Neighborhood Walkability, Personal Active Travel, and Health in Asian Americans: Does English Proficiency Matter?

Backgrounds

Given that the environmental characteristics of neighborhood in which people live (e.g., population density, land use mix, street connectivity, etc.) have the potential to enhance or damage individuals’ health via their health behavior, we investigated a model on how neighborhood walkability influences an individual’s active travel, which in turn is associated with overall health status among Asian Americans. In addition, since English proficiency uniquely represents racial/ethnic minorities’ ability to access resources and benefits in the host society, we examined the moderating effects of English proficiency in the relationship.

Methods

The data were drawn from the 2015 Asian American Quality of Life Study funded by the City of Austin, TX. Of total 2,614 survey participants, 1,447 who provided full residential address were included in the analyses. To examine the effects of walkability on individual’s active travel and health, we used a structural equation modeling (SEM) framework because it allows us to not only develop path models that account for possible relationships among multiple variables in one model but also handle possible endogenous and exogenous issues. The multiple group analysis, also known as moderated mediation model analysis, was employed to examine the moderating effect of English proficiency in the SEM model.

Results

For the entire sample, neighborhood walkability was significantly associated with a higher level of active travel (β = .269, p < .001). However, the mediation effect of active travel was not significant (indirect effect = .004, p = .111, 95% bias-corrected CI = -.003 — .026). The results of the multiple group analysis showed that the neighborhood walkability was positively associated with active travel for both English proficiency group (β =.329, p < .001) and the group with limited English proficiency (β =.201, p < .001). However, the mediation effect of active travel on health status was only significant in the English proficiency group (β = .110, p < .05), indicating that active travel influenced by the neighborhood walkability was positively associated with better health status only for the English proficiency group.

Conclusions

Our findings add to the growing literature on the influence of the neighborhood walkability on individuals’ walking behavior and health status. Similar to existing studies, the findings of this study suggest that people living in neighborhood with greater walkability (i.e., walkable environment design) are more likely to have active walking behavior and better health status. However, such association is only significant among people with higher level of English proficiency. Given that English proficiency uniquely represents racial/ethnic minorities’ ability to access resources and benefits in the host society, our findings suggest implications for tailored interventions with respect to subgroups and strategies to be employed. Public health intervention should target not only the general Asian American population but also specific groups who may not fully utilize and access resources and benefits in community.