing in East Village. Participants 1278 participants took part in the study (58% female). Complete data on adiposity (body mass index (BMI) and fat mass %) were available for 1240 participants (97%); of these, a subset of 1107 participants (89%) met the inclusion criteria for analyses of accelerometer-based measurements of PA. We examined associations between housing sector sought, neighbourhood perceptions (covariates) and PA and adiposity (dependent variables) adjusted for household clustering, sex, age group, ethnic group and limiting long-standing illness. Results Participants seeking social housing had the fewest daily steps (8304, 95%CI 7959 to 8648) and highest BMI (26.0kg/m(2), 95%CI 25.5kg/m(2) to 26.5kg/m(2)) compared with those seeking intermediate (daily steps 9417, 95%CI 9106 to 9731; BMI 24.8kg/m(2), 95%CI 24.4 kg/m(2) to 25.2kg/m(2)) or market-rent housing (daily steps 9313, 95%CI 8858 to 9768; BMI 24.6kg/m(2), 95%CI 24.0 kg/m(2) to 25.2kg/m(2)). Those seeking social housing had lower levels of PA (by 19%-42%) at weekends versus weekdays, compared with other housing groups. Positive perceptions of neighbourhood quality were associated with higher steps and lower BMI, with differences between social and intermediate groups reduced by 10% following adjustment, equivalent to a reduction of 111 for steps and 0.5kg/m(2) for BMI. Conclusions The social housing group undertook less PA than other housing sectors, with weekend PA offering the greatest scope for increasing PA and tackling adiposity in this group. Perceptions of neighbourhood quality were associated with PA and adiposity and reduced differences in steps and BMI between housing sectors. Interventions to encourage PA at weekends and improve neighbourhood quality, especially among the most disadvantaged, may provide scope to reduce inequalities in health behaviour.