Area-level social fragmentation and walking for exercise: Cross-sectional findings from the Quebec Adipose and Lifestyle Investigation in Youth study

Objectives: We determined whether social fragmentation, which is linked to the concept of anomie (or normlessness), was associated with a decreased likelihood of willingness to walk for exercise. Methods: Data were collected from mothers and fathers of 630 families participating in the Quebec Adipose and Lifestyle Investigation in Youth Cohort, an ongoing longitudinal study investigating the natural history of obesity and insulin resistance in children. Social fragmentation was defined as the breakdown of social bonds between individuals and their communities. We used logbinomial multiple regression models to estimate the association between social fragmentation and walking for exercise. Results: Higher social fragmentation was associated with a decreased likelihood of walking for exercise among women but not men. Compared with women living in neighborhoods with the lowest social fragmentation scores (first quartile), those living in neighborhoods in the second (relative risk [RR] = 0.91;95% confidence interval [CI] = 0.78, 1.05), third (RR = 0.83;95% CI = 0.70, 1.00), and fourth (RR = 0.80;95% CI = 0.65, 0.99) quartiles were less likely to walk for exercise (P =.02). Conclusions: Social fragmentation is associated with reduced walking among women. Increasing neighborhood stability may increase walking behavior, especially among women.