Built Environment and Physical Activity among Adults in Hong Kong: Role of Public Leisure Facilities and Street Centrality

Physical inactivity has been identified as the fourth leading risk factor for global mortality, and has been shown to be related to the built environment. To fill the literature gap from a non-Western setting, we examined: (1) the associations between the built environment and physical activity (PA) behaviors, (2) how the association of street centrality with PA is mediated by public leisure facilities, and (3) whether the association of the built environment with PA differs among people with different perceived PA barriers in Hong Kong. Cross-sectional survey data on 1977 adults were used. Exposure to the built environment was assessed in terms of the density of four types of public leisure facilities (gyms, parks, recreational facilities, and sports facilities) and street centrality. Street centrality was a composite index calculated by gathering four related indicators (reach, betweenness, straightness, and intersection density). Covariates, including socio-demographic variables, perceived neighborhood environment, and perceived PA barriers, were considered. Gym density was significantly associated with vigorous physical activity, but the association became non-significant after controlling for covariates. Sports facility density was associated with a greater probability of moderate physical activity (MPA) and was greater in those who had perceived PA barriers. Additionally, sports facilities partially mediated the association of street centrality with MPA, and fully mediated the association of street centrality with prolonged sitting. Higher park density was associated with lower odds of prolonged sitting. It is important for governments to provide more sports facilities and parks to promote active PA, and to reduce sitting time in adults by creating an active built environment.